As the vaccine rollout continues nationwide and states begin to loosen restrictions, more employers are eager to resume full operations. But while companies prepare their workforce for life in a post-COVID era, there is another potential health concern that needs to be addressed: long COVID (or medically referred to as Post Acute Covid Syndrome).
Individuals who recovered from COVID-19 but still suffer with symptoms months later have been pegged with the name “COVID long haulers,” and the prevalence of this condition is quite high. There have been consistent reports of patients with lingering symptoms including in those whose original disease severity was mild. In some cases, symptoms persist for more than three months. Researchers estimate about 10% of COVID-19 patients become long haulers, according to The Journal of the American Medical Association.
The illness, which is not yet understood, may keep certain employees from returning to work for unknown amounts of time. As research continues and we learn more about this illness (which can affect many different systems in the body and not just the lungs), it is likely that COVID long haulers will get bucketed into two major groups. In one group will be those with what has previously been characterized as “post-ICU syndrome” -- the aftermath of a severe infection as well as the trauma that is caused by the treatment they have received. The other group will include those with a post-viral syndrome following a mild or moderate episode of Covid-19. The ongoing needs of these two groups are going to be different. For those in the first group, the clinical aspects, though serious, are relatively straightforward.
For those in the second group, who started out with mild to asymptomatic cases, problems can include persistent cough, loss of senses of smell and taste, muscle aches and fatigue, headache, cognitive issues often described as “brain fog” and sleep disruption. Many have experienced frustration when they try to get back into shape and do not seem to make any progress. Many experience anxiety and fatigue related to the whole experience. This can be exacerbated by extensive diagnostic testing that typically does not produce conclusive findings. A more holistic approach to this condition is needed in order to help these patients get better. Here are a few considerations employers should take into account:
Post- COVID recovery programs: Employers can help employees suffering with Long COVID by finding recovery programs that make sense for them. Fortunately, there is now a movement to establish multidisciplinary post-COVID clinics in efforts to provide a more comprehensive assessment and treatment program. These programs provide a single source for all health care providers so that the patient doesn’t need to go shopping for many different doctors.
Disability and leave programs: Some COVID long-haulers are reporting symptoms that may limit their major daily life activities. Depending upon the severity of the symptoms, some employees may require intermittent FMLA, while others may qualify for short and/or long term disability, and may qualify for an accommodation under ADA. For those that are not eligible for FMLA or disability/ADA, other leaves such as personal or medical leave may be considerations. Additionally, state and local laws pertaining to COVID-related leaves must be taken into account.
Employers and their administrators may need assistance in making decisions about leaves and disability eligibility. Because many of the multidisciplinary post-COVID clinics are rehab medicine-based, they are able to provide functional assessments and disability evaluations that can help streamline disability and leave claim determinations. Employers may also see an increase in disability and leave durations driven by employees who recover from COVID and develop a new disabling condition with symptoms that are exacerbated by the effects of the prior COVID event.
Behavioral health support: Employers – and their employees -- need to clearly understand what behavioral health support may be accessed through the current benefits programs. While COVID is still a relatively new illness, many resources are already available, such as counselling services for depression and anxiety associated with Long COVID and guidance on coping with symptoms and aspects of the illness. Employee assistance programs (EAPs) can be another helpful resource – employers should look into what their current EAPs include and make sure to communicate that with employees. Virtual care or teletherapy services can be another beneficial outlet for suffering employees.
Fortunately, recent studies show that some COVID-19 long-haulers are experiencing a bit of relief from their symptoms after getting vaccinated. However, that’s not the case with everyone, and until we know more, all we can do is acknowledge and offer support and empathy to those who are suffering by helping them find the resources they need to get them back on their feet.