CARE for Long COVID Act

Madam President, I rise today to talk about the importance of March 15, which for the first time has been designated ``International Long COVID Awareness Day.''

This is a topic of importance to millions of Americans who deal with long COVID every day and tens of millions of people around the world who are dealing with long COVID, from mild symptoms to symptoms that are so debilitating that they are unable to work.

There is still an awful lot to learn about the condition, but what we do know is that long COVID is comprised of ongoing health problems that people experience after being infected with COVID-19. For some, long COVID can last weeks or months. For others, like me, long COVID has now lasted for 3 years.

Long COVID symptoms can vary. Some people experience general symptoms like fatigue, neurological symptoms like headache or difficulty concentrating, digestive problems, shortness of breath, heart palpitations, and other neurological conditions.

The prevalence of long COVID is a best estimate, but the recent survey by the Census Bureau, in partnership with the National Center for Health Statistics, shows that about 5.8 percent of Americans have long COVID, and that amounts to about 11 percent of Americans who have had COVID who continue to experience long COVID symptoms.

I am on my own long COVID journey. My symptoms are mild, but they have been continuous for 3 years. When we were working in the Capitol in March of 2020 at the very beginning of COVID, most of us had dispatched our staffs and sent them home. So I was working in my office together just with my chief of staff. It was kind of a lonely time, as those of us who were here remember, but we were working hard. We were working hard to pass the first COVID relief bill, the CARES Act, and we did good work, in a bipartisan way, to provide relief to individuals and our businesses and hospitals and universities and schools in those early days.

I noticed one day that my nerve endings turned on like a light switch was flicked, and all of them started to tingle like my skin had been dipped in an Alka-Seltzer--24/7, every nerve ending in my body. It has not gone away in 3 years.

I had a mild case of COVID. I never had respiratory problems. I never had fatigue. Within a few days after getting this, I was fine except for the nerve tingling, and I assumed because of the pollen on my car that it was hay fever gone wild. Other symptoms were more like allergic symptoms--pinkeye and skin rashes.

That all went away, but when I went home, I gave COVID to my wife-- just one more thing for a husband to feel guilty about. She got the standard case of COVID, and that is what made us realize that that is what I had. We both had mild cases. Within a very few days, we were up and at `em and feeling great, but this nerve tingling sensation has never gone away.

I kept waiting, thinking next week it will go away or next month it will go away, but after 6 months, I finally decided I should see a neurologist. I went

to George Washington and did fine on neurological tests, but the neurologist told me: Look, viruses can have a neurological aftereffect. The good news is, it is probably not going to get worse. The bad news is, it may not get better.

The doctor was perfectly right on both counts. It has never gotten worse, and it has never gotten better. It is not painful. It is not debilitating. I can work. I can exercise. I can focus. It is harder to sleep--that would be the only area where it is affecting my life. But it is eerie that, after 3 years, it hasn't changed.

My wife said: Well, but then doesn't that mean you just get used to it and you don't notice it?

No. It is just a little too intense. I notice it all the time, everywhere.

Well, the good news is, my symptoms are mild and I can continue to work, but as I have shared my story, what I have found is many come and share their stories with me, including people here around the Capitol. They share their own long COVID stories, and many are very, very troubling: The marathon runner who can't walk around the block. I have a dear friend who--I am godfather to her oldest child--has a very physically demanding job as a dialysis nurse, which involves a lot of helping patients around. She got COVID, and both fatigue and balance issues are so challenging that she is not able to do the work.

I had a State employee who worked in my department of transportation who saw me on a bike ride by his house one day in Richmond, where I live, and he flagged me down and stopped me. He said: Hey, look, I was your employee when you were Governor working with the department of transportation. I am a young dad. I have two boys under age 10. I want to be a great father for them, but I got COVID, and now my long COVID symptoms are so significant, I can't play baseball with them.

He can't do the kinds of things that a dad wants to do with his children. This individual is now on long-term disability, unable to work at all.

These are very, very serious stories.

