The effort of returning to work with Long Covid

The effort of returning to work with Long Covid

Anderson, E. et al (2024) summarised by Rachael McGill

Introduction

Due to fluctuating and unpredictable symptoms, people with Long Covid can struggle to return to and stay in employment. The researchers drew on 65 interviews with adults with Long Covid conducted between 2021 and 2022, from three studies, from the Scottish Chief Scientist Office, the NIHR and the Economic and Social Research Council. They considered the concept of ‘episodic disability’ to be a useful framework to understand the barriers faced by people with Long Covid when returning to employment.

Summary

The researchers asked people about the impact of Long Covid on their employment and ability to work. They identified four main themes:

1. Altered identity

Most people were keen to return to work; they missed the social contact and feeling of purpose and worried about the financial implications of losing their job. Having Long Covid could lead to a loss of identity. Some felt unable to disclose the full extent of their symptoms for fear of being judged as less capable or losing their job. They described debilitating symptoms such as problems with thinking, memory and decision-making.

2. Between classifications

Sickness absence policies that classify employees in binary terms such as healthy/ill or able/disabled do not accurately describe people with unpredictable illnesses that vary in severity. Some participants fluctuated between being almost able to work and being completely unable to. Returning to work too soon could worsen symptoms, but having repeated sick notes was dispiriting; some felt they had to repeatedly show employers they had a legitimate illness. Remote working could mask the severity of symptoms.

3. Disabling or engaging workplaces

Some people were expected to maintain the same pace as their colleagues. Most said a standard 4-week phased return to work was not suitable; gradual and tailored returns were more effective. Some were offered additional adjustments like flexible hours, frequent breaks and adapted roles, which could enable a sustainable return to work.

4. Adjustment work

People described doing ‘adjustment work’, including limiting time spent sitting and standing and cutting back on leisure activities to prioritise energy for work. Some participants had to repeatedly explain symptoms to managers and colleagues to justify their need for adjustments. For those who could not return to work, the challenges of navigating the benefits system were heightened by Long Covid symptoms such as fatigue and brain fog.

Conclusion

Employment is linked with health benefits, but to experience these, people with Long Covid need workplace and welfare support. The researchers call for employers to recognise that some staff with Long Covid could be considered disabled under the Equality Act. Long Covid has, or is likely to have, a substantial and long-term negative effect on an individual’s ability to undertake normal daily activities. Workplace adjustments and flexible support can help employees return to and stay in work.

Read the research here