Long COVID – the top considerations for employers

Advice and top tips

Long COVID – the top considerations for employers

Although COVID-19 infection rates and hospitalisations continue to fall, many, it seems, are still living with the after-effects of having the virus. In the following guide, we outline the symptoms, the key considerations for employers and how Occupational Health support can help employees.

Long COVID – a condition that sees people having new or ongoing symptoms four weeks or more after their first initial coronavirus infection – affects an estimated one in five COVID-19 sufferers(1), around 1.1 million people across the UK. Yet, it remains a poorly understood element of the pandemic. Scientists are still to get to the bottom of why some of us are plagued with long-haul symptoms, far beyond the usual recovery period.

For more detailed clinical definitions of Long COVID, please refer to the following NICE guidance.

Facts about Long COVID

  • Long COVID is used to describe signs and symptoms that continue or develop after acute COVID-19 (up to four weeks). It includes both ongoing symptomatic COVID-19 (four to 12 weeks) and Post-COVID-19 syndrome (signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis)
  • Long COVID is not contagious
  • It can affect any organ in the body
  • According to the ONS, of those people who reported signs of Long COVID, almost 700,000 said they had COVID-19 at least 12 weeks previously, with another 70,000 revealing they had the virus almost one year ago
  • A person who was asymptomatic or had mild symptoms when testing positive for COVID-19 could still be affected and suffer from Long COVID
  • The condition can affect anyone of any age, but research from King’s College London has suggested that females, older people and those that experienced a greater number of symptoms in their first week of infection were at greater risk(2) . Younger people with active, busy, family lifestyles also tend to struggle with Long COVID, due to the challenges of daily life

Unfortunately, there is no way to predict how long it will take anyone to recover from Long COVID.

Signs to look out for

According to the NHS, common Long COVID symptoms can include:

  • Fatigue
  • Shortness of breath
  • Chest pain or tightness
  • Memory and concentration problems (brain fog)
  • Difficulty sleeping
  • Heart palpitations
  • Dizziness
  • Pins and needles
  • Joint pain
  • Depression and anxiety
  • Ear issues, like earache and tinnitus
  • Sickness, diarrhoea, stomach ache and loss of appetite
  • High temperature, cough, headaches and sore throat
  • Changes to sense of smell or taste
  • A rash

Affecting all age groups, and consequently the working population, symptoms can result in employees being off work for a long-term, indeterminate period of time. Furthermore, workplace productivity can be negatively impacted should they return to work too early.

With symptoms reminiscent of other health problems and diseases, employers must also take into consideration that it could take some time for employees to receive the correct medical diagnosis of Long COVID. In some cases, employees may be soldiering on in silence and working when unwell, so employers should look to make their workforce aware of the symptoms they may suffer in the wake of a COVID infection and encourage them to speak to a medical professional should they display any signs of Long COVID. So, how can employers support workers suffering from the condition?

Here, we share the top 5 considerations for employers.

A case-by-case approach

With a wide range of possible symptoms, a one-size-fits-all strategy is ill-advised when it comes to supporting employees.

Instead, employers should judge employees by the extent to which they are affected by the condition.

Employers should talk with employees to discuss and address their individual Long COVID symptoms, signposting the support that can be available from Occupational Health teams and offering practical advice on physical ailments, as well as emotional support to help deal with the psychological fallout.

Educate and inform your workforce

Although not much is currently known about Long COVID and why it occurs, awareness is improving – every week GPs are being exposed to more cases and the NHS is responding by investing £10 million in dedicated clinics.

From a business perspective, it is important HR teams make managers and employees aware of the signs and symptoms, advising them on how to spot if a colleague is struggling and what actions they can take.

Long COVID can have a negative impact on employees both physically and mentally, so a holistic approach is needed when it comes to support. While research into the impact and treatment of Long COVID continues, recommended interventions currently include physiotherapy to deal with muscle, joint and bone pain, respiratory physiotherapy for breathing problems, complementary therapies such as yoga and acupuncture, occupational therapy, talking therapies and CBT. GPs can also refer patients to integrated multidisciplinary rehabilitation services (Long COVID clinics).

To manage breathlessness and fatigue, the British Heart Foundation (BHF)(3) recommends that sufferers pace themselves and prioritise daily activities, taking frequent short rests and gradually increasing the amount of exercise they do.

It is advised that they do not stop undertaking activities that make them breathless, as this can cause muscles to get weaker. Flexibility and strengthening exercises are also suggested to relieve joint and muscle pain, as well as keeping active to release endorphins and boost mental wellbeing.

If an employee is experiencing serious symptoms, such as chest pain or shortness of breath, encourage them to dial 999 to safeguard their health and wellbeing. For example, they may require a blood pressure check, chest x-ray and blood tests to check nothing else is wrong and that their symptoms are indeed Long COVID-related.

Signposting the benefits

The availability of employee benefits that can help support in the management of the illness should be highlighted to workers.

Private medical insurance, for example, can help cover treatments, while income protection policies can offer a financial safety net. Employees can also use an EAP to access counselling services should their mental health be affected.

Some insurers have even created Long COVID care and rehabilitation services, which can help guide employees on their road to recovery and direct them to the most appropriate treatments. They can also help support managers in understanding the impact of Long COVID, as well as helping ensure compliance with health and safety regulations.

Online advice and support is available via Public Health England, which has published guidance on the long-term health effects of COVID-19. The NHS has also developed a website to help those impacted by the condition.

Furthermore, a Long COVID support group has been set up where employees can access resources and read stories from other Long COVID sufferers.

Is Long COVID a disability?

The Equality Act (2010) makes it a legal requirement for companies to make reasonable adjustments to ensure employees with long-term health problems are not disadvantaged in the workplace.

According to the Act, a person is considered disabled if:

    • They have a physical or mental impairment which adversely affects their ability to carry out normal day-to-day activities
    • The adverse effect is substantial
    • The adverse effect is long-term

It is not yet clear if Long COVID meets the conditions of a disability, with the issue likely to be decided by a future Employment Tribunal.

Employers, however, should err on the side of caution and take all reasonable steps to support employees, including reasonable adjustments to the workplace and their job roles. This might involve reallocating tasks to other workers, moving employees to quieter areas, revising working hours, allowing them to work from home or making changes to the physical working environment.

Returning to work

Symptoms of Long COVID can cause employees to be off work for extended periods of time, meaning careful planning and execution is required when facilitating their return to work.

Following periods of long-term absence, workers may experience feelings of isolation or apprehension, and if their return-to-work is not effectively managed, relapses can result.

Advice should be sought, as required, from Occupational Health physicians or GPs to help make informed decisions, such as whether employees are fit enough to return to work and what adjustments are needed.

Return to work interviews will allow workers to raise any issues of concern and for line managers and HR practitioners to discuss plans to phase them back into working life, including options such as flexible working and part-time hours where these are deemed necessary.

Regular contact between employer and employee is essential but be sure that the right balance is struck. Too much contact can cause employees to feel pressured to return to the office too soon; too little can make them feel undervalued or cut off.

Understanding of Long COVID is constantly evolving. For the latest government guidance on the condition, please visit Public Health England’s advice page.

1 https://www.health.org.uk/news-and-comment/blogs/what-might-long-covid-mean-for-the-nations-health

2 https://www.kcl.ac.uk/news/study-identifies-those-most-risk-long-COVID

3 https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health/long-covid#Heading3