The public health emergency around COVID is likely to come to an end on May 11, but we can't forget millions of people who are dealing with this issue.

Now, let me just share some statistics. Across the United States, adult women are more likely than men to experience long COVID. Individuals who identify as Hispanic or Latino experience long COVID more than any other racial or ethnic group. People with disabilities are more likely to experience long COVID than those without disabilities.

Long COVID is not limited to people like me. I just turned 65. A lot of young people are dealing with long COVID symptoms. Their initial COVID presented differently than it did with most adults, but some of the long COVID symptoms are those I have described. Twenty-five percent of people who have long COVID say that their symptoms significantly limit their activity.

The economic cost of long COVID disability is upward of $200 billion a year. Up to 4 million people are out of the American workforce right now because of long COVID, at a time when I know all of us are hearing from our employers: I can't hire people. It is so hard to hire people now.

The unemployment rate is the lowest it has been since 1969. If there are things we could do that could help those 4 million come back into the workforce, it would be good not only for them, for their happiness, for their pocketbooks; it would be great for our economy.

To better understand the impact of long COVID, in January, I worked together with the Agency for Healthcare Research and Quality to gather patients and providers from Virginia and State and Federal officials from everywhere to come to a summit in Richmond to talk about long COVID. The conversations that day allowed us to, nearly 3 years in, dig into long COVID and what are its impacts and, most importantly, what can we do. We were able to discuss experiences, share best practices and research.

I was honored to have four Virginians with long COVID who joined me in discussing their own journeys.

Cynthia talked about having unusual symptoms and not being believed initially that she even had COVID and then not being believed that she had long COVID. Her symptoms were more in the allergic reaction space, similar to mine. In fact, she went multiple times to emergency rooms because her symptoms were so intense and found that, without telling her, she was often being drug-tested because they assumed that she was there and maybe she was suffering from some kind of a drug overdose. So they were testing her for that and not believing her long COVID story.

She has since found healthcare professionals who believe her and are offering her treatments that have not ended her long COVID symptoms but are enabling her to more effectively negotiate her schedule.

Mattie from Southwest Virginia was kind of your quintessential do- everything, 35-year-old mom of three, who also worked, who also went to school. She could juggle everything and make it seem easy. When she got COVID, she got hit with fatigue so intense she couldn't do any of those things, and then that spiraled into depression. She was a healthcare provider herself, working with seniors, and really started to question, What kind of purpose do I have if I can't be the mom I want to be, if I can't be the healthcare provider I want to be? It caused tremendous anxiety and depression.

Now, Mattie's was a story of hope because she eventually found a physician who realized COVID had exacerbated an underlying medical condition called Hashimoto's disease that she had had probably since birth but had never really been serious enough to notice. COVID exacerbated it. She is being treated for Hashimoto's, and many of those symptoms have abated. So hers is a story of hope. This is not a hopelessness story. You can find paths forward. She is doing better.

ZZ and Katy. ZZ is a middle schooler who had serious long COVID experiences, and Katy talked about trying to help her son and not being believed until they finally found their way to the Children's National Hospital, just up the hill from where we are.

Finally, Rachel--a longtime human resources professional at a community college in Virginia--used to working with people, including people with disabilities, to help them either get jobs or do coursework at the local community college. Her long COVID experience was so debilitating in fatigue and migraine headaches and other problems with respect to focus that she eventually had to leave her job and apply for long-term disability and her Social Security.

She was told when she applied that there were more than half a million applications before hers, and after a year, she was turned down with little explanation. She described the challenges of trying to negotiate the system and fill out forms when she is suffering from such fatigue and headaches and other symptoms that make even filling out a form difficult.

So these four stories were a mixture of young people and adults, some stories that didn't yet have happy endings and at least one that did have a positive ending, and it was important that we understand them.

Congress has taken some steps. I have colleagues in the room, and I just want to thank them for this. We provided $1.15 billion in Federal funding to the National Institutes of Health to advance understanding, prevention, and treatment. In December, Congress passed a budget that included $10 million for this Agency for Healthcare Research and Quality to do critical research. These efforts are a step in the right direction, but more must be done.

