Having long-lasting symptoms after COVID-19 is dubbed “Long COVID” or “Long-haul COVID-19”. Employers should take note of how this will affect worker productivity and medical capacity in the workplace, says Anton Engelbrecht, Alexander Forbes Senior Health Risk Consultant and Myrna Sachs, Head of Alexander Forbes Health Management Solutions.

Usually, COVID-19 symptoms last two weeks for a mild infection and up to six weeks in a severe case. If your symptoms persist or you develop new symptoms relating to SARS-CoV-2, the virus which causes COVID-19, then you have contracted Long COVID.

Long COVID may linger for three months or more after isolation has ended. This may affect an employee’s overall work performance and their extended medical incapacity, disability claim or both.

According to the World Health Organization (WHO), Long COVID symptoms may be consistent or fluctuate.

Symptoms include:

• Fatigue, a cough and shortness of breath.
• Inflammation and injury to the lungs or heart.
• Damage to the nervous system.

Based on WHO presentations, symptoms which linger beyond two weeks and up to six weeks should raise concern around the possibility of Long COVID. Symptoms that persist beyond six weeks should be considered as Long COVID.

Medical journal The Lancet stated that one in five people with COVID-19 had persisting symptoms for more than five weeks, and one in ten had symptoms for longer than 12 weeks.

What employers need to consider

Adopt a holistic approach across all health intervention service providers, including occupational health, absenteeism and incapacity investigation, and employee assistance programme support. Help employees return to work through work accommodation and a graded process.

Calling or arranging an online meeting with the individual helps to find out:

• The symptoms and how these affect their productivity.
• Whether the employee is being accommodated or needs to be accommodated at work.
• The status of follow-up appointments with the treating doctor.

Follow this process:

1. Human Resources submits a signed consent form and provides contact details of the individual and a family member
2. The health risk manager:

• Contacts the individual or family member to find out what the medical condition is (hospitalisation, self-isolation, symptoms).
• Follows up regularly with the individual on how their medical condition is progressing.
• Establishes whether they will require any reasonable accommodations when they reintegrate back to work.

3. With Long COVID cases, initiate a referral for an incapacity investigation to find out whether the individual can fully perform the duties of their own occupation (contact with the treating doctor, specialist, physiotherapist may be necessary).
4. Depending on the outcome, make further referrals for:

• Extended sick leave
• Disability application
• Chronic disease management with medical aid
• Fitness for work or return to work programme
• Ergonomic assessments

5. Approach each case in light of the varying symptoms every individual presents with.

From an employee wellbeing perspective, tracking and following up with employees that have COVID-19 offers the following benefits:

• Long COVID is not common knowledge. Many people could experience persisting symptoms and may not understand or recognise what is happening. This in turn could lead to the condition being downplayed which could further impact on the employee’s wellbeing and ability to cope in the workplace.
• Manager’s concerns of an employee’s performance can be addressed via early intervention. This could take the form of a follow up telephonic functional status check-in with an employee with respect to general wellbeing and any support needed. Support offered can then assist with any short-term difficulties but also assist with longer term management and further referral for medical intervention as part of an integrated approach.
• Cross referral between EAP and the Medical Scheme can further allow for an integrated and holistic approach to support employees.

COVID-19 sick leave data analysis and intervention:

• Identifying employees who could be at risk for Long COVID-19 via the absenteeism data, e.g. if leave taken for COVID-19 is greater than 18 days, this could signal possible Long COVID risk.
• This should be a parallel process to the Long COVID incident and assist in understanding the ongoing symptoms the employee presents with.
• Employees that are on the high-risk register could demonstrate an aberrant sick leave pattern that warrants closer management through the appropriate channels.
• Understanding the impact of the COVID-19 pandemic on sick leave utilisation and establishing the trend within the various industries.

References:

1. SAMJ Vol 111, No 1 (2021) Long-COVID: An evolving problem with an extensive impact. M Mendelson 2020.
2. Lancet (21 December 2020) Long COVID guidelines need to reflect lived experience
3. Dr Salim Ahmed, Life Occupational Health

Sources:

• Alexander Forbes Health newsletter
• https://iafrica.com/long-covid-could-be-the-biggest-employee-health-challenge-facing-employers/

Neil Enslin | Occupational Health and Safety Manager