Workers with ‘long Covid’ may need personalised and long-term support

Referral to physiotherapy may be helpful for musculoskeletal symptoms associated with “long Covid”. Image: Shutterstock

Employers wishing to minimise the impact of “long Covid” on both their employees and their organisation should ensure their health and wellbeing programmes include holistic and personalised support for staff for as long as they need it, argues Christine Husbands.

“Long Covid” is a condition currently affecting approximately 60,000 people in the UK – and which will inevitably continue to rise as we move through the pandemic – that is characterised by a variety of physiological and psychological issues. These can include fatigue, breathlessness, cognitive blunting (“brain fog”) and pain, and can require practical, medical and emotional support similar to that already offered by employers for conditions such as cancer, ME and diabetes.

This is, clearly, an emerging situation and one, as Occupational Health & Wellbeing has highlighted, that is likely to be challenging for employers in terms of providing support for those with this new relatively unknown condition and its long-term implications.

While the NHS has begun to step up support in this area, offering employer-backed practical help and emotional support for those diagnosed with the condition will nevertheless help to ensure that staff receive the most appropriate course of treatment, in turn helping to steer them back on the path to recovery.

Types of support

As well as the known physical ailments associated with long Covid, the National Institute for Health Research (NIHR) has raised concerns about the potentially huge psychological impact of the condition, which includes patients suffering from post-intensive-care syndrome and post-viral fatigue syndrome.

Therefore, support provided by employers needs to be holistic, combining practical advice to manage the varying physical symptoms, signposting to appropriate NHS medical care and services, and timely provision of relevant therapies as well as emotional support to deal with the psychological impact.

Some examples of specific external interventions are:

• Respiratory physiotherapy. This can include breathing exercises/techniques.
• Occupational therapy. This can include pacing to manage fatigue and help with memory problems.
• Complementary therapy. This can include therapies to aid sleep and reduce stress.
• Talking therapies. These can help with fear, anxiety and low mood and other psychological impacts.
• Physiotherapy. This can be valuable in the context of post-Covid musculoskeletal pain.

As the symptoms are variable and fluctuating, any care and support needs to be tailored to the employee’s specific needs at that particular time with the flexibility to adapt as necessary.

The need for emotional support cannot be underestimated, particularly in these times when social interaction is so limited. The ability to rely on close family, friends or work colleagues for support during times of ill health has been taken away from many people, leaving them to cope with their symptoms in isolation and in desperate need of human support.

Many employers already have relevant support in place. In the paper ‘Long Covid’: evidence, recommendations and priority research’, authored by doctors from Oxford University and Royal Berkshire Hospital, recommendations were made for a four-tier clinical service to be developed for long Covid patients.

These ranged from tier one support, which was mainly focused on resources and support for self-care, through to community-based interdisciplinary rehabilitation in tier two, and specialist management of specific conditions in tier four.

Layered approach to support

Many employers already have this layered approach to support in place for other conditions via health and wellbeing benefits, including protection insurance, group insurance or PMI, and so it may be that employers simply now need to communicate the availability of this added-value service to their staff.

It is important to recognise that, for an unfortunate few, long Covid is serious and potentially life-threatening. For most, even if not life-threatening it is still likely to be a long-term chronic condition that could prevent them returning to their working life or normal activities for some time.

If in doubt, employers should speak to their insurer, employee benefits consultant or adviser so get a better understanding of what, if any, support is already included within their current employee benefits packages. At a practical level, help, advice and support from occupational health practitioners can also of course be extremely valuable.

As a final important point, those employers that encourage their employees to access a long Covid support programme (whatever that looks like in practice) at the start of their illness and prior to a significant deterioration in their physical or mental health are likely to see a faster return to normal “modus operandi” than those who don’t take the impact of long Covid seriously.

References
“Could ‘long Covid’ become the biggest return-to-work challenge yet for OH?”, Occupational Health & Wellbeing, November 2020, https://www.personneltoday.com/?p=258799

“Living with COVID: NIHR publishes dynamic themed review into ‘ongoing COVID’”, National Institute for Health Research, October 2020, https://www.nihr.ac.uk/news/living-with-covid-nihr-publishes-dynamic-themed-review-into-ongoing-covid/25891

“‘Long Covid’: evidence, recommendations and priority research questions”, Professor Trisha Greenhalgh, Dr Emma Ladds, University of Oxford; Dr Matthew Knight, Watford General Hospital; and Dr Deepak Ravindran, Royal Berkshire Hospital; https://committees.parliament.uk/writtenevidence/12345/pdf/