Just last week, the President introduced the fiscal year 2024 budget. He requested additional funding for AHRQ and additional funding for the HSRA to do long COVID.

Today, I am reintroducing a bill, the CARE for Long COVID Act, with Senators Markey and Duckworth and eight other Senators. It is also being introduced in a bipartisan way on the House side. The bill will expand research to increase understanding of treatment efficacy and disparities and provide more recommendations, educate long COVID patients and health providers, facilitate interagency cooperation, and develop partnerships between community-based organizations, social services, and others.

But there is more work to be done, so as I conclude--I see my colleague from Louisiana on the floor waiting to

speak--we just have to keep focused on this to try to address this challenge. When the public health emergency ends, we can't forget those who are dealing with long COVID, and we can't forget those who are dealing with the significant amount of mental anxiety and stress that has been present in the lives of all for the last 3 years. We have to improve our outreach and education, we have to accelerate our research to come up with treatments and cures that work, and we have to do it with a sense of urgency. I am committed to working with you all to do that.

Madam President, I rise today to talk about the importance of March 15, which for the first time has been designated ``International Long COVID Awareness Day.''

This is a topic of importance to millions of Americans who deal with long COVID every day and tens of millions of people around the world who are dealing with long COVID, from mild symptoms to symptoms that are so debilitating that they are unable to work.

There is still an awful lot to learn about the condition, but what we do know is that long COVID is comprised of ongoing health problems that people experience after being infected with COVID-19. For some, long COVID can last weeks or months. For others, like me, long COVID has now lasted for 3 years.

Long COVID symptoms can vary. Some people experience general symptoms like fatigue, neurological symptoms like headache or difficulty concentrating, digestive problems, shortness of breath, heart palpitations, and other neurological conditions.

The prevalence of long COVID is a best estimate, but the recent survey by the Census Bureau, in partnership with the National Center for Health Statistics, shows that about 5.8 percent of Americans have long COVID, and that amounts to about 11 percent of Americans who have had COVID who continue to experience long COVID symptoms.

I am on my own long COVID journey. My symptoms are mild, but they have been continuous for 3 years. When we were working in the Capitol in March of 2020 at the very beginning of COVID, most of us had dispatched our staffs and sent them home. So I was working in my office together just with my chief of staff. It was kind of a lonely time, as those of us who were here remember, but we were working hard. We were working hard to pass the first COVID relief bill, the CARES Act, and we did good work, in a bipartisan way, to provide relief to individuals and our businesses and hospitals and universities and schools in those early days.

I noticed one day that my nerve endings turned on like a light switch was flicked, and all of them started to tingle like my skin had been dipped in an Alka-Seltzer--24/7, every nerve ending in my body. It has not gone away in 3 years.

I had a mild case of COVID. I never had respiratory problems. I never had fatigue. Within a few days after getting this, I was fine except for the nerve tingling, and I assumed because of the pollen on my car that it was hay fever gone wild. Other symptoms were more like allergic symptoms--pinkeye and skin rashes.

That all went away, but when I went home, I gave COVID to my wife-- just one more thing for a husband to feel guilty about. She got the standard case of COVID, and that is what made us realize that that is what I had. We both had mild cases. Within a very few days, we were up and at `em and feeling great, but this nerve tingling sensation has never gone away.

I kept waiting, thinking next week it will go away or next month it will go away, but after 6 months, I finally decided I should see a neurologist. I went

to George Washington and did fine on neurological tests, but the neurologist told me: Look, viruses can have a neurological aftereffect. The good news is, it is probably not going to get worse. The bad news is, it may not get better.

The doctor was perfectly right on both counts. It has never gotten worse, and it has never gotten better. It is not painful. It is not debilitating. I can work. I can exercise. I can focus. It is harder to sleep--that would be the only area where it is affecting my life. But it is eerie that, after 3 years, it hasn't changed.

My wife said: Well, but then doesn't that mean you just get used to it and you don't notice it?

No. It is just a little too intense. I notice it all the time, everywhere.

