‘They Have to Work to Make Ends Meet’: Long Covid Is Affecting the Workplace

"We talk a lot about the physical symptoms like respiratory issues, but there’s also a mental health impact."
(illustration: iStock)

Nadine, who requested her name be changed for privacy reasons, caught Covid in December 2021. At first, the communications professional experienced dizziness and breathlessness, but within three weeks her symptoms worsened. Nadine, 34, began to experience major fatigue, chest pain and a loss of sensation in her hands, feet and face. Standing became nearly impossible, so she started to rely on a chair for most activities—including showering and preparing meals. Her symptoms made focusing difficult and the numbness in her hands interfered with her ability to write, which was a significant part of her job. Fortunately, she had access to six paid weeks of medical leave through her employer and took the time off with their support. She hoped that six weeks would be enough time for her to recover. It wasn’t. 

Nadine is among the likely hundreds of thousands of Canadians affected by long Covid, a condition often defined as having symptoms lasting more than three months after acute infection. Post-Covid-19 condition, as the World Health Organization calls it, can be debilitating. It causes symptoms like brain fog, exhaustion, shortness of breath and depression, that range in severity. Because long Covid doesn’t follow a linear path—people often say they feel better one day only to feel worse the next—it can affect an employee’s ability to work at the level they did previously, or even prevent them from working entirely. Stats vary, but a study published in The Lancet found that 22 per cent of people with long Covid were unable to work due to ill health and another 45 per cent had to reduce their work hours. A Canadian survey by a long Covid support group found that nearly 70 per cent of affected workers had to go on leave, and more than half had to reduce their work hours.

While members of the NDP party are calling for a national long Covid strategy that includes interdisciplinary rehabilitation clinics across the country, there currently isn’t much in the way of financial support for businesses supporting team members with the condition. In September, Ontario’s top doctor said the province will make funding decisions for a long Covid response in the near future as health officials work to create standard definitions and treatment protocols. But with so many people impacted, and the long-term implications still somewhat unknown, workplace leaders across Canada are having to take matters into their own hands and find patchwork solutions to an ongoing problem.

The impact of long Covid in the workplace

Long Covid is not only having a material impact on employees, but on businesses, too. On top of the disruptions to worker availability and productivity caused by an initial Covid infection, ongoing illness is creating a more complex staffing challenge. Research from the Brookings Institution suggests that the condition may be contributing to the current labour shortage in the U.S. People out of the workforce because of long Covid disproportionately worked in service jobs, like health care, social care and retail, according to research published in JAMA Health Forum—industries that are grappling to retain workers right now.

With an estimated 200 possible symptoms, long Covid shows up in various ways in the workplace. It can lead to productivity issues, like presenteeism, absences and even disability claims. Some workers are reluctant to tell their employers about their illness out of fear that they will face stigma, as some colleagues might not believe the condition exists. It is so new, and comes with a wide-range of symptoms, there isn’t a single test to determine whether someone definitively has long Covid. This can pose problems when it comes to accessing the right supports and meeting the criteria for medical leave.

How workplaces can support employees with long Covid

Some experts say workplaces need to treat long Covid as they would any other health condition, as it can impact day-to-day functioning. Denise Lloyd, founder and CEO of Engaged HR, an HR management consultancy in Victoria, B.C., believes that taking a human-focused approach grounded in empathy is the right way to start conversations with workers in order to find effective solutions. “Are they being treated the same as someone who’s having cancer treatment?” says Lloyd. “You want to make sure that you’re following any precedent that’s been set in the organization and treat this individual with fairness and equity.”

In the U.K., advocacy group Long Covid Work started a website with resources to help both workers and workplaces find solutions to support affected team members. The advice is clear: Organizations should focus on flexibility, whenever possible, and consider policies that allow workers to switch shifts or work their own hours, for example. Being creative and adaptive with workload allocations and structures can be a game-changer for those coping with long Covid. Lloyd says bosses should discuss options with the employee in a way that doesn’t infringe on their medical privacy while offering support. “That communication should be very much about: What can they do? What can’t they do at work?” Lloyd says. “Solutions should be customized depending on the situation of the employee.”

Marie-Chantal Côté, the senior vice president of group benefits for Sun Life, says there’s a lot of focus on the physical symptoms of long Covid, like respiratory issues, but employers should also be aware of the mental health impact. Dealing with the long-term uncertainty of the ailment can lead to anxiety and/or depression, or worsen these mental health issues for people who already struggle with them. Côté encourages leaders to speak up and support team members by normalizing mental health conversations in the workplace. This can be done by promoting mental health supports in team newsletters, Slack channels and meetings. Actively sharing what resources are available at a workplace can help those who haven’t disclosed their struggle to learn what options are available. In cases where an employee has come forward with long Covid and needs more than just mental health support, an employer should connect them directly with the workplace’s benefits provider to access the right supports in their plan.

Once Nadine’s six weeks of paid leave ended, she was still very ill and knew she wouldn’t be able to return to full-time work. Her employer collaborated with her to create an accommodation plan that allowed her to keep working at a level that was realistic for her. A part-time contractor was hired to help support her role. Nadine’s workplace also allows her to work from home—something she is especially grateful for as it saves the energy she would expend on a commute to work. “Working from home gives me the ability to care for myself without people watching me,” she says, noting that just being able to lie down for a short period can make a difference. The privacy of working from home also allows her to use voice-to-text software to assist with writing when her hands are too numb for typing.

Lloyd recognizes that offering the ability to work from home can be an effective solution for some employees, but is not an option for all roles. In cases where employees need to be in person, she recommends exploring whether duties can be reallocated or adjusted to accommodate limitations. For workers who do not have such flexibility in their schedules, a leave of absence may be the best route, Lloyd says. Some workplaces will cover medical leave for a certain period of time, whereas others may require workers to take an unpaid break.

While government support is available, accessing it can be challenging. Workers can apply for Employment Insurance, or EI, benefits that can provide financial support for up to 15 weeks. Longer-term cases may be eligible for government disability benefits or workplace insurance coverage, but some employees with long Covid are reporting issues accessing these supports as the condition is often hard to “prove.” Many patients will have clear medical tests despite experiencing real symptoms, which can result in an insurer rejecting their disability claim. Not having a positive molecular test result to show an initial Covid infection can also cause issues for long-haulers applying for benefits; at different points of the pandemic, PCR tests were hard to access for many people so some patients may not have ever officially tested positive for Covid.

Lloyd acknowledges that managing team members with long Covid can be a hurdle for employers. “It can be hard to maintain a positive ‘we’ll do whatever you need’ approach because you start to see the work is not getting done, costs start to creep up a bit and it’s not as productive,” she says. Despite this frustration, employers should ensure they are treating staff equitably. This can help retain employees and lead to more productive solutions.

Receiving support from her workplace has made a difference for Nadine as she continues to work through her symptoms. She faces daily challenges but being able to keep her job helps financially—it’s one less stressor. “So many people are trying to work through symptoms because they have no other choice,” Nadine says. “They have to work to make ends meet.”