Professor Andrew Shaw, Founder & Chief Scientist, Attomarker Ltd
The comment that stopped the conversation
I have spent most of my career operating at the intersection of immunology, diagnostics, and clinical reality. I am comfortable with uncertainty, regulatory complexity, and long development cycles. What I am less accustomed to is cognitive dissonance.
During a recent discussion with an experienced angel investor, reviewing Attomarker’s work in Long COVID, the opportunity was described as “too short term” to justify investment.
The remark was not confrontational. It was delivered matter-of-factly, almost casually. Yet it landed with force, because it exposed a deeper question that deserves scrutiny. If Long COVID is too short term, then what, precisely, qualifies as long enough in modern healthcare investment?
This was not a conversation about a hypothetical market. Our diagnostic work is already in use in specialist clinics from Hong Kong to Seattle. Nor was it a discussion about an early scientific signal. We are now dealing with a well-characterised, growing patient population, five years into accumulation.
Long COVID is not a transient opportunity, it is a compounding one
From an investment perspective, Long COVID is often framed implicitly as a post-pandemic aftershock, a tapering tail rather than a structural market. The data do not support that framing.
Current estimates suggest approximately 74 million people globally are living with Long COVID. Of these, around 18 million are in the United States and roughly 34 million across the European Union. These numbers are not static. Reinfection, incomplete recovery, and limited disease resolution mean the pool continues to grow.
This matters because Long COVID behaves economically like other chronic immune-mediated conditions. Patients persist in the system. They consume resources over time. They cycle through services without clear resolution. From a market perspective, this is not a spike, it is an accumulation curve.
The uncomfortable implication is that Long COVID looks far more like an under-diagnosed chronic disease category than a short-term dislocation.
Why governments are acting while private capital hesitates
Public capital has begun to respond accordingly.
Germany’s commitment of approximately £500 million to its National Decade Against Post-Infectious Diseases is not speculative science funding. It is infrastructure investment, grounded in workforce impact, long-term healthcare cost, and national productivity. Similar policy-level discussions are now taking place in the United States through federal roundtables and research coordination initiatives.
Governments are not known for rapid consensus, yet here the direction of travel is clear. Post-infectious and immune-mediated diseases are being recognised as long-horizon problems requiring durable diagnostic and care capability. Long COVID is referenced specifically, alongside others.
The question for private capital is not whether the disease burden exists, but why that burden is still being discounted when translated into investment logic. has private capital become focused on only the blockbuster markets or is it simply disconnected from the leading edge of innovation in emerging diseases, the place it is arguably most needed?
The diagnostic gap in immunology, amplified by Long COVID
Diagnostics in immunology have historically been underserved relative to oncology, cardiology, or genetics. The reasons are familiar: biological complexity, heterogeneous presentation, and regulatory conservatism. Accurate diagnostics that produce meaningful and actionable clinical insight are not your typical squirt, spin, swish and read type. Our gold nanoparticle array highlights this – that’s nano, or one billionth – we’re working on quite a small, precise scale.
Long COVID magnifies this gap. It is not a single disease entity but a collection of immune dysregulation patterns, representing multiple endotypes, each driving different symptoms and requiring different clinical interventions. Without diagnostics capable of characterising that immune disturbance, clinical care defaults to more basic symptom management and trial-and-error intervention.
From a systems and investment standpoint, diagnostics sit upstream of both clinical outcomes and cost control. Without stratification, pathways fragment and expenditure rises. This is precisely the bottleneck we are addressing.
What makes this even more interesting is that investors can sometimes pour money into emerging treatments based on win-lose trial outcomes when in fact the success of such trials could well be reliant on just the sort of patient stratification we are describing.
Importantly, this is not about a single test or disease. Long COVID is just one large-scale expression of a broader class of post-infectious immune dysfunction. Which brings us to Lyme disease.
Lyme as the next test of “short term” thinking
Lyme disease presents a strikingly similar investment paradox.
Global prevalence estimates run into the millions, with the US alone seeing approximately 476,000 new cases annually. A significant subset of patients go on to experience persistent symptoms associated with immune dysregulation. The diagnostic challenges are well documented, and the economic burden substantial.
We have recently entered a co-development agreement to extend our immune profiling platform into Lyme-associated disease. The scientific logic is clear. The immune mechanisms overlap. The diagnostic gap is real. The patient need is persistent.
Which raises an uncomfortable but necessary question. If Long COVID is considered too short term, will Lyme be viewed the same way? If not, why not? How many patients, over how many years, constitute an investable horizon? Grand View Research puts that market at around $11 billion today, rising to nearly $19 billion by 2030.
Time horizons, capital models, and biological reality
Healthcare does not conform neatly to short venture cycles. Diagnostics rarely do. Regulatory pathways take time. Adoption, particularly in conservative systems, takes longer.
Yet these same characteristics underpin resilience. Chronic disease markets do not disappear. Diagnostic platforms that embed into clinical decision-making tend to persist and expand. From an economic perspective, they create compounding rather than transient value.
The friction here is not scientific. It is temporal. A mismatch between biological timescales and financial expectation.
Context matters
This reflection arises at a moment when Attomarker is entering an acceleration phase, just launching a small but strategically important investment round. That context is unavoidable, it is the very reason the conversation surfaced the conundrum.
However, the point is more fundamental. If tens of millions of patients, five years of accumulated disease, and active government investment are still described as “too short term”, then the investment community needs to ask itself a harder question.
Is the issue really the market, or is it the lens through which the market is being viewed?