Well, the good news is, my symptoms are mild and I can continue to work, but as I have shared my story, what I have found is many come and share their stories with me, including people here around the Capitol. They share their own long COVID stories, and many are very, very troubling: The marathon runner who can't walk around the block. I have a dear friend who--I am godfather to her oldest child--has a very physically demanding job as a dialysis nurse, which involves a lot of helping patients around. She got COVID, and both fatigue and balance issues are so challenging that she is not able to do the work.

I had a State employee who worked in my department of transportation who saw me on a bike ride by his house one day in Richmond, where I live, and he flagged me down and stopped me. He said: Hey, look, I was your employee when you were Governor working with the department of transportation. I am a young dad. I have two boys under age 10. I want to be a great father for them, but I got COVID, and now my long COVID symptoms are so significant, I can't play baseball with them.

He can't do the kinds of things that a dad wants to do with his children. This individual is now on long-term disability, unable to work at all.

These are very, very serious stories.

The public health emergency around COVID is likely to come to an end on May 11, but we can't forget millions of people who are dealing with this issue.

Now, let me just share some statistics. Across the United States, adult women are more likely than men to experience long COVID. Individuals who identify as Hispanic or Latino experience long COVID more than any other racial or ethnic group. People with disabilities are more likely to experience long COVID than those without disabilities.

Long COVID is not limited to people like me. I just turned 65. A lot of young people are dealing with long COVID symptoms. Their initial COVID presented differently than it did with most adults, but some of the long COVID symptoms are those I have described. Twenty-five percent of people who have long COVID say that their symptoms significantly limit their activity.

The economic cost of long COVID disability is upward of $200 billion a year. Up to 4 million people are out of the American workforce right now because of long COVID, at a time when I know all of us are hearing from our employers: I can't hire people. It is so hard to hire people now.

The unemployment rate is the lowest it has been since 1969. If there are things we could do that could help those 4 million come back into the workforce, it would be good not only for them, for their happiness, for their pocketbooks; it would be great for our economy.

To better understand the impact of long COVID, in January, I worked together with the Agency for Healthcare Research and Quality to gather patients and providers from Virginia and State and Federal officials from everywhere to come to a summit in Richmond to talk about long COVID. The conversations that day allowed us to, nearly 3 years in, dig into long COVID and what are its impacts and, most importantly, what can we do. We were able to discuss experiences, share best practices and research.

I was honored to have four Virginians with long COVID who joined me in discussing their own journeys.

Cynthia talked about having unusual symptoms and not being believed initially that she even had COVID and then not being believed that she had long COVID. Her symptoms were more in the allergic reaction space, similar to mine. In fact, she went multiple times to emergency rooms because her symptoms were so intense and found that, without telling her, she was often being drug-tested because they assumed that she was there and maybe she was suffering from some kind of a drug overdose. So they were testing her for that and not believing her long COVID story.

She has since found healthcare professionals who believe her and are offering her treatments that have not ended her long COVID symptoms but are enabling her to more effectively negotiate her schedule.

Mattie from Southwest Virginia was kind of your quintessential do- everything, 35-year-old mom of three, who also worked, who also went to school. She could juggle everything and make it seem easy. When she got COVID, she got hit with fatigue so intense she couldn't do any of those things, and then that spiraled into depression. She was a healthcare provider herself, working with seniors, and really started to question, What kind of purpose do I have if I can't be the mom I want to be, if I can't be the healthcare provider I want to be? It caused tremendous anxiety and depression.

Now, Mattie's was a story of hope because she eventually found a physician who realized COVID had exacerbated an underlying medical condition called Hashimoto's disease that she had had probably since birth but had never really been serious enough to notice. COVID exacerbated it. She is being treated for Hashimoto's, and many of those symptoms have abated. So hers is a story of hope. This is not a hopelessness story. You can find paths forward. She is doing better.

ZZ and Katy. ZZ is a middle schooler who had serious long COVID experiences, and Katy talked about trying to help her son and not being believed until they finally found their way to the Children's National Hospital, just up the hill from where we are.

