Warehouse employee wearing a mask holding his head.

Vital Support for Employers Addressing Long COVID in the Workplace

By Michelle Hopkins | 03/09/2021

Occupational health expertise is key

When confronting cases of “long COVID,” “occupational health advice is key to understanding where adjustments at work can be made. Getting this advice is the first thing an employer should do,” a legal expert has told People Management, a prominent human resources publication in the United Kingdom, which ranks fourth in global COVID-19 infections.1,2 In addition to advising on work accommodations for employees, Concentra®, a leading occupational health provider, offers physical examinations, pulmonary function testing, imaging and specialist referrals, when needed, to more fully understand long-term effects of COVID-19 and how to talk with employees. This article will explore what is meant by “long COVID” and describe other recommendations for employers.

Long COVID – persistent and documented

“Long COVID” describes persistent and often debilitating COVID-19 symptoms.3 So far, there is no definitive correlation between cases where long COVID symptoms emerge and acute disease severity, hospitalization, presence of comorbidities, or demographics like gender or age. One or more of the following long-COVID symptoms may last for weeks or months after they have cleared the COVID virus: severe fatigue, shortness of breath, cough, joint pain, chest pain, muscle pain, headache, rapid heartbeat, difficulty thinking or remembering (brain fog), sleep problems, loss of smell, hair loss, or rash.

International surveys, cited by the Centers for Disease Control and Prevention (CDC) in a January 2021 presentation to medical professionals, are helping clinicians understand more about long COVID.4 Some specific findings are:

  • 35 to 54 percent of people with mild acute COVID-19 had persistent long-COVID symptoms after two to four months.
  • 50 to 76 percent of people reported new symptoms they did not experience in their acute illness or the reappearance of symptoms that had resolved.
  • Nine percent described their long-term symptoms as severe.

In addition to these persistent symptoms, Yale School of Medicine says long COVID-related interstitial lung disease also may develop. Interstitial lung disease refers to a group of disorders that cause progressive scarring of lung tissue, as seen with hazardous exposures, such as asbestos, coal dust, and respirable silica.

Investigations into long COVID are not completely without precedent. In the 2003 outbreak of severe acute respiratory syndrome (SARS), many people who recovered from SARS went on to develop chronic fatigue syndrome, a complex disorder characterized by extreme fatigue that worsens with physical or mental activity but does not improve with rest.5 Could this be true for COVID-19 also? No one knows for sure yet.

But it is revealing to read the blog posts of Paul Garner, a United Kingdom physician and infectious disease specialist who made a complete recovery from long COVID after almost nine months of persistent symptoms. He was aided immeasurably in his recovery by sessions with another medical professional who had recovered years earlier from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). From his mentor, he learned that his symptoms were likely due to his brain misinterpreting and misdirecting his autonomic system. In short, his brain had triggered a self-reinforcing, vicious cycle by misinterpreting perceived threats to the body.

With a gradual process of reprogramming the brain by reinforcing and reassuring Garner that he was safe and healthy, he began to improve. It would be wrong to draw the conclusion that Garner’s symptoms were imaginary or “all in his head.” They were real, physical symptoms triggered by complex brain science.

How employers should respond to long COVID cases

The scientific and medical communities are just beginning to learn more about COVID-19 and long COVID. For this reason, the CDC urges employers to remain open-minded and to talk with affected employees without making judgments or being overly assertive about returning to work. “There is a lot we do not understand, and empathy toward patients experiencing long COVID is fundamental,” the CDC says.6

Health and benefits experts recommend that employers invest in health assessments and a range of support to evaluate each case independently – the type of services Concentra offers. Employers need to understand how each employee with long COVID is affected, “rather than just saying it’s a medical condition and we need to treat it this way,” says Mike Blake, director of health and benefits at Willis Towers Watson.7

Long COVID should be viewed like any other chronic condition that requires long-term care. “Employers should be prepared for this and – if they don’t already – make sure they have policies in place to ensure that those with chronic illness are not discriminated against,” says Dr. Ken Abrams, the managing director and chief medical officer of Deloitte.8

It's unknown how many cases of long COVID there are currently in the United States or how many may develop. A frequently cited research study of 1,733 people who had been hospitalized for COVID-19 in China found that 76 percent reported at least one long COVID symptom at six months post-recovery.9

Employers should not assume they will be unaffected by long COVID. Now is the time to reach out to Concentra for more COVID-19 information and occupational health support.

Concentra COVID-19 information page: https://www.concentra.com/coronavirus-2019-covid-19/
Concentra Webinar, “What Employers Need to Know About COVID-19 Vaccine Administration”
https://www.concentra.com/resource-center/webinars/covid-19-vaccine-administration-your-questions-answered/


NOTES

1  Long COVID: What employers need to know. People Management. November 17, 2020. https://www.peoplemanagement.co.uk/experts/advice/long-covid-what-employers-need-to-know#gref  
2  Johns Hopkins University Coronavirus Resource Center. Global Case Map. https://coronavirus.jhu.edu/map.html 
3  Long-Term Effects of COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html   
4  Treating Long COVID: Clinician Experience with Post-Acute COVID-19 Care. Clinician Outreach and Communication Activity (COCA) Webinar. Centers for Disease Control and Prevention. January 28, 2021. https://emergency.cdc.gov/coca/calls/2021/callinfo_012821.asp
5  COVID-19: Long-term effects. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351   
6  Treating Long COVID. CDC. 
7  Long COVID. People Management. https://www.peoplemanagement.co.uk/experts/advice/long-covid-what-employers-need-to-know#gref 
8  Employers are rethinking sick leave, work from home policies to protect COVID-19 ‘long haulers’. ABC News. November 3, 2020. https://abcnews.go.com/Health/employers-rethinking-sick-leave-work-home-policies-protect/story?id=73981815 
9  Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet. January 16, 2021; 397(102700: 220-232. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext