Long COVID: Keep On Trucking

Adam Marcus and James Prudden

The next time you get a shipment of toilet paper from Amazon, or a knickknack from Etsy, or even a letter from your Aunt Sue in Tuscaloosa, thank a trucker. According to one estimate, roughly 4 million Americans work full-time as long-haul truckers, with another 3 million holding part-time jobs on the nation’s roads. Meanwhile, the U.S. Department of Transportation lists some 770,000 for-hire fleets.

What do all those numbers have to do with COVID-19? A lot more than you might think.

According to Healthy Trucking of America (HTA), an advocacy group for the profession, truckers—the preferred term is professional drivers—are among the least healthy workers in the United States. Roughly 54% are obese, many have liver conditions like hepatitis C infection and fatty liver disease, half suffer from sleep apnea, and smoking and excessive drinking are common.

In other words, says Jon Slaughter, the CEO of the HTA, truck drivers in America are prime candidates for bad cases of COVID-19.

Even mild or asymptomatic cases of the infection can take an enormous financial toll on the nation’s economy. As Slaughter explains, truckers who test positive for the SARS-CoV-2 virus:

“will be sidelined by quarantine for up to 2 weeks.  Consequently, you’re looking at a severe loss of income for some drivers, such as owner operators, who exceed 10% of the driving population.”

The economic cost is massive, too:

“When you add in the amount of freight that is not moved and deliveries not made, the numbers get into the billions.”

We spoke recently with Slaughter about the impact of the pandemic, and Long Covid in particular, on the trucking industry.

LC: How has the trucking industry acknowledged COVID-19 risks associated with the profession, and has there been some attempt to address, by extension, Long Covid?

JS: The American Trucking Association and dozens of state trucking associations are calling on the CDC’s Advisory Committee on Immunization Practices to reclassify truck drivers into priority group ‘1b’ of the committee’s vaccination order recommendations. [See letter.]

LC: Have the medical personnel who take care of truckers been given any specific training on Covid, acute or Long, and if so, what, and if not, why not? What are your plans for training?

JS: We don’t know of any special training that was provided to medical examiners specifically about COVID when it relates to drivers.  I can tell you the Federal Motor Carrier Safety Administration suspended the need for drivers to have a required medical exam due to COVID.  That will be lifted later this year, and the burden went back to the fleets and their policies when it came to driver safety following COVID policies that are unique to fleets and not overseen by any government standard—other than the standard mask-wearing requirement. It’s just filled with extensions and waivers to not require physicals and to wear a mask at the end of the day.

LC: Given higher rates of chronic disease among truckers, and given the nature of trucking, which moves the drivers in and out of more and less infective zones, what are your recommendations for truckers who are out on the roads as they read this? How can they reduce the risks for COVID-19?

JSClick here for what the CDC says—nothing more than what common sense allows, however fleets have a responsibility to keep up with their drivers and ensure when symptomatic for COVID they are quarantined.  Many fleets including large fleets like UPS and FedEx have excellent programs, but there are NO state or federal reporting requirements. Consequently, small- to mid-size fleets  that cannot afford elaborate software are left unprepared.

LC: What are your recommendations for pro drivers who have had a bout of COVID-19 and who feel they still have symptoms that may indicate Long Covid? What should they do, who should they see?

JS: The first response of course is go see your doctor and respect the health of everyone you interact with.  Sadly, many drivers who don’t know they are symptomatic are contributing to the spread of COVID.  So it’s important to get frequent COVID tests.

LC: Finally, some Long Covid symptoms, like fatigue and brain fog, would be dangerous for someone negotiating a multi-ton vehicle on the road. When should a driver put away the keys and stop driving, and focus on their health? What should they do about lost income in those circumstances?

JS: What is particularly alarming is that the CDC also warns that adults of any age with obesity are at increased risk of severe illness from the virus that causes COVID-19, while adults of any age with liver disease might be at an increased risk for severe illness from the virus that causes COVID-19.  According to our survey, one in three professional truck drivers has symptoms of prediabetes and doesn’t know it. Unfortunately, the incidence of diabetes or obesity are conditions which lead to onset of fatty liver disease, including non-alcoholic fatty liver disease and the more problematic non-alcoholic steatohepatitis. These diseases often prompt the development of other issues such as advanced fibrosis, increased risk of cardiovascular events and—at the extreme—liver cancer, liver transplantation and death.

Our Take:

To be sure, the interview above has a lot of “what ifs.” The biggest unknowns being: We don’t know how many truckers have had COVID-19, and how many of them are long haulers. But the potential problem is concerning enough, both from an economic and public safety problem, that the Biden Administration needs to pay close attention. @PeteButtigieg @SecretaryPete: are you listening?

Adam Marcus and James Prudden

Managing Editor

Freelance science and medical writer. Articles have appeared in Science, New Scientist, Nature Medicine, The Scientist, New York Daily News and other publications. Frequent contributor to

Long COVID: Keep On Trucking

The next time you get a shipment of toilet paper from Amazon, or a knickknack from Etsy, or even a letter from your Aunt Sue in Tuscaloosa, thank a trucker.

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