The Long COVID economy is bigger than you think

And how the Long COVID Lens can equip you to seize the moment

Last fall I delivered the keynote address at the world’s first Infection-Associated Chronic Condition (IACC) Case Competition at the University of Michigan’s Ross School of Business.

And while listening to a panel on how children were developing Long COVID at alarming rates and dropping out of school, I realized that the breadth of Long COVID and IACC Innovations needed to extend beyond just the chronic-care continuum and digital health solutions.

It needed to look at the systemic issues the virus exposes in our society (namely, food, education, shelter, and transportation.)

And so, the inspiration for the Long COVID Lens was born, a new intellectual framework to empower investors to think about the problems and solutions available to tackle post-viral conditions.

The piece below, originally published in Impact Alpha, represents what I believe is the boldest attempt by the investment community to speak about the crisis and opportunity that IACCs represent.

Over the next few weeks, I will be creating a series of LinkedIn posts highlighting the concepts in this piece. You can follow me along and track the hash tag #LongCOVIDLens.

I hope you enjoy reading this piece as much as I enjoyed writing it.

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For some, a COVID infection lasts a few weeks. For others, it’s fatal. But for me — and more than 400 million people globally — it can last for years.

In my early 20s, I battled heart issues, brain fog, body aches, fatigue and difficulty walking — all signs of “Long COVID.” It limited my ability to hold down a job and complete my degree and strained my relationships. I am not alone in bearing these costs. At least two million Americans were too sick to work, resulting in higher medical debt alongside loneliness and depression.

In the five years since my initial infection, I recovered and regained my health, ran a startup tackling this condition and became an impact investor helping shape the emerging ecosystem that I call the Long COVID Economy.

Through my transformation from patient to founder to investor, I’ve witnessed one consistent challenge around this condition: a lack of imagination and vision.

The limits of imagination

As a patient, providers and friends struggled to understand that a virus can cause long-term effects, even though we all learned in health class that HIV leads to AIDS and HPV can cause cervical cancer.

As a founder, I heard from investors that my market was too small to be investable, even though Long COVID has a higher disability burden than cancer and heart disease. And while rising disability from arthritis, diabetes and other chronic conditions — combined with healthcare staffing shortages — has fueled rapid adoption of remote patient monitoring, that same potential is often dismissed when applied to Long COVID.

The logic usually goes like this: Fewer tests and masks must mean fewer patients, and fewer patients must mean no market. But Long COVID is, by definition, post-viral; its prevalence is decoupled from current testing behavior.

Investors are mistaking the visibility of the virus today for the size of the chronic illness it left behind.

As an investor, whenever I share Long COVID-related deal flow with co-investors, I receive aversion and dismissal.

It is true that Long COVID presents a complex challenge.

With twelve core symptoms that manifest inconsistently across patients, providers are forced to deploy non-specific care pathways and rely on imprecise insurance coding. The very tools investors rely on to size markets and model reimbursement — diagnostic clarity and payment codes — fail to capture this population’s true scale. This situation obscures both outcomes and economics, making Long COVID appear smaller than it actually is.

But complexity does not preclude investability.

Defining the Long COVID Lens

It is hard to understand how a virus most of us have been exposed to could render a triathlete immobile for years, unless you’ve seen or experienced it yourself. So, to make this idea feel real, and hopefully actionable, I propose coining a new framework to help investors spot innovations to address this problem: The Long COVID Lens.

And while I use the term “Long COVID,” it sits within a broader class of infection-associated chronic conditions, including Chronic Fatigue Syndrome, Chronic Lyme Disease, Guillain-Barré Syndrome, Postural Orthostatic Tachycardia Syndrome and Fibromyalgia. The Long COVID Lens applies across this wider category.

Layer 1: Direct solutions

The first layer of the Long COVID Lens includes health-related businesses explicitly targeting Long COVID and other infection-associated chronic conditions as a core part of their value proposition and marketing strategy.

Some of these companies include RTHM, a Y Combinator–backed virtual telemedicine clinic for Chronic Fatigue Syndrome and Long COVID patients; Visible, which uses wearable devices to help patients manage symptoms and track their “energy bucket” while contributing to essential research; and ArtiMed, which employs data-mining and risk stratification to help health systems identify who is likely to develop Long COVID, identify who qualifies for SSDI or Medicaid, and assess the financial cost of inaction. ArtiMed plays a particularly important role in this ecosystem by directly addressing the data and prevalence gaps that have long constrained complex, post-infectious illnesses, enabling the market to be sized, segmented and reached.

Even as many investors continue to shy away from anything labeled “Long COVID” and the broader market of complex chronic illnesses, others are leaning in.

“Our conviction in RTHM stems from their mission to simplify what has been a deeply fragmented and opaque journey for people with complex chronic illness,” says Kristina Simmons Founder and Managing Partner of Overwater Ventures and RTHM’s lead investor. “By unifying health data, offering personalized clinical insights, and integrating expert telehealth care, RTHM gives patients a roadmap toward better outcomes.”

