‘Long Covid’ – with symptoms of brain fog, fatigue and shortness of breath lasting for six months or more – is set to become the biggest health challenge facing business and the healthcare system beyond the Covid-19 pandemic, says Prof Renata Schoeman, head of the Health Care Leadership MBA programme at the University of Stellenbosch Business School.<\/p>\n
Schoeman said the likely long-term impact of Long Covid on productivity and employee retention will require employers to be flexible and adaptable to accommodate employees on the long road to recovery.<\/p>\n
Since the global spread of Covid-19 from early 2020, there is an emerging body of evidence from many countries of a growing number of people who experience prolonged symptoms beyond the initial, acute stage of the disease.<\/p>\n
\u201cIndividual studies indicate that between 10% and 30% of patients who recover from acute Covid-19 become \u2018long-haulers\u2019, still experiencing symptoms six months later.<\/p>\n
“In one study of 3,762 patients who had confirmed or suspected Covid-19, most of whom had symptoms lasting longer than 90 days, 45% needed a reduced work schedule compared to before they became ill and 22% were not working due to their health conditions.<\/p>\n
\u201cThis illustrates the scale of the likely impact on employers, employees, and the healthcare system that will need to accommodate these patients,\u201d Schoeman said.<\/p>\n
Although definitions and diagnostic criteria have not yet been settled, Long Covid is generally seen as symptoms that last for more than 28 days after initial infection or diagnosis of Covid-19.<\/p>\n
It affects multiple bodily systems, with cognitive dysfunction (brain fog), fatigue and post-exertional malaise (a relapse or flare-up of symptoms after physical or mental effort) being the most common lasting symptoms, still experienced six months after infection.<\/p>\n
Brain fog is an umbrella term referring to symptoms such as memory loss, confusion, muddled thinking, poor concentration, and generally feeling mentally sluggish, and up to 25% of people infected with Covid-19 experience this and other neurological symptoms.<\/p>\n
Long-term impact on businesses<\/strong><\/p>\n “Organisations are facing a potential increase in employees needing workplace accommodations for ill health or disability, on long-term sick leave or even medically incapacitated and no longer able to perform their current job,” said Schoeman.<\/p>\n “Employers need to be reviewing their occupational health services, employee assistance and wellness programmes, policies on sick leave and reasonable accommodation, post-illness return-to-work plans, and ensure they are not discriminating on grounds of mental health or disability.”<\/p>\n She said the timeline for when maximum improvement of the condition can be expected remains to be determined.<\/p>\n \u201cThe implications are far-reaching, and the likes of healthcare funders and income-protection insurers need to be reviewing their policies and guidelines on treatment and disability.<\/p>\n “The medical profession and policy-makers need to arrive at objective diagnostic and assessment criteria, and guidelines for best practice in evidence-based treatment and management of Long Covid.\u201d<\/p>\n Sick leave<\/strong><\/p>\n Schoeman said developing objective criteria for a diagnosis of Long Covid is important since many of its key aspects such as brain fog and fatigue are largely \u201cinvisible\u201d, and employers would need to guard against abuse of sick leave, flexible work arrangements and workplace accommodations.<\/p>\n Similar to acute Covid-19 disease, the symptoms of Long Covid are diverse and vary between individuals, and also change over time.<\/p>\n Schoeman said that where Long Covid persisted for more than a month, during which the person may need to take sick leave, by the second month the employer would need to be looking at reasonable accommodation and\/or reduced responsibilities.<\/p>\n Beyond two months, she said it was likely that assessment and treatment by a multi-disciplinary team would be the correct approach, involving the general practitioner along with professionals in areas such as psychiatry, neuropsychology and occupational therapy.<\/p>\n “For anyone experiencing symptoms of brain fog, Prof Schoeman recommends tried-and-tested self-care and good mental hygiene \u2013 getting enough sleep, regular exercise (gradually phased-in if experiencing fatigue and post-exertion relapse), eating healthily and taking time out from digital devices.”<\/p>\n
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