Finally, Rachel--a longtime human resources professional at a community college in Virginia--used to working with people, including people with disabilities, to help them either get jobs or do coursework at the local community college. Her long COVID experience was so debilitating in fatigue and migraine headaches and other problems with respect to focus that she eventually had to leave her job and apply for long-term disability and her Social Security.

She was told when she applied that there were more than half a million applications before hers, and after a year, she was turned down with little explanation. She described the challenges of trying to negotiate the system and fill out forms when she is suffering from such fatigue and headaches and other symptoms that make even filling out a form difficult.

So these four stories were a mixture of young people and adults, some stories that didn't yet have happy endings and at least one that did have a positive ending, and it was important that we understand them.

Congress has taken some steps. I have colleagues in the room, and I just want to thank them for this. We provided $1.15 billion in Federal funding to the National Institutes of Health to advance understanding, prevention, and treatment. In December, Congress passed a budget that included $10 million for this Agency for Healthcare Research and Quality to do critical research. These efforts are a step in the right direction, but more must be done.

Just last week, the President introduced the fiscal year 2024 budget. He requested additional funding for AHRQ and additional funding for the HSRA to do long COVID.

Today, I am reintroducing a bill, the CARE for Long COVID Act, with Senators Markey and Duckworth and eight other Senators. It is also being introduced in a bipartisan way on the House side. The bill will expand research to increase understanding of treatment efficacy and disparities and provide more recommendations, educate long COVID patients and health providers, facilitate interagency cooperation, and develop partnerships between community-based organizations, social services, and others.

But there is more work to be done, so as I conclude--I see my colleague from Louisiana on the floor waiting to

speak--we just have to keep focused on this to try to address this challenge. When the public health emergency ends, we can't forget those who are dealing with long COVID, and we can't forget those who are dealing with the significant amount of mental anxiety and stress that has been present in the lives of all for the last 3 years. We have to improve our outreach and education, we have to accelerate our research to come up with treatments and cures that work, and we have to do it with a sense of urgency. I am committed to working with you all to do that.

Mr. President, inflation numbers for February came out yesterday morning, and they confirmed what every American knows: We are still squarely in the middle of Democrats' inflation crisis, with no end in sight.

Overall, inflation was up 6 percent in February compared to a year ago and a staggering 15 percent since President Biden took office--15 percent. Grocery prices were up 10.2 percent in February compared to a year ago and 20 percent since President Biden took office. Electricity prices were up 12.9 percent. Utility gas service was up 14.3 percent. Rent prices were up 8.8 percent. And the list goes on. Overall, energy prices have increased by 37.2 percent since President Biden took office--37.2 percent.

Again, there is no end in sight to this crisis. Digging out of an inflation crisis like this isn't easy, but there are things we can and should be doing to help, like restraining government spending, unleashing American energy production to help drive down energy prices, and growing the economy. These are the things President Biden should be pursuing. But, as the President's budget last week made clear, the President hasn't learned anything from the last 2 years. President Biden and congressional Democrats helped create our current inflation crisis with their $1.9 trillion American Rescue Plan spending spree. And what does President Biden have planned in his budget? More reckless government spending--a lot more reckless government spending.

Our last Federal budget before the pandemic was in 2019. That year, total Federal spending was $4.4 trillion. Over the last 3 years, COVID and then Democrats' profligate spending pushed up the size of the Federal budget to levels in excess of $6 trillion. So $4.4 trillion in 2019 before the pandemic, $6 trillion at the conclusion of the pandemic, and two big reconciliation bills passed along party lines by Democrats. But the need for extra COVID dollars is long over.

Given the economic havoc Democrats' reckless spending has created, you would think Democrats would be looking to return the budget to somewhere approaching pre-COVID levels,

but you would be wrong. President Biden wants to take the inflated budgets of the past 3 years as his new baseline, and then the President is proposing $6.88 trillion in spending next year--a 54-percent increase over 2019 levels. And then--and then--he is proposing increased spending every year until the Federal budget reaches an eye- popping $10 trillion in 2033--$10 trillion in 2033.

