In early March, when cases of coronavirus began their sharp ascent in the UK, it was those people so sick they were hospitalised, and those who sadly lost their lives, who made headlines. But in April, a growing number who had suffered only ‘mild’ symptoms at first just did not seem to be getting better. In fact, some began to feel worse.
Many were not ill enough to be admitted into already stretched hospitals and therefore were not tested for the virus. Some were lucky enough to have sympathetic GPs who had seen post-viral illnesses before. Others were not believed, and some were told they had anxiety. The GPs themselves had never seen this disease and no clear treatment paths lay ahead. Seven months on, with tens of thousands of individuals globally seeking support from fellow sufferers on Facebook, and research and articles in the media starting to appear, ‘long Covid’ is emerging as a growing problem – and something that will impact many workplaces.
On 8 March I woke up with a cough, sore throat and earache. I didn’t think it was coronavirus at first as I didn’t have a fever but I self-isolated just in case. I felt so ill I couldn’t have tried to leave the house even if I’d wanted. After two weeks I returned to work. I managed half a day before developing a fever and my symptoms returned with added breathlessness. I spent each day lying in bed or on the sofa, thankful that I was still able to get online food deliveries. At week five I called 111 as I was really struggling to breathe, but by then it was in the height of the first wave and when a doctor called me back five hours after my initial call he told me I was better off at home. I left my front door unlocked just in case I didn’t wake up.
At week nine, my symptoms worsened and I was struggling to speak without gasping for air. Despite having spoken with my GP each fortnight, mostly just to be signed off work, this was the first time I was told to go to a testing centre. After testing my oxygen saturation levels and heart rate they sent me to A&E. At week nine, unsurprisingly I did not test positive for Covid-19. This was the first of four visits to A&E over the next few months. I was never admitted to hospital. Each time I had multiple tests that all came back normal except for the blood test that showed inflammation in my body.
I also developed tonsillitis, a nasty infection that took two months of antibiotics and steroids to reduce, and a racing heart (tachycardia). The worst A&E visit involved a 999 call following my arms going dead and shooting pains in my nerves, as well as breathing difficulties and a resting heart rate varying between 60 and 180 beats per minute. Two antibody tests both came back negative.
I returned to work after five and a half months off. By this stage I knew I was not going to recover quickly but I needed work for my mental health, which inevitably was suffering. I needed to feel structure and a sense of achievement. I also needed to be paid. At an occupational health appointment they advised slowly increasing my hours over eight weeks. But the challenge I found starting on two hours a day was my illness did not abate at the speed my hours increased. Unfortunately, once I had got up to five hours, I had a return of symptoms and since then have remained on four hours a day. I may need some time off again to fully rest.
This has a number of implications: financial, social and psychological. As much as I enjoy work, I also work to get paid. And it is hard to feel a sense of achievement when the brain fog prevents you from thinking clearly and you are so exhausted you have to sleep as soon as you finish work.
So what can employers do to support employees suffering from long Covid? First, they must be very clear about their sickness absence policy, occupational health support (if available) and policies around reasonable adjustments and return to work. As I have discovered, there is a lot of admin when you are ill. I have had numerous appointments with ear, nose and throat specialists, a cardiologist, a counsellor and my GP, and I’m waiting to see a chronic fatigue consultant. All of these involve phone calls, forms and planning, which when you feel unwell takes a lot of time and energy.
If the policies and procedures at work also involve a lot of searching and questions, this can zap a significant amount of energy that could have been used for work. I encourage line managers and HR to have support ready to signpost employees to. If no support is available internally, signposting staff to external routes may also be helpful and will demonstrate that you care.
The challenge with long Covid is no one really knows how long symptoms will last – there is simply no precedent. Some people get better quickly, others take many months. Some may not get better. This uncertainty may be challenging for organisations to support in the long term, but the key is not to jump to conclusions and have an open dialogue with the employee, with input from their GP. Be kind and prompt with information, whatever that information might be.
Little did I suspect in March that more than seven months on I would still be unwell. The illness has undulated over the months with occasional but brief respites where I thought I was getting better, only for it to return with a new and random symptom. I had headaches, fatigue, tonsil stones, gastric problems, nerve pains, chilblains, post-exertional malaise and weird sensations in my heart. Now I am left with fatigue (at times debilitating), a swollen larynx (voice box), hoarse voice and tachycardia.
Long Covid was an unknown term back in March, but research suggests one in 10 may have symptoms three months after having the virus. Many of those with long Covid are of working age, and as we progress through the second wave of the virus the numbers will inevitably increase. This will have life-changing implications for employees – and employers need to be prepared.
Dr Judith Grant is director of health and wellbeing at Mace