A study in PLOS One in June 2024 explores the “ongoing workforce issues” caused by a “significant incidence of Long COVID” in the population. Researchers at the University of Birmingham and Keele University found that people with Long COVID symptoms lasting longer than 28 weeks, which is over the maximum period of statutory employment protection in the UK, are more likely to leave employment. They suggest that the extension of Statutory Sickness Pay and “greater flexibility” to manage partial (returns to) work would “help preserve employment and mental health”.
Long COVID and employment
Long COVID is a “long-term debilitating illness” that follows infection with the SARS-CoV-2 virus. Symptoms are “multidimensional” and can include chronic or episodic physical, cognitive, or mental illness. This causes “significant limitations on daily activities”. An estimated 65 million people worldwide have experienced Long COVID, with those between the ages of 45 and 54 at greatest risk. The authors state that the “higher prevalence” of Long COVID in working-age people and the “withdrawal of public vaccination programmes” for people under 65 years in the UK mean that Long COVID is “set to have a significant and lasting impact” on health, employment, and earnings.
Three “contrasting, although not mutually exclusive” effects on employment outcomes are identified:
- Leaving the labour market, either on a permanent or temporary basis until health may recover
- Reducing hours worker in order to accommodate health problems, including sickness absence
- Continuing in existing work arrangements, with possible consequences for health and wellbeing
Although there are “large numbers” of the population reporting Long COVID and a “sharp rise in economic inactivity” has been observed, there is little evidence on the potential workforce consequences. Therefore, the authors sought to address the knowledge gap and provide evidence on the effects of Long COVID on workers with data from the UK.
The study
The researchers used a large national longitudinal survey of people 16 years and older and multi-variate panel regression modelling to estimate how the development of Long COVID has changed employment and in-work experiences. They found that having short COVID (symptoms <5 weeks) or Long COVID 5-28 weeks, the duration covered by Statutory Sickness Pay under employment protection law, increases odds of not working while still being in employment. For people with Long COVID beyond the maximum period of employment protection in the UK, there was not a relationship with working zero hours. The effect of Long COVID on working hours appears to be due to workers not working at all, rather than working reduced hours. Previous research shows that working fewer hours can help accommodate a work-limiting disability, so the authors infer a “lack of accommodation by employers of Long COVID at work”.
The paper also considers the in-work experiences of those with Long COVID, finding “large negative effects” on workers’ general mental health and happiness for the Long COVID group with symptoms lasting 29+ weeks. Findings for the group with symptoms lasting between 5 and 28 weeks are “more mixed”, which implies that “negative impact on mental health is mediated by earnings and the possible job characteristics associated with high/lower incomes”.
Policy implications
For the UK, the researchers suggest that the extension of Statutory Sickness Pay and greater flexibility would “help to stem the flow out of employment of those with Long COVID”. Financial support for employers would also help “preserve employment”. Dr Darja Reuschke, Associate Professor at the City-Region Economic Development Institute, University of Birmingham, recognised that “Long COVID is still a fairly new illness for society to deal with”. However, it is one that “does not seem to be going away any time soon”.
“By the end of March 2024, there were an estimated 2 million people in England and Scotland experiencing Long COVID symptoms. This undoubtedly will have an impact on the working population, particularly for those whose symptoms continue past statutory sick pay.”
Dr Reuschke suggests that extending sick pay and “giving people greater flexibility to manage phase returns to work” would mitigate the risk of losing workers.
“Financial support for employers to maintain employment until recovery from Long COVID would help to preserve employment and tackle the rising level of inactivity in the UK, something the new Labour government has said it is keen to realise.”
Professor of Regional Economic Development Donald Houston states that the study “shows that those with Long COVID who can work, want and do continue to work”.
“Working zero hours is associated with people who fall within the statutory sick pay/leave limits, and then after that people go back to work if they can, or leave work either through resignation or redundancy.”
Professor of Regional Economic Development and Policy at Keele University, Paul Sissons, commented on the “significant impact” of Long COVID on individuals’ employment outcomes.
“The research highlights important gaps in the sickness benefits system, but also points to the importance of the role of employers in supporting the management of long-term conditions in the workplace. Our analysis suggests that Long COVID poses a twin challenge to employers of providing adaptations and flexibility to help employees manage the physical symptoms, as well as better supporting mental health and wellbeing.”
To explore “outstanding questions” around Long COVID, why not join us at the Congress in Barcelona this October for a panel with global health experts? Don’t forget to subscribe to our weekly newsletters here.