Again, let me just remind people that the entire Federal budget in 2019--just a few short years ago--was $4.4 trillion. President Biden wants to more than double that--$4.4 trillion to $10 trillion.

This level of spending and the accompanying level of debt would present a serious danger to our financial stability going forward. The President's budget all but ensures that the size of our national debt would be larger than the size of our economy. In other words, we would owe more money than our entire economy produces. These levels of spending could easily prolong our inflation crisis for years to come.

But the economic dangers of the President's budget don't end there. At the same time the President is essentially ensuring an unsustainable level of debt going forward, he is also planning to load up the economy with $4.7 trillion in tax hikes, and that is not counting some of the tax hikes that would result from allowing provisions of the Tax Cuts and Jobs Act to expire. He plans to undo much of the good work done by the 2017 Tax Cuts and Jobs Act, which helped grow our economy and improve opportunities for American workers.

Under the Biden tax plan, American businesses would become less competitive in the global economy, investment would be discouraged, and Main Street job creators and family-owned businesses would face a higher tax burden, which would make it more difficult for them to grow, expand, and create jobs.

I said earlier that one of the things we could do to ease our inflation crisis and drive down prices is increase American energy production. Well, President Biden's tax plan would discourage American energy production by hiking taxes on oil and gas companies, and not for the first time during his Presidency. Instead of lowering energy prices, the President's plan would likely drive them up even further with all the new taxes.

The problems with the President's budget go on and on. While the President has no problem driving up spending to a staggering $10 trillion per year by 2033, somehow very little of that money gets put toward priorities like securing the border and defending our Nation.

For next year, the President is proposing an increase in defense spending that fails to keep pace with current levels of inflation, meaning that his supposed defense spending increase would actually be a defense spending cut.

The Department of Homeland Security would see an outright spending cut next year. Despite the security and humanitarian crisis wreaking havoc at our southern border, the President is proposing barely any additional funding for U.S. Customs and Border Protection and Immigration and Customs Enforcement next year, but somehow--somehow-- the President managed to find a 15-percent increase in funding for the IRS. Think about that. That is from the 2023 enacted budget for the IRS, over and above the $80 billion funding increase the IRS got just last August. Think about that. Last August, the IRS got $80 billion and 87,000 new employees. Yet, this year, under this President's budget, they are not only going to get all that funding and a massive influx of new employees but a 15-percent year-over-year increase in spending on the IRS at a time when defense spending is going to be 3.2 percent below the rate of inflation. You can't make it up.

It doesn't stop there. The President's budget would also provide an additional $29 billion to the IRS to ``continue [Inflation Reduction Act]-funded enforcement and compliance initiatives.''

I guess maybe what the President is thinking with respect to all of this is that he will need more IRS agents to administer all the new tax hikes that are included in his budget proposal. It is extremely disturbing that the President's tax-and-spend agenda is taking precedence over the national security imperative of securing our border.

President Biden's budget is the wrong prescription for our country. It would shrink our economy, prolong our inflation crisis, and essentially guarantee unsustainable levels of debt.

The American people had a rough couple of years under the Biden administration, and the President's budget would be almost guaranteed to prolong their economic pain well into the future. I hope Democrats, as well as Republicans, will recognize this and quickly consign the President's budget to where it belongs, and that is to the dustbin.

I yield the floor.

I suggest the absence of a quorum.

Mr. President, I ask unanimous consent to speak for up to 30 minutes prior to the scheduled rollcall vote. I do not think I will have an issue, but out of an abundance of caution, I ask unanimous consent for that, please.

Mr. President, I do appreciate Senator Kaine's remarks. He has highlighted a serious problem for many Americans. We don't completely understand it. I have every confidence in our medical community and our research and development community that we will figure it out, but in the meantime, there are a lot of Americans suffering, some silently, and I appreciate Senator Kaine highlighting this issue.

Mr. President, I ask unanimous consent that the order for the quorum call be rescinded.

I yield the floor.