Long Covid in the workplace

The news is increasingly reporting on the worrying impact of Long Covid, a condition which can last for weeks to months beyond the initial Covid illness and is thought to affect one in 10 people who have had the virus. Many are people of working age – and many of these appear to be women.

This weekend it was reported that women under 50 who have been admitted to hospital for Covid may be five times more likely to develop long Covid than men. The preliminary research presented to Sage suggests such women are five times more likely to report a new disability after suffering Covid, six times more likely to experience greater breathlessness and twice as likely to feel exhausted for up to 11 months after leaving hospital.

Research is just in the beginning phase, however, and a recent pledge from the Government of £18 million to support research into it indicates it’s likely to be around for quite some time and likely to have a significant impact at work.

No two people experience Long Covid in the same way. Some have mild symptoms while others are left wheelchair-bound and unable to work. In addition to the higher gender risk, it is also emerging that those who are overweight and asthmatic may be more likely to suffer from it. Nevertheless, we are increasingly hearing cases where it has hit anyone from marathon runners to children.

There are four different syndromes of Long Covid:

• permanent organ damage to the lungs and heart
• post-intensive-care syndrome
• post-viral fatigue syndrome
• continuing Covid-19 symptoms

According to NHS England, some 60,000 people in the UK are thought to be experiencing Long Covid and at least a quarter of a million people in the UK alone who have experienced effects of the virus lasting for more than 28 days. The NHS has spent £10m on creating a network of Long Covid clinics.

If all this wasn’t bad enough, it is currently thought that some people may never recover from Long Covid and that others may see the condition morph into a series of other conditions. What’s clear is it’s not fully understood, and that, for employers makes planning difficult, says Steve Herbert, Head of Benefits Strategy at Howden Employee Benefits & Wellbeing.

“We’ve only had Covid-19 with us for a year so it’s hard to see how prevalent it will be, but if you’ve had Covid it seems that you’re four to five times more likely to get Long Covid than you are to die of it. That’s a lot of people.”

What should employers do?

At the moment, says Herbert, the answer is not a lot – the biggest single reason being that people are in lockdown and still working from home, he says.

“As we come out of this, it will suddenly become a very real issue for employers to grapple with,” he states.

Of course, those with Long Covid who have been hospitalised and may have sustained permanent organ damage, such a lung scarring, may never get back to work.

“Those with the all-pervading fatigue, and those with intensive care syndrome, which can include continuing symptoms of impairment in cognition, psychological and physical health, will need additional support to get back to work. But here’s the real kicker,” says Herbert. “You can just about be recovering from one of the symptoms, think you’re coming out of it, and then go down with something else you didn’t have – and that can hang around for months, or even years. We’ve had people who’ve had symptoms for six-eight months, but that’s pretty much as long as we’ve had Covid.”

Where should employers start?

The easiest place to start for employers is providing private health care coverage. Herbert says: “That’s probably the only way of short-circuiting treatment as there’s so much pressure on the NHS and there will be in the future. Having that as an employee benefit at the point when they need it is vital. If you have cover in place, point staff towards it,” he says.

Lucky employers will already have established what’s called a group income protection scheme. “If someone is offered long-term sick pay, it picks up a large percentage of their salary until the end of the contract, until retirement age, or until they return to work,” says Herbert. “Companies with group compensation schemes need to be telling their insurer that they have got people who are absent and trying to give them medical assistance to get that person back into the workplace more quickly. That’s good for the employee and doesn’t cost the employer anything.

“If they can’t provide medical cover, and employers aren’t covered by a group compensation scheme, at the very least, they should be trying to support their employees in some way. There are various options, for instance, offering a nurse-led support option to help.”

Finally, Herbert says employers should have Group Life Insurance. “I’ve heard people say they would support families if an employee died by dipping into their own pockets, but at this time many haven’t had an income themselves so aren’t in the financial position to support them at all,” he states.

He advises employers to do what they can, as early as they can to improve outcomes and to limit the cost of more employees being off with Long Covid in the future.

Is Long Covid likely to be considered an occupational disease?