Kirsten Connell who invested in Visible as a partner at Octopus Ventures, adds, “With Visible, we saw two exceptional founders who had a deep product background and a drive to tackle a huge market from firsthand experience. It was clear that their product would become a ‘must have’ for their customers rather than a nice to have. We have high conviction that this is the team to build a product that will impact millions of lives, and when reading customers’ feedback, they are well on track to deliver.”

Layer 2: Adjacent solutions

The second layer consists of health-related businesses whose products are not explicitly designed for Long COVID, but nonetheless serve this population.

Wildwood Ventures, an early-stage fund focused on healthy and active lifestyles, recently invested in Meo Health, which uses computer-vision-assisted biofeedback therapy to modulate the nervous system and manage symptoms.

“We invest in founders that are trying to do two things simultaneously: build a generational company with a meaningful mission to improve people’s lives,” says Wildwood’s General Partner Jesse Marble. “The nervous system is the operating system of the body, and Meo’s ability to improve users’ nervous system function is incredible.”

Though Meo Health began with a focus on Long COVID and I have met physicians who still recommend their technology to Long COVID patients, it has since expanded to other neurological disorders and autoimmune diseases.

GoodPath, which recently raised an oversubscribed Series A led by MassMutual Ventures with participation from Enable Ventures, offers health coaching, care packages and learning modules as an employee benefit. Primarily focused on cancer, musculoskeletal conditions and diabetes, Enable Ventures has found Long COVID to be an important driver for their disability carrier business and work with health plans.

“What we see so often—almost axiomatically—is that when early-stage companies take on the hardest-to-serve end users in health care, the spaces others dismiss as too ‘edge,’ they end up mastering the entire system. GoodPath addresses the design constraints of serving people with Long COVID and, in doing so, is also able to serve a wide range of other chronic conditions—creating meaningful impact across multiple disability domains,” says Regina Kline, Founder and Managing Partner of Enable Ventures. (Disclosure: Enable Ventures is a Sorenson Impact Fund, part of the same family office the author works for).

For me, the significance of GoodPath goes beyond the product itself. It represents the first Series A raised in the Long COVID ecosystem. That it was oversubscribed should send a clear signal to the broader market that solutions serving this population can scale.

Layer 3: Socio-emotional and systemic solutions

The third and most expansive layer addresses the socio-emotional and systemic challenges Long COVID patients face beyond their daily physical symptoms.

This includes equipping newsrooms and public health agencies with the tools to detect and counter health-related misinformation at scale.

Many Long COVID patients qualify for Social Security Disability Insurance but struggle to navigate the process due to their brain fog. I’m waiting to see AI voice agents completely eliminate the need for paper applications for benefits all together. There’s also the need for accessible, affordable transportation for patients who cannot drive. For example, when I was in graduate school at the University of Chicago, the disability services office arranged a van to transport me to classes and medical appointments.

There is also an urgent need to study and support children with Long COVID. The science is only now just emerging on Long COVID’s deep impact on children and their families, yet countless stories — like that of a parent chronicling their child’s battle with the virus — highlight how this crisis risks robbing children of their youth. Educators, technologists and policymakers must urgently design systems that support these kids so they are not left behind.

A call to investors

While the jury is still out whether this population is best served by specialized or generalized solutions, there are countless companies in today’s market (and likely in your portfolio) already tackling these challenges and poised to reimagine how we interact with the world.

“There’s a long track record of disability innovations becoming so mainstream that we forget their origins [like the keyboard, voice assistants and touch screens],” says Francesca Colombo, an investor with Sidecut Ventures who lives with Chronic Fatigue Syndrome and Long COVID. “Disability tech is too often underestimated and underfunded and I’m excited about companies that integrate accessibility and disability equity into their business model so both financial success and impact wins push each other forward.”

Investing in Long COVID today is not just about addressing a neglected population and spurring innovation. It is also about preparing our systems for the pandemics of tomorrow. In an increasingly globalized world, pandemics are not anomalies; they are inevitabilities. The next one could be far worse than COVID-19.

As capital allocators, we have the power to shape what gets built and to strengthen our collective bio-defenses. To that end, I’ll close with three simple asks:

If a company pitches you on a Long COVID solution, meet with them.

If one of your portfolio company’s core solutions could serve this population, raise it in a board meeting.

And finally, if you’re as hungry as I am to build the future, let’s work together to make the Long COVID Lens a staple of the impact investing industry.

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Ibrahim Rashid supports the catalytic capital portfolio at the Sorenson Impact Foundation and serves as Investment Committee Chair of the Sirman’s Global Impact Foundation. He is the author of Strong Haulers, a book chronicling his experience with Long COVID, and the founder of Strong Haulers, a digital health startup. The views expressed here are his own and do not reflect those of his employer or any organizations he is affiliated with.