Supporting employees with long COVID to return to work

Getting infected with COVID-19 can cause some people to experience health problems that won’t go away. This is commonly referred to as ‘long COVID’ and can result in symptoms such as extreme tiredness, coughing, breathlessness and problems with memory and concentration.

It is estimated that anywhere from 10% to 30% of patients might experience long COVID after recovering—even if they weren’t very sick in the first place.ⁱ People can experience the effects of long COVID for weeks, months and even years. This means it can affect someone's ability to work or cause them to take time off sick.

When it comes to long COVID, there are range of issues and support options that employers need to be aware of to ensure employees successfully return to work. This might include the need for physical rehabilitation, mental health support or education around things such as energy conservation.

We have been working closely with our customers to research the ongoing impacts of long COVID, particularly from a return-to-work perspective. Some of the challenges employees face in returning to work is outlined in our Long COVID Research report.

Some of these challenges include:

Societal and medical attitudes towards long COVID: Since long COVID is a very new concept, there is very little research in this emerging field and, as a result, many long COVID patients report dismissive attitudes by medical providers, friends, and family, which can make seeking care—whether psychological or physical—even more challenging. These attitudes must be considered in the return to workspace where employers and insurers may not be understanding of the difficulties faced by someone experiencing long COVID trying to return to preinjury duties and hours.

Cognitive function and mental health: Patients with long COVID frequently rank cognitive function and mental health at the top of their concerns. When talking with patients who have long COVID, it’s important to start by asking about their most prominent concerns and what their goals are. This may include asking the following overarching questions:

• “What are you hoping to get back to?”

• “If you weren’t sick, what would you do today?”

Answering these questions can help patients and health practitioners to identify specific goals and start developing a plan for what a meaningful life could look like. It is important for patients to know that their experiences are valid and real and that they can try to alleviate them by making changes to their mood, behaviour, and more.

So far, research indicates that COVID-related encephalopathy may lead to other neuropsychiatric outcomes, including psychosis. It’s important to bring in psychologists who can monitor and address any mental health symptoms that emerge. For patients with brain fog or memory loss, their mental health will affect their cognition. Patients with severe cognitive issues, such as difficulty accessing important memories or lack of executive functioning would require referrals to a specialised psychologist or neuropsychologist.

Reduction in work capacity: Clients with fatigue may need help mapping out plans for how many tasks they can complete that day, and what they can ask their families to take on. Many people with long COVID may not be able to accept having reduced or no capacity to work, leading to a decline in self-worth and independence. Other consequences may include feelings of hopelessness, thoughts of self-harm and suicide, and the fear that COVID could affect the rest of their lives.

Fear returning to workplace: Many people with long COVID experience fear and anxiety returning to the workplace. This may include fear of infecting others, past infection of others and fear of becoming reinfected. This is particularly prominent if they have infected someone previously who has deconditioned or passed away. These are additional factors that must be considered when planning the return to work of someone with long COVID.

Physical capacity: A number of symptoms of long COVID are related to fatigue, shortness of breath, heart palpitations and pain which may not only affect someone’s capacities and abilities to complete pre-injury duties/hours but may also pose a risk to themselves or others in the workplace. Consideration of additional risk factors due to symptoms of long COVID is crucial to facilitate a safe return to work.

When the employee feels able to return to work

Employers should keep in touch with their employee and discuss with them any support they may need prior to returning to work. This may involve getting an occupational health assessment or making changes to the workplace or how the employee works, such as different working hours. Provide support during the early days of the return to work. Provide early and ongoing support, and review regularly with the employee.

Modifications to workplace duties and hours that may facilitate a return to work and recovery at work plan include:

• Alterations to timings and hours

• Alterations to workload

• Taking regular breaks

• Additional support and supervision

• Time off for healthcare appointments

• Phased return to work and option for working from home

• Equipment adjustments

• Counselling

Ultimately, employers can better retain workers experiencing long COVID and other chronic illnesses by creating supportive policies. If this is not a company’s area of expertise, experts such as Rehab Management, can provide advice and support.

Rehab Management is part of the Arriba Group, which recently was recognised as Australia’s #1 Best Place to Work (Health) by AFR BOSS.

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