6 Considerations in Addressing the Prevalence of ‘Long Covid’

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—between 15 percent and 30 percent of those who have 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 for weeks or months, even following a mild case of the disease. Neither accurate diagnoses nor optimal treatment plans are easy to come by.

Here are six factors that employers should consider as they look to keep their workforce 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, as well as the  immunocompromised. Vaccinations and boosters are the most effective way to prevent Covid-19. Moreover, studies from the U.K. and Israel show that Covid-19 cases in those who are vaccinated are less likely to lead to long Covid. Employers can promote higher vaccination rates through work schedule flexibility, paid time off for vaccination, communication of available vaccination sites, financial incentives, and/or 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 percent of companies are offering training to line managers related to addressing long Covid symptoms. Employers can educate employees and managers to recognize long Covid and reduce the stigma.

Long Covid symptoms often include behavioral health issues, so afflicted employees 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 (EAPs). Keep in mind that long Covid affects employees and their families; employers that offer help and support may better convince employees to return to work.

3. Long Covid will exacerbate current workforce shortages.

Researchers at the Brookings Institution concluded that as many as 1.1 million U.S. 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 to proactively address workforce absenteeism, employee capability assessments, possible re-skilling of the workforce, and the 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 whether long Covid symptoms will resolve with time. Some employees will be able to return to work at least part-time, while others may be permanently disabled.

Long Covid is considered an official disability under the Americans with Disabilities Act (ADA). 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, while others 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 for long Covid.

Long Covid centers of excellence use multidisciplinary clinical teams to treat the wide range of patient symptoms. These centers are commonly located in major metropolitan areas, and many 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 under way to evaluate 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 about the syndrome and its impact on employees’ 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.

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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 she 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 healthcare 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.

From: BenefitsPRO