Darja Reuschke explains some of the key findings of her latest paper with Donald Houston and Paul Sissons on the impacts of Long COVID on workers.
Context
COVID-19 infections are on the rise again. While for some, the symptoms will be flu-like, for others, an infection with the virus will cause long-term illness. By the end of March 2024, an estimated 2 million people in England and Scotland were experiencing Long COVID. The term Long COVID is used to describe persistent COVID-19 symptoms or late complications of a COVID-19 virus infection that develop at least five weeks after an initial infection with the virus.
In a new study, Darja Reuschke and Donald Houston (City-REDI, University of Birmingham) and Paul Sissons (Keele University) study the consequences of this new multi-symptom post-viral illness for UK workers.
Characteristics of Long COVID
Symptoms of Long COVID are multidimensional and can include physical, cognitive and mental illness. Often reported are chronic fatigue symptoms, breathing problems and chest pain, inability to concentrate and muscle pain. Because of the complexity of the health conditions, Long COVID is difficult to diagnose. Most people who are suffering from Long COVID had mild symptoms at first or could even have been asymptomatic. What is more, there is no effective treatment for the illness which often limits what people can do.
Some people are more likely to develop the post-viral illness than others. International evidence supports that people between 45 to 54 years of age, women and those with a pre-existing health condition are more likely to develop Long COVID. For the UK, the ONS has identified a greater risk of Long COVID for those between 35 to 69, highlighting the risk for the working-age population.
The study
We investigate whether Long COVID increases the risk of leaving employment and whether those who remain in employment with Long COVID experience a reduction in hours worked and/or an impact on mental health.
Because the study looks specifically at risk of leaving employment, two different groups of Long COVID sufferers are distinguished:
- A first group experiences COVID symptoms for 5 to 28 weeks which is up to the maximum period of Statutory Sick Pay in the UK.
- A second group has symptoms for 29 weeks or more. After 28 weeks (six months) of sickness leave, especially workers on low income and those in non-professional jobs (which often do not come with employer sick pay schemes), face redundancies.
These two groups are compared with people who do not have COVID symptoms or who have COVID symptoms for a short period (less than 5 weeks which is within the period of recovery from a viral infection).
Using a large population survey for the whole UK population, for these four groups we investigate the likelihood of employment exit; working zero hours (sickness absence); reduction in working hours; and reduction in mental well-being.
Key findings
- Long COVID sufferers with symptoms lasting for more than 28 weeks, which is beyond the maximum period of statutory employment protection in the UK, have a higher risk of employment exit compared to those without COVID symptoms.
- Working zero hours (sickness absence) is increased among those with Long COVID 5-28 weeks, similar to those with short COVID. But those with Long COVID 29+ weeks are not more (or less) likely to be temporarily absent from work than those with no COVID symptoms.
- Having Long COVID (5-28 weeks or 29+ weeks) is not associated with reduced working hours. Moreover, if still in work, those with Long COVID 29+ do not work less (or more) than they did before the pandemic.
- Comparing the mental health across the study groups shows large negative associations with Long COVID compared to those with no COVID symptoms – and more so on average for those who experienced symptoms for 29+ weeks. The study also finds that people with Long COVID for 29+ weeks seem to ‘buffer’ the low mental well-being found in group comparison which is likely to point to adaptations to live and work with Long COVID.
- For those with Long COVID 5-28 weeks, the negative impact on mental health is mediated by earnings which hints at possible job characteristics associated with higher/lower income that facilitate workplace adaptions (or not).
Policy implications
COVID-related health impacts on our society and workforce have not gone away. The pandemic is over but the longer-lasting health effects continue to pose risks to public health, the economy, and individuals’ employment and earnings.
The extension of Statutory Sick Pay beyond 28 weeks and greater flexibility to manage phased returns to work would help to reduce the risk of leaving employment of those with Long COVID. Financial support for employers to maintain employment until recovery from Long COVID would help to preserve employment and tackle the rising level of inactivity in the UK.
Working fewer hours can help accommodate a work-limiting disability. But the study did not find that those with Long COVID work fewer hours (if they are still in work). This is a concern and calls for better management of this complex illness in the workplace. Employers need to provide adaptions and flexibility to manage the physical and mental symptoms of the illness. A sizeable number of workers with Long COVID are likely to meet the definition of disability (long-term activity-limiting illness) and therefore have the right to receive reasonable workplace adjustments.
This blog was written by Dr Darja Reuschke, Associate Professor at City-REDI, University of Birmingham.
Disclaimer:
The views expressed in this analysis post are those of the authors and not necessarily those of City-REDI / WMREDI or the University of Birmingham.