Report tracks COVID misery: UH researchers document lingering negative impacts from the pandemic

A report released this week by the University of Hawaii Economic Research Organization found nearly two-thirds of adults had a negative impact from COVID-19 related to mental health, food and job security, housing and poverty.

The survey of 2,000 individuals throughout Hawaii also addressed vaccination rates, estimated current immunity levels, and provided some of the first statistics related to “Long-COVID,” or the lingering symptoms following an infection.


Researchers found that one-in-four individuals in the state received a positive COVID-19 test since the pandemic began, estimating 96% of adults have some degree of immunity through vaccination or previous infection. But even with the high percentage of protection, adverse effects tied to the pandemic continue to present challenges.

“This information is critical to understand where to put the resources to more effectively treat our populations,” said Ruben Juarez, HMSA endowed professor of Health Economics at UHERO. “These impacts are all over daily life, and they all need to be addressed.”

Financial impacts from the pandemic resulted in 22.9% of individuals reporting their savings had been depleted, and 15% reporting they were unable to pay rent. Another 12% were laid off or had their work hours reduced, and 11.8% had a family member who was furloughed or had their working hours reduced.

The report also provided some of the first data for the state related to Long-COVID.

“This is the first time that we have quantified the extent of Long-COVID in Hawaii,” said Juarez. “Almost one-in-three adults in Hawaii who got infected with COVID-19 experienced symptoms of Long-COVID.”

The most common symptoms were a lingering cough and shortness of breath, reported in 57.9% of Long-COVID cases, followed by extreme fatigue reported in 49% of cases, and mental fog and headaches in 47.1% of cases.

“We do have a few patients in clinics who have Long-COVID that we know of, but I’m sure there’s a lot who are going undiagnosed,” said Dr. Christine Chan, medical director of the East Hawaii Health Clinic. “Some people are fortunate that their symptoms improve, but anecdotally, I can think of a handful of folks who are more than a year out from their exposure to COVID and are still having long-term (consequences) of the disease.”

According to the report, the length of long-term symptoms varied by vaccination status. Unvaccinated individuals experienced Long-COVID for an average of five months, while vaccinated individuals experienced symptoms averaging 3.5 months.

“The symptoms can be so nonspecific, especially the fatigue and the mental fog, that I think people try their best to not bring it up to their doctor, and I think that does them a disservice,” Chan said. “I would encourage people, if they are concerned at all, to go talk to their primary care doctor about it, because those can affect someone’s quality of life pretty significantly. That’s what we’re seeing when patients do come in.”

Food insecurity was also affected by the pandemic, with more than 20% of adults reporting low or very low levels of food security. The impact has been felt by The Food Basket, Hawaii Island’s Food Bank.

“Prepandemic, we served on average 14,000 individuals per month, and during the height of the pandemic, the number rose to an unprecedented 80,000 individuals plus per month,” said The Food Basket Executive Director Kristin Frost Albrecht. “While that number has come down, we are still serving between 40,000 to 50,000 individuals per month.”

Mental health continues to impact individuals as well, with more than one-third of adults reporting symptoms of depression and 11% reporting low self-esteem.

“The large effect on depression, one-in-three adults, even larger among unvaccinated individuals, is very shocking,” said Juarez. “Four percent of adults in our cohort had serious suicidal thoughts, and this is even larger among unvaccinated individuals.”

Education was another area of concern, according to the report, with 17.8% of adults reporting education-related troubles for their children and 8.7% having trouble with child care.

“I think these all need to be addressed by different partners, including (the Department of Health, the Department of Education), health insurers, etc.,” Juarez said. “We are hoping this would enable and develop targeted programming.”

The severity of the illness was reflected in the report, where 12.5% of individuals reported losing a close friend due to COVID-19, and 9.2% reported losing a family member.

UHERO plans to continue releasing quarterly public health reports with support from the state that will address implications for labor markets, education and financial impacts, among other factors.

“We’ll follow this cohort monthly to track changes and obtain further information relevant for the community,” Juarez said. “This will allow us to estimate the financial impact and cost of COVID-19, which will come in future reports.”

Email Grant Phillips at

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