Long Covid: what employers need to know

With thousands of people still unwell months after contracting coronavirus, how can organisations support employees suffering from the condition? People Management asked the experts

The immediate effects of Covid-19 on employers and employees cannot be underestimated, with the mounting death toll set against a backdrop of major job losses and a fundamental shift away from traditional working patterns to remote working.

But several months on from the onset of the outbreak, so much is still unknown about the long-term impact of coronavirus. A significant number of people who have had Covid-19 are simply not getting better, with 60,000 people in the UK thought to be experiencing so-called ‘long Covid’ – where they have symptoms and other side effects long after first contracting the virus – according to NHS England. The Royal College of General Practitioners also reports that this figure may be an underestimate.

The spectre of long Covid, which can render people unable to work for months, is posing a major long-term challenge for employers and employees alike, and has prompted the NHS to spend £10m on creating a network of long Covid clinics.

So what do we know so far about the condition, and how should employers be preparing? People Management speaks to HR experts, wellbeing specialists and employment lawyers to get their answers to key questions about long Covid and the workplace.

What is it and how can it affect employees?

In simple terms, long Covid is where people suffer from poor health for a long period of time after getting the virus. It affects people in myriad ways and symptoms can vary from breathlessness and heart problems to joint and muscle pain, neurological problems such as lack of concentration, fever, exhaustion and mental health issues.

“These symptoms are physical and emotional. There is little empirical data at this stage but, whereas usual recovery is within two weeks, long Covid cases are reported for months,” says Dr Karen Michell, researcher at the Institution of Occupational Safety and Health.

Karen Matthews, a member of the LongCovidSOS campaign group, says: “It can affect employees in different ways. Some people are unable to work with their symptoms and have mobility issues. Some are on reduced hours or have agreed with their workplaces to have phased returns.” And while some people are able to go back to work full time, “in the worst-case scenario sufferers are now losing their jobs as they have used up their statutory sick leave period”, she adds.

Steve Herbert, head of benefits strategy at Howden Employee Benefits & Wellbeing, echoes the complexity of the condition, and warns employers they should not assume they will be unaffected. “A key point here is that such post-viral conditions can happen regardless of age or underlying health conditions, so potentially this could be a problem for a far larger section of the working population than those who are threatened by the mortality risk of Covid-19 alone,” he says.

Is it recognised as a medical condition?

The short answer is yes, but the formal process is still ongoing. “The concept that Covid-19 infection can lead to longer-term issues and the term ‘long Covid’ have certainly been embraced by the medical profession, and the concept is already turning up in the scientific literature,” says Dr John Briffa, a health and wellness expert.

However, there isn’t yet a diagnostic code for long Covid, notes Matthew Holder, interim head of policy and engagement at the British Safety Council, which is already causing problems for some employees. “We know anecdotally that employees are struggling to get the support from their companies because they are treating it like any other illness and deploying a procedural approach,” he says.

“In some cases we have heard of employers putting long Covid down as ‘fatigue’ or ‘depression’ simply because there aren’t any other boxes in the HR system to put the symptoms in.” 

In a review of evidence around long Covid, released last month by the National Institute for Health and Care Excellence – the government body responsible for creating clinical guidelines – acknowledges a working diagnosis of the condition will “facilitate access to much-needed support” for people with long Covid. But a lack of consensus on a diagnostic criteria was a “major obstacle”.

“While it is too early to give a precise definition, guidance on reaching a working diagnosis and a code for clinical datasets is needed,” the review says.

How can businesses manage workers with long Covid when the symptoms are so varied?

Mike Blake, director of health and benefits at Willis Towers Watson, says the complexity of long Covid, which presents in a number of ways, is a challenge for employers. As such, businesses should ensure they invest in health assessments and consider a range of support. “You have to judge the employee by the extent to which they are affected by this medical condition rather than just saying it's a medical condition and we need to treat it in this way,” he says.

And Paul Holcroft, managing director of Croner, stresses that long Covid should be dealt with in the same way as any other medical condition. “The important thing is not to have a blanket approach to employees who are confirmed to have long Covid, which means discussing with each employee to identify how it affects them and deciding on the support that is needed to ensure the employee can continue working well.”

Michell agrees with the need to deal with employees on a case-by-case basis. “It is not going to be possible or effective to lump all post-Covid patients into one ‘box’ and say ‘this is what we do’,” she says.

As well as managing absences, Lauren Harkin, partner at Royds Withy King, says employers will also need to address issues with employees who try to continue working with long Covid but are unable to perform at their normal level because of the symptoms. Organisations will need to be “as sympathetic as possible, and accommodate temporary adjustments to working practices such as reduced hours”, she says.

Occupational health advice is key to understanding where adjustments at work can be made. Getting this advice is the first thing an employer should do if they are “concerned that an employee may have a condition that could be classified as a disability”, says Rhian Radia, partner at Bishop & Sewell.

Holder adds it is important that employees are allowed to take their time returning to work. “Have open conversations and don’t put too much pressure for an employee to return too early or get back to 'normal' hours too quickly,” he says.

Is it likely to be classed as a disability?

Long Covid is unlikely to be classed as a disability under the Equality Act, says Harkin. “This is because of the Equality Act’s definition that a disability has to have a ‘long term’ negative effect on a person’s ability to carry out day-to-day activities. ‘Long term’ means 12 months or longer.”

Radia agrees that it is too soon for long Covid to be treated as a disability: “An employee would need to show that the condition has or is likely to affect them for at least a year. Covid has not been with us long enough to provide a definitive answer.”

Long Covid could become similar to chronic fatigue syndrome and ME, says Briffa, in that it won’t automatically be viewed as a disability, but could be if the symptoms have a significant impact on daily life and overall functioning of the individual.

However, says Michell: “Over time it will be recognised that workers have been left with such severe sequelae that they will be left with disability.”

What happens if employers fail to acknowledge or support an employee suffering from long Covid?

Failing to acknowledge or support an employee with long-Covid symptoms could leave an employer on the wrong side of an employment tribunal decision, warns Blake. Companies need to invest in medical evidence and ways of supporting staff with long-term health problems, as well as becoming more involved in promoting healthy lifestyles, he says.

There are also other considerations employers should make. “Employees on long-term sick leave can become more difficult to bring back to work, especially if they feel they have not been supported by the employer,” warns Holcroft. “Disengagement can be a real problem with long-term sick leave, which makes it more likely that the employee will begin to question their future in their job.”

Herbert adds that colleagues of an ill employee will also look to their employer for appropriate support and understanding. “A failure to do so might damage wider workforce relations, which in turn can harm employee engagement and productivity,” he warns.