Stepping up to support people with long COVID

Rachel Suff, Senior Policy Adviser (Employment Relations), CIPD. 

We’re now 18 months into the health pandemic and the world’s scientific and medical communities continue to grapple with the COVID-19 disease as it evolves. More evidence emerges all the time, including 
findings showing that over a third of people who had COVID-19 reported symptoms lasting at least 12 weeks. 

NHS advice says that long COVID symptoms can last for months, and the chances of having long-term symptoms doesn’t seem to be linked to how ill someone is when they first catch the virus. And someone who had mild symptoms at first can still have long-term health problems. The NHS publishes a very long list of common symptoms, including fatigue, chest pain or tightness, heart palpitations, brain fog, depression and anxiety, rashes and dizziness.

The REACT-2 studies suggest that the prevalence of persistent symptoms increases with age, with long COVID more likely among women, people who are overweight or obese, who smoke, live in deprived areas, or had been admitted to hospital.

There’s still a lot even the medical profession doesn’t know about so-called ‘long COVID’ or ‘post-COVID-19 syndrome’ and its long-term health consequences. This makes it even more challenging for individuals, as well as employers, to understand it. But it’s vital that organisations and HR, working with occupational health services and other health professionals, are as informed as possible about this potentially debilitating condition so that they can effectively manage people. If employees don’t receive appropriate understanding and support, the risk is that work could exacerbate an individual’s symptoms, and many employees could even fall out of the labour market. Employers should promote understanding and awareness of long COVID among managers, and ensure they have sickness absence, return-to-work and health and wellbeing policies that encourage a flexible and individualised approach to managing fluctuating long-term health conditions.

Should long COVID be a disability?

The potentially severe, multiple and long-term health consequences of long COVID have led the TUC and others to call for long COVID to be urgently recognised as a disability and COVID-19 as an occupational disease, to give workers access to legal protections and compensation. It highlights that half (52%) of respondents with long COVID said they had experienced some form of discrimination or disadvantage due to their condition.

New Acas guidance advises organisations not to focus on whether long COVID should be considered a disability, but instead what adjustments can be made to combat symptoms and help staff return to work. To this end, Acas also cautions against capability procedures until all other options have been considered.

An important point for employers in developing a supportive framework for managing people suffering from long COVID is that it affects people’s health in very different ways at an individual level, and how long it takes to recover is also different for everybody.

What’s the right support?

In the CIPD webinar with health experts on providing long-term health and wellbeing support for people, Dr Jo Yarker highlighted the complex challenge for returning employees with long COVID. Typically, when people are unwell, they return to a stable and supported environment, but those with long COVID (and other conditions) are returning to environments that are likely to be depleted.

Acas says the usual rules for sickness absence and sick pay apply when someone is off work because of long COVID.

However, the unpredictable nature of long COVID can make it even more challenging for individuals – and therefore employers and managers – to manage than other fluctuating health conditions. The Society of Occupational Medicine’s COVID-19 return-to-work guide for recovering workers, developed with the CIPD and other expert organisations, points out that long COVID can have ‘unusual patterns: relapses, phases with new, sometimes bizarre symptoms’ and that ‘an initially mild case can be followed by later severe problems that can impact markedly on day-to-day activities’.

This joint guide provides valuable practical advice for people suffering or recovering from long COVID to help them understand the condition, as well as the information an employee needs to communicate with their employer/manager about how their illness is affecting them, as well as their contractual responsibilities. It also highlights the crucial relationship between the individual and their manager in facilitating an effective return to work where this is possible.

Our HR Guide (sponsored by Bupa) on managing a return to work after long-term sickness absence cautions that recovery can be slow and the fluctuation of symptoms means that employees often need to increase their activity and work slowly over time. This means some employees may need work adjustments or job modifications (including reduced hours or flexible work) over many months. There are still a lot of unknown factors when it comes to managing an employee’s return following long COVID. What we do know from employees experiencing other conditions (such as mental ill health or cancer) is that many absence management policies lack the flexibility to effectively support employees with fluctuating and long-term conditions.

Therefore, it’s important that HR professionals review their existing provision, with occupational health if available, using the information provided in the guide, to ensure that adequate provisions are in place to support employees returning from long COVID. For example, employees may need support to develop their ability to manage their condition effectively. This could include self-management strategies, resilience and developing their confidence in their ability to manage their work and health. Return-to-work is not a one-off event but should be approached as an ongoing process.

Line managers – the crucial link in the chain

CIPD research shows that most organisations look to line managers to manage sickness absence and they play a key role in the return-to-work process; cases involving long COVID are no exception. Managers are typically the key point of contact for conversations between the unwell or recovering individual, they act as a gateway for rehabilitative support, helpful workplace adjustments and are best placed to provide ongoing support and flexibility when the employee returns.

Guidance by the Society of Occupational Medicine sets out guiding principles for managers on how they can best help someone with long COVID return to work. It says it’s ‘important to listen to their needs and concerns, allow them to be proactive in making changes that allow them to manage their health and work, and work together to find solutions.’

The CIPD/Bupa guide for managers on managing a return to work after long-term absence has valuable advice on the practical steps a manager should follow, including in cases of long COVID. It emphasises the need for managers to build trust-based and supportive relationships with individuals. As with any fluctuating long-term condition, it will be important when managing someone who is suffering from long COVID to take a flexible, individualised and compassionate approach. This could involve a phased or part-time return, a change to someone’s duties or responsibilities, enabling someone to work from home or in another flexible working arrangement, as well as ongoing review and discussion as their symptoms may fluctuate for some time.

A long-term challenge

Science and medicine have moved at a phenomenal rate to help the world combat COVID-19 and its many variants. The disease continues to evolve, with long COVID just one of the additional burdens it bestows on populations across the globe. Organisations need to play their part in helping individuals and communities recover from the devastating health issues it can cause. The health impacts of long COVID will be with us for a long time. By embedding support for people with long-lasting symptoms of COVID-19 within their wider health and wellbeing framework, employers can help to ensure their support is sustainable and long-term. It will also help to ensure that the organisation’s guidance and support continues to reflect evolving NHS and other clinical advice and treatment for long COVID.

Visit our long COVID resources page for a list of resources on supporting employees who are affected by long COVID. 

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