There’s a new breed of worker among us: those who have survived Covid-19.
Because many of them struggle physically and mentally long after the infection is gone, businesses must be prepared to navigate issues related to these so-called long-haulers of the disease, experts say.
Symptoms of long-haul Covid-19 — also known as long Covid or post-acute sequelae of SARS-CoV-2 (PASC) — can include fatigue, sleep disorders, shortness of breath, brain fog, fevers, gastrointestinal symptoms, anxiety and depression. They can persist for months or perhaps indefinitely and can be mild or incapacitating. There’s no clear definition of post-acute Covid, and it can be tricky to diagnose.
A study this year looked at self-reported data from 4,182 people in the U.K. who had Covid-19. Of them, 13.3 percent reported symptoms lasting more than 28 days, with 2.3 percent reporting symptoms of 12 weeks or longer.
British government data found that one in seven had symptoms after 12 weeks, of about 1.1 million who reported experiencing long Covid. Smaller-scale U.S. research tracking 234 Covid-19 survivors for up to nine months since having the virus found about 30 percent reported persistent symptoms.
A U.K.-based immunologist said at the end of last year that he thinks that “way more” than 5 million people globally may have long Covid, Scientific American reported.
Alison Sbrana, a Colorado-based board member of the Covid-19 support group Body Politic, was disabled by a viral infection seven years ago. Currently, she helps coronavirus survivors navigate workplace benefits.
“It’s really important to recognize that while Covid-19 is a novel disease, the disability following infection and the many barriers long-Covid patients face are not new,” Sbrana said.
The pandemic has put a spotlight on inequalities, Sbrana notes, and long Covid is yet another example of how workplaces and disability benefit systems aren’t accommodating people with chronic illnesses and disabilities.
Review benefit plans and HR policies
John Anderson, chief medical officer for Texas-based employee healthcare provider Concentra, said that health and worker’s compensation plans generally cover long Covid symptoms.
“This should include physical rehabilitation as well as emotional health support, but plan benefits vary widely and employers should be prepared to have those discussions when PASC is suspected or identified,” he said.
He advises companies to review their benefit plans and human-resources policies to ensure that they address long Covid patients appropriately.
“I think most employees who have had a difficult time with the coronavirus and are experiencing some level of post-acute symptoms are still very anxious to get back to work and want to work with their employer to do that,” Anderson said.
Such employees may need a prolonged leave of absence, and returning to work may require certain job accommodations, such as flexible hours, more breaks or remote work, he added.
“The employer should be prepared to have those discussions,” he noted.
Legalities of long-haulers
Every organization should have a plan of action to manage long-haulers or risk HR-related legal concerns, said David Reischer, an employment lawyer and chief executive officer of LegalAdvice.com.
Specifically, the Americans With Disabilities Act (ADA) and the Family Medical Leave Act (FMLA) may have relevance to Covid long-haulers, experts say.
It defines a person with a disability as someone with “a physical or mental impairment that substantially limits one or more major life activities; has a record of such an impairment; or is regarded as having such an impairment.”
The law does not identify an exhaustive list of medical conditions that are considered disabilities, so assessments are be made on a case-by-case basis, according to experts.
In addition, the U.S. Equal Employment Opportunity Commission does not specifically address whether long-term symptoms from Covid-19 are a disability under the ADA, notes Melissa Silver, an HR lawyer and legal editor at XpertHR.
Temporary, nonchronic impairments that have little or no long-term impact — think broken bones, appendicitis, the common cold or pneumonia — are generally not considered disabilities by the ADA, Silver said. Long Covid would generally be considered a temporary condition, she said.
“However, these conditions can possibly qualify for disability protection if the residual impact of the temporary impairment — even with mitigating measures — would result in the substantial limitation of a major life activity,” she said, citing functions like eating, breathing and sleeping.
When such limitations exist, the company can provide reasonable accommodations, such as offering a more flexible schedule or letting the employee work from home, experts say.
Over time, a disability status can be re-evaluated as someone who may have long-haul symptoms now may not in a year, so the reasonable accommodations would then be lifted, Reischer explains.
Still, organizations must be careful not to conclusively classify a condition as temporary before the employee has provided proper medical documentation, Silver says. Companies may have overlapping obligations under other laws such as the FMLA and applicable state laws.
‘Significant protection under the ADA’
Andrew Lacy, a Pennsylvania-based employment lawyer, states more directly than Reischer or Silver that long-haulers may be considered disabled under the ADA and entitled to reasonable accommodations.
Companies may want to adjust their HR policies to mandate doctor’s notes — something the law allows employers to do in order to confirm a true medical need, Lacy says.
“This means that [companies] should be prepared to offer reasonable accommodations to those employees [who provide documentation of illness]. Failure to do so will result in potential legal liability,” he said.
Reasonable accommodations should be granted to avoid discrimination or uneven treatment in business decisions, he adds.
“Long-haulers will enjoy significant protection under the ADA, and employees must prepare for this reality,” Lacy said.
There might be an increase in accommodation requests so businesses should train their HR team to identify what is reasonable, he notes.
“If the company can afford added flexibility with respect to work schedules, this should be allowed,” Lacy said. “Courts are increasingly finding that flexible work schedules are a reasonable accommodation.”
“The impact of Covid-19 is a real concern for businesses,” Lacy added. “There should be uniform policies in place so that additional claims of discrimination are not invited. … The uneven application could lead to some employees suing for race, age or gender discrimination.”
As for the FMLA, it may grant employees up to 12 weeks of unpaid leave with job protection and continued health insurance coverage.
“This includes complications that might arise from a ‘serious health condition’ as defined by the FMLA,” LegalAdvice’s Reischer said.
Much is left to employer discretion, so if a company agrees an employee has such a condition, they may qualify for FMLA benefits, he says.
In addition to those laws, employers should be careful about how they handle evaluating employee health, he noted.
“Employers should be aware of conducting health inquiries or examinations that constitute prohibited medical examinations,” Reischer said.
While it’s clear that the law supports some accommodations for long-haulers, there’s still much that remains undefined, says Misty Guinn, director of customer advocacy at the South-Carolina-based benefits platform Benefitfocus.
It’s still too early to predict how long-haulers will begin to impact healthcare costs, workplace policies and compliance requirements for employers, she says.
“The bottom line is that planning at this stage is premature,” Guinn added. “Ultimately, we do not have enough data and evidence needed to inform business strategies on how to best handle long-term Covid-19-related cases.”