An Employer’s Guide to Supporting People Living With Long COVID

by Adam Brown
Registered Physiotherapist  BScPT, MClScPT
updated June 7, 2023

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According to the National Institute for Health one in three Canadians live with chronic disease. If you are an employer, this means that chronic disease is a factor in the health of your employees and the trajectory of your organization. Great leaders position their organizations to help employees living with chronic conditions be successful. In the coming years this fact will become a more powerful differentiator. 

Why now? What has changed?……Long COVID.

Unlike cardiovascular disease, Diabetes or milder mental health concerns, Long COVID has a clearer impact on the individual while living with the disease. While an employee with Diabetes may need to manage their condition with medication, diet, and other lifestyle changes, the impact on work can be minimal with almost no effort required by the employer to accommodate. 

Long COVID is a different story. People living with Long COVID can be excellent employees who contribute meaningfully to an organization. To make that a reality, leaders need to understand the condition and adapt in ways that help the employee be successful. 

The World Health Organization estimates that 1.4 Million Canadian Adults are living with Long COVID. Some other estimates are much higher. This is a condition that is disproportionately impacting working age adults. Within those 1.4 million Canadians is a large and diverse talent pool. Doctors, lawyers, executives, teachers and everyone in between. Understanding how to work together with these individuals and to help them contribute their talent to the organization will be a powerful advantage for the companies that take it seriously. 

With Long COVID being a new condition, there is no known cure. Symptoms range widely and often include crushing fatigue, brain fog, pain, headaches and more. Although the cure currently alludes researchers, there are important lessons that have been learned. Working with people suffering from Long COVID and listening closely to their experience reveals some common truths about how best to help. There are features of Long COVID that seem to be consistent. 

Great companies and great leaders, should consider the information that follows and begin to transform their organizations. Not just because it is the right thing to do, but also because it will quickly become a strategic advantage.

 

Return to Work in the Context of Long COVID

A return to work plan for an individual living with Long COVID is unlike any of the common conditions that an employer or HR department will have encountered before. Some of the common methods for evaluating a person’s readiness to return could cause harm. For example a Functional Capacity Evaluation may look fine when testing, but could have serious implications for people who suffer from Post-Exertional Malaise (PEM). Canadian employers should familiarize themselves with the REALIZE guidelines to ensure they understand the condition and can avoid doing harm. What follows are some practical suggestions on how an organization can improve the chances of a successful return to productive work for people living with Long COVID. 

 

1. The Return To Work Schedule

Long COVID can be unpredictable and episodic. Flexibility is key. People need to make small changes to their activity (physical and cognitive) and evaluate symptoms for 7-10 days before considering any more change. It is best not to plan based on a typical linear ramp up of an individual’s schedule. It will not play out that way. Some will be able to move faster, some slower, and many will need to pause at different points to allow for symptoms to settle. If everyone understands the nonlinear nature of recovery at the beginning it will avoid making the employee feel like they are failing to meet an expectation that was unrealistic at the outset. Progression of the plan is based on stability of symptoms and will not follow healing timelines that have previously been developed for MSK or cardiac conditions.

2. Go Slow To Go Fast

All parties involved (insurers, employers, HR reps, and individuals) MUST understand that pushing the timeline for return to work despite increasing symptoms will result in longer delays and likely a return to being completely off work. It is imperative that the plan makes small incremental changes and waits for 10 days to 2 weeks to see what the results are before moving forward with more change.

3. Pacing is Key

People living with long COVID have to become experts at pacing. They can extract the most from their day by tightly controlling physical, cognitive, social and emotional demands. Ignoring pacing can lead to a lengthy exacerbation of symptoms or “crash”. Here are some ways that an organization can support pacing and set the employee up for success.

• Allow employees to take breaks when needed – at the time that is most beneficial for them. 
• Many people suffering from long COVID need to be recumbent when taking breaks. Many offices have a space where this is possible. A quiet, low stimulation environment where an individual can lie down for a short break can be very helpful. 
• Allow employees to vary their tasks as necessary. Changing up cognitive tasks and physical ones can assist in pacing.
• Allowing for virtual participation in meetings will reduce physical exertion and travel time. 
• Keep meetings short. Have an agenda and run meetings with discipline. 
• Only have individuals in meetings that need to be there – reducing unnecessary participation. 
• Record meetings and presentations for individuals who could not attend, or who may need to go back over the material later. 
• Avoid after hours obligations. This may be precious time to rest and be ready to perform the next day. 
• Minimize travel and when it is unavoidable, build in lots of transition time. 

4. Common Pitfalls for the Well Meaning Employer.

Remember that your employee who is living with Long COVID has valuable ideas and abilities. They may need to pace themselves to participate but do not let these differences get in the way of a meaningful contribution. Remember that nobody wants to be treated as diminished, or lesser. It may seem supportive to insist that they rest or to decrease their involvement, but realize that it may be very important to them that they are able to contribute. They simply need to do so while respecting the condition. 

Engagement in their work team may be an important part of the individual’s life – telling an employee to simply return when they are ‘all better’ is not supportive. 

 

Long COVID is a big problem, but it is everyone’s problem. This includes insurers, health care providers AND employers. Trying to have your organization function “normally” is simply a manager ignoring an important change in the business environment. Successful employers will be those who understand the problem and can build an organization where people living with Long COVID can succeed.