The pandemic continues to cast a shadow over the workforce. Long Covid, a combination of symptoms that emerge months or even years after recovering from the virus, is keeping up to 4 million Americans from working, according to a new study.

The Brookings Institution report, released Wednesday, finds that about 16 million working-age Americans (between the ages of 18 and 65) have long Covid today.

People suffering from long Covid face a range of symptoms that can make it challenging to work, including brain fog, anxiety, depression, fatigue and breathing problems.

Brookings estimates that 2 to 4 million people are out of work due to long Covid. The midpoint of that range — 3 million full-time equivalent workers — represents a sizable 1.8% of the entire US civilian labor force, the report said.

The findings come as many industries, including education, restaurants and healthcare, struggle with serious labor shortages that are contributing to the worst inflation in four decades.

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The economy had 10.7 million unfilled jobs as of June. Although that’s down from recent record highs, it’s still well above pre-Covid levels of 7 million.

The economic cost from long Covid is significant.

Based on the average US wage of $1,106 per week, Brookings estimates the absence of 3 million people from the workforce because of long Covid translates to about $168 billion a year in lost earnings.

However, that sum does not include the full economic burden of long Covid, Brookings said, a burden that includes the cost of lower productivity of people working while sick, the health care costs and the lost productivity of caretakers.

“If long Covid patients don’t begin recovering at greater rates, the economic burden will continue to rise,” the Brookings authors wrote.

They find that if the long Covid population grows by just 10% each year, after 10 years the annual cost of lost wages will amount to half a trillion dollars.

“These impacts stand to worsen over time if the US does not take the necessary policy actions,” the Brookings authors said.

They call for at least five government actions to ease the economic burden of long Covid: better prevention and treatment; expanded paid sick leave; improved workplace accommodations; wider access to disability insurance; and enhanced data collection.

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