6 considerations to help employers address the rising prevalence of long COVID
With so many unknowns, businesses will yet again need to make vital decisions without as much information as they would need or like.
Employers have faced tremendous business disruptions due to the pandemic. And they’re not out of the woods yet. Long COVID is affecting a significant number of workers – 15-30% of those who recovered from COVID-19. With so many unknowns and so many employees impacted, businesses will yet again need to make vital decisions without as much information as they would need or like.
Long COVID can affect almost any system in the body. It causes a range of symptoms including fatigue, memory fog (“COVID brain”), shortness of breath, anxiety, and depression – all of which can persist from weeks to months, even in mild cases of infection. Neither accurate diagnoses nor optimal treatment plans are easy to come by.
Related: Is there a link between long COVID and the U.S. labor shortage?
This article highlights six factors that will guide employers as they look to keep their workforces safe and healthy.
1. Vaccination decreases the risk of long COVID
Employees are at risk for long COVID only if they get a COVID-19 infection. Those employees most at risk include those who have not been vaccinated and boosted, and the immunocompromised. Vaccinations and boosters are the most effective way to prevent COVID-19. Studies from the UK and Israel show that COVID-19 cases in those who are vaccinated are less likely to lead to long COVID. Employers can promote higher vaccine rates through work schedule flexibility, paid time off for vaccination, communication of available vaccination sites, financial incentives and vaccine mandates.
2. A rising wave of employees with long COVID will need employer support.
Millions of Americans are living with long COVID. Many face skepticism from supervisors or colleagues as their symptoms are varied and mainly self-reported. Supervisors might believe symptoms of fatigue represent malingering, and only 26% of companies train line managers to address long COVID symptoms. Employers can educate employees and managers to recognize long COVID and reduce stigma.
Long COVID symptoms often include behavioral health issues, and those afflicted are likely to need ongoing access to mental health support. Employers can offer behavioral health solutions (including virtual mental health services) and provide a resource list of long COVID rehabilitation centers. They can also provide support through Employee Assistance Programs. Keep in mind that long COVID affects employees and their families; employers can attain better outcomes and more employees will return to work with additional help and support.
3. Long COVID will exacerbate current workforce shortages
Researchers at the Brookings Institution concluded that as many as 1.1 million US workers might be off the job due to long COVID, and an additional 2.1 million might be working reduced hours due to long COVID. A survey in the United Kingdom reported that almost a fifth of those with long COVID missed enough work that they faced potential disciplinary action.
Employers will need to assess how long COVID is likely to impact their workforce and proactively address workforce absenteeism, employee capability assessments, possible reskilling of the work force, and cost of replacing employees lost to long COVID. It’s also smart to review return-to-work policies to balance worker shortages with a safe work environment.
4. Long COVID will lead to increased disability claims and requests for work accommodations
The lack of a uniform definition creates problems in identifying and documenting long COVID. We don’t yet know if long COVID symptoms will resolve with time. Some employees will be able to return to work at least part-time, while others will be permanently disabled.
Long COVID is considered an official disability under the Americans with Disability Act. Employees may have a hard time proving they are disabled because many long COVID symptoms are self-reported and initial COVID-19 infection is not always documented. Disability-related to long COVID has many unknowns, including length of disability which is required for Social Security benefits. Some might apply for disability unnecessarily and some may have applications inappropriately denied because the documentation required for disability are not specified for long COVID.
Disability insurance carriers will play a big role. It’s important for them to appropriately evaluate long-term disability claims for long COVID so that valid claims are receiving support and invalid claims are not paid out. Employers will need to provide accommodations including reduced work hours for employees with long COVID to allow them to remain on the job.
5. Employees will need assistance in finding credible treatment of long COVID.
Long COVID centers of excellence use multi-disciplinary clinical teams to treat the wide range of patient symptoms. These centers are more commonly located in major metropolitan areas, and many currently have long wait times due to staffing shortages and patient demand. Employers can ensure that insurance coverage is available for such treatment. Virtual second opinion services, if available, can sometimes expedite access.
6. There is hope that better treatment for long COVID is on the way.
Long COVID treatment is currently focused on patient symptomatic support, but the pipeline for future therapies is robust. Ten or more early-phase studies are now underway evaluating drugs to treat long COVID. These drugs are aimed at many symptoms, including fatigue, shortness of breath and inflammatory disease in children, and they have a variety of modes of action. Researchers are also evaluating the potential to decrease symptoms by using pneumatic cuffs to increase blood flow. We don’t know how long those with long COVID will need treatment, or how much that treatment will cost.
There is still much to learn about long COVID. As we gain knowledge of long COVID and its impact on employee lives, employers can improve support for their workforce. Employers that proactively work to mitigate the risk of long COVID will be best positioned to succeed in the long-term management of this potentially crippling manifestation of COVID-19.
Siupo Becker, MD is a senior director in the health management practice of Willis Towers Watson. She is an Internist, trained in infectious diseases, and collaborates with employers to develop health management solutions focused on population health, data analytics, and innovation.
Patricia Toro, MD MPH, is a senior director in the health management practice of Willis Towers Watson. She is trained in infectious diseases and works with payors, providers, and employers to improve the quality and outcomes of health care delivery.
Jeff Levin-Scherz, MD, MBA, is a managing director and population health leader of the North American Health and Benefits practice at Willis Towers Watson. He is an assistant professor at the Harvard TH Chan School of Public Health.
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