Returning to work after “Long COVID”

With Office of National Statistics (ONS) estimates of 1.3 million people amongst the UK population affected by “Long COVID”, the HSE published (December 2021) its analysis of the existing medical evidence, to provide guidance to employers.

Firstly, the HSE recognises the limited epidemiology specific to “Long COVID”, upon which to base its conclusions — noting that in over 2,500 studies it reviewed, just seven were considered to be directly relevant.

Secondly, it accepts the continued absence of a settled definition of “Long COVID”, adopting the definition set by the National Institute for Clinical Excellence (NICE), which compartmentalises “Long COVID” patients into two categories:

1. Those four to 12 weeks from diagnosis as having “Ongoing Symptomatic COVID” and
2. those with ongoing symptoms 12 weeks from diagnosis as having “Post COVID-19 Syndrome”.

It notes that the most common symptoms of either patient group are fatigue, cognitive dysfunction, including memory loss, change in taste and smell which are often accompanied by high rates of depression, anxiety and PTSD. As such, these preliminary findings, suggest “Long COVID” shares several characteristics with ME/Chronic Fatigue Syndrome — a condition where there is currently divided opinion on how best to manage rehabilitation.

The HSE’s current recommendation for employers dealing with “Long COVID” conditions is to follow the Faculty of Occupational Medicine Guidance which includes early contact to be made by the employer and the involvement of health professionals and other stakeholders.

Additionally, these Guidelines recommend the drawing of the individual tailored return to work plans including both phased return and flexibility over hours. It describes intervention in the first four to six weeks following diagnosis as “crucial” to any effective return to work.

With the HSE noting the sobering statistics that only half of employees manage to return to work once the absence has lasted three months and just 20% return to work where the absence has lasted over a year, early intervention will be of paramount importance for all employers given the prevalence of “Long COVID” amongst the working population.