Kate Hindmarch, a partner in Employment Law at Langleys Solicitors, thinks not. “Currently Long Covid sufferers would need to meet the definition of a disabled person under the 2010 Equality Act to be eligible for protection at work,” she says.

Employees would have to prove they have a physical or mental impairment with long-term (12 months or more) substantial and adverse effects.

Although Hindmarch says that The Equality Act does include some illnesses under disabilities protection, such as cancer, MS and HIV, she adds that “it would be surprising to see Long Covid added to that list”.

To satisfy this legal definition, employees will have a protected characteristic under the Act, meaning employers will have to ensure they don’t discriminate because of the disability itself or because of any absence associated with it.

“The key is to have an early dialogue with the employer, to make reasonable adjustments to the working method or workplace and perhaps talk to their medical advisors or to occupational health to see what can be accommodated and agreed. If an extended absence is required, furlough can be considered while the scheme lasts,” says Hindmarch.

Lauren Harkin, an employment lawyer at Royds Withy King, also feels Long Covid is not likely to classified as a disability under the Equality Act 2020 any time soon because a disability has to have a substantial “long term” negative effect on a person’s ability to carry out day-to-day activities.

“If Long Covid sufferers start to report symptoms for a much longer period, it certainly is possible that it could meet with the Act’s disability definition. This would then trigger the obligation for employers to consider making reasonable adjustments, as well as ensuring employees are not treated in a discriminatory way.”

She also advises employers to accommodate temporary adjustments to working practices, such as reduced hours and, where possible, she says they should reach out to their employees to let them know the support mechanisms in place.

Keeping the means of communication open

Lucie McGrath Director, Health & Benefits GB, at risk management firm Willis Towers Watson, says the “no two individuals experience the illness in the same way. This makes it incredibly hard for employers to manage and support employees with Post Covid Syndrome in a consistent way”.

However, she is keen to point out that employees who have persistent symptoms might have had very mild Covid-19 at first, but gone on to “experience severe ongoing issues for an extended period”. “The severity of their initial infection is no indicator of how long they may experience symptoms and issues for,” she says.

She advises employees to engage with occupational health to really understand the challenges they are facing and ensure they have a structured and well-supported return to work programme in place, that is supported by both clinically qualified individuals and also line managers or an HR team. This needs to be reviewed regularly and changed as needed.

McGrath advises employees who have ongoing issues to feed this back to bosses, and for bosses to offer emotional wellbeing support.

She says: “Try to understand that it can be extremely scary for people to cope with. They don’t know why this is happening to them and very often, what is happening. Ensure people know what support services and employee benefits their employer provides (and also the NHS services that can help them as well). Many health insurance programmes will cover the cost of diagnostics and support services to help people with their rehabilitation and access to counselling services is critical too.”

Women with caring responsibilities need job reassurance

Suzanne Smith, specialist practitioner with online fatigue recovery programme The Chrysalis Effect, says: “Typically, with Long Covid we’re seeing 75% to 80% female incidence. Stress and anxiety very much contribute to symptoms…” She said the impact of the double shift at home and at work could make things worse.

“One day you might be able to walk around the house or run in the street, and the next day you can’t even get yourself dressed. And it’s especially difficult for women who take on most of the caring responsibilities,” she states.

She warns that means we’re more likely to see “people returning to work before they are 100% ready” and she adds that it’s hard for employers to see that when everyone is working remotely. “Employers have a responsibility. Big ones will have a sick policy, medium-sized ones should perhaps get in touch with an HR specialist sooner rather than later to make sure practices around employees and their fitness don’t leave them exposed,” she says.

She also advises employers to be open to listening and to reassuring employees that their jobs are safe and to communicate this helpfully as well as informing them of what happens if they don’t have the energy to work and what their sick pay entitlement is.

“Having that clarity for your employees and leaving the door open so that if they have got any worries that there is somebody that they go and talk to without losing their job,” says Smith. “If you’re a small company, working with an HR specialist who knows their stuff can take a lot of those worries away and help plan for long-term cover as part of business planning so there is no pressure for an employee to come back sooner than they are ready. That way there’s less disruption for employers and channels of communication are kept open.”

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