What Employers need to know about Long COVID
Long COVID is becoming an increasingly common topic of discussion among health professionals, policymakers and the media alike, and for good reason. This long COVID employers guide aims to help employers understand the topic.
As cases of COVID have arisen over the past year, so has the reporting of its longer-term effects for those who recover. Now, studies are beginning to quantify its occurrence – and the implications are stark.
What is Long COVID?
Long COVID, also known as post-COVID syndrome, is not a single affliction. It is a set of symptoms and syndromes around which knowledge is still growing. What sufferers have in common are a set of persistent symptoms lasting 12 weeks or more.
[Updated] The ONS has estimated that over 2 million people have already experienced long COVID (at May 2022). It is continuing to monitor the prevalence of long COVID. Estimates suggest that long COVID may impact anywhere between 10 and 25% of people who catch COVID.
37% of people had at least one long-COVID symptom diagnosed in the 3-6 month period after COVID-19 infection
University of Oxford and the National Institute for Health Research (NIHR) – end September 2021
Very significant long COVID symptoms can be experienced even after a mild or asymptomatic case of the disease.
What are the symptoms of long COVID?
Long COVID is complex, and individuals may have markedly different symptoms and disability. However, it is often multi-system, impacting different parts of the body.
An international study led by UCL has suggested that there might be around 200 separate long COVID symptoms affecting 10 organ systems.
Common functional loss arises from fatigue, pain, coincident mental or muscular health issues and symptoms such as breathlessness.
According to data collected by the ONS (at October 2021) , fatigue is the most commonly reported symptom (56% of those with self-reported long COVID), followed by shortness of breath (40%), loss of smell (32%), and difficulty concentrating (31%).
Symptoms of long COVID include:
- extreme tiredness (fatigue)
- shortness of breath
- chest pain or tightness
- problems with memory and concentration (“brain fog”)
- difficulty sleeping (insomnia)
- heart palpitations
- dizziness
- pins and needles
- joint pain
- depression and anxiety
- tinnitus, earaches
- feeling sick, diarrhoea, stomach aches, loss of appetite
- high temperature, cough, headaches, sore throat, changes to sense of smell or taste
- rashes
Long COVID implications for employers
For employers this may become extremely challenging. The needs of members of the workforce who experience long COVID may vary and fluctuate. It is impossible to predict prognosis. Many cases recorded are now over a year old.
Legacy employment approaches to manage long term sickness are already proving difficult to apply in many businesses.
Many line managers will be in the front line of helping support employees through long-Covid. Either in managing a slower or more complex return to work process, following a COVID infection absence. Or in helping monitor and support returned staff whose symptoms may be spasmodic.
“Long COVID is a relatively new illness and for some people it can be debilitating. For others, its effects are variable and a worker could be fine one day but need to be off work if their symptoms worsen.”
Susan Clews, ACAS Chief Executive
Line managers need to be aware of the help available, both within and external to the organisation.
Internally that will include knowing how to engage effectively with HR and ER specialists, refer staff swiftly for Occupational Health referrals, directing staff to Employee Assistance Programme support, and more.
“The symptoms of long COVID which commonly impact on function and may impede return to work are fatigue, shortness of breath, chest pain and neurocognitive impairment. These symptoms may also impede travel to work.”
Faculty of Medicine
The Council for Work and Health is very concerned about the impact of poor management support on staff experiencing long COVID. Due in part because it is such a new health condition, it counsels employers to take great care – not just with compassion, but to support staff through future difficulties. It highlights the critical importance of line management.
“For people with Long COVID, there needs to be workplace support for return to work. There needs to be sustained joined up services to assist people with Long Covid who are at work to stay at work, through medical, biopsychosocial and workplace support and vocational rehabilitation.”
Council for Work and Health
Is long COVID a disability?
Although long COVID itself may not be classified specifically as a disability under the Equalities Act, many of its symptoms may easily meet the definitions of a disability if they have substantial impact on someone’s ability to work or conduct normal activities over a long period of time.
In this case employers must, as with any other disability, consider how to make reasonable adjustments can be made to help the individual remain able to work, whether that is in flexibility of work pattern, location, or any other reasonable change.
Managing employees with long COVID – where employers can find help
Externally there is a growing body of help, including the availability of specialist long-Covid healthcare hubs across England – 89 at the time of writing.
The principles of care start with self-management and good employers can help signpost many good resources for their staff and line managers that are produced by organisations such as Society of Occupational Medicine, Royal College of Occupational Therapists, Chartered Society of Physiotherapy and many more.
Useful long COVID and COVID resources for employers
- Working with Long COVID: research evidence to inform support – a report by the CIPD – February 2022
- Presenteeism during the COVID-19 pandemic Risk factors and solutions for employers – guidance from the Society of Occupational Medicine
- COVID-19 return to work guide: For managers – guidance from the Society of Occupational Medicine
- Guidance for managers and employers on facilitating return to work of employees with long COVID – guidance from the Faculty of Medicine
- Long COVID – advice for employers and employees – guidance on long COVID sickness, absence and disability from ACAS
- Statement on long COVID work and health – from the Council for Work and Health
Useful post-COVID and long COVID resources for employees
- Your COVID Recovery: Supporting your recovery after COVID-19 – self-help guidance from the NHS
- Long Covid Support – a peer support and advocacy group for people with long COVID
- Covid Aid – a new UK charity
The scale of the long COVID challenge
At mid 2021, faced with the inevitability of many hundreds of thousands more COVID infections to come during the remainder of the year, the reality is that nobody knows the true scale of the long COVID challenge to come. Read our article outlining why COVID worker absences are already a huge challenge.
A common misconception is that double vaccination can prevent COVID infection. This is not true, and some people who have had two injections will not just become infected but may get long COVID.
The Government and the NHS are becoming acutely aware of the growing challenge of long-Covid. The APPG Coronavirus committee met to discuss this in June 2021 and heard evidence about the growing potential volume of long COVID cases. It saw many experts confirming the need for more well organised multidisciplinary care to support employers and employees. Among them, Dr Steve Boorman CBE, our own employee health consultant and expert.
“The reality is that we don’t yet have consistent clear data to understand true numbers – we may only be diagnosing the tip of the iceberg. For workers we risk both recognised and unrecognised cases of long COVID causing both prolonged sick absence but also presenteeism. Presenteeism carries safety, quality and performance risks for employers, but also may result in exhausted staff using time away from work purely for recovery.”
Dr Steve Boorman CBE
One thing is very clear. All employers must be better prepared in future if they are to adapt to a future that features long COVID. Better employee health management and care overall should be an absolute priority.
Technology that can support timely return to work processes, give line managers accurate advice and guidance, and enable effective employee health monitoring and excellent HR and OH case management will be increasingly essential for any employer with a substantial workforce.
