By Colin Hawes, Head of Claims , Generali UK Employee Benefits
The Coronavirus pandemic currently sweeping the globe may in fact constitute a second and more long term illness to follow in its wake, according to recent research. Long Covid is a term being increasingly used to describe illness in people who have recovered from Covid-19 but are still reporting lasting effects of the infection; which present similarly to Post-Viral Fatigue Syndrome (PVFS). Here, we examine the symptoms, impact and what you as an employer can do to help your people.
Viral infections have previously been linked with long term health implications, so this phenomenon is not a new one. After the SARS outbreak of 2002 a study in Canada found some of those who had been infected were still suffering fatigue, muscle weakness and sleep issues up to three years later and had not been able to return to work for an average of 19-months after their initial infection.1
Increasing medical evidence and patient testimony is suggesting that a small but significant minority of people who contract Covid-19 are not free of the effects of the virus months after their initial illness.
Researchers in Italy found that 87% of patients discharged from a Rome hospital after a Covid-19 infection were still experiencing at least one symptom 60 days later, with two fifths of patients reporting a worsened quality of life.2
Meanwhile in the UK, the Covid-19 Symptom Study app, which has collected information from nearly four million users, shows that one in ten people with Covid-19 are unwell for three weeks or more.3 A third of doctors have treated patients with long term Covid-19 symptoms including chronic fatigue, a survey by the British Medical Association (BMA) found.4
What is Long Covid?
The main symptom of any Post-Viral Fatigue is a significant lack of energy that is not improved with sleep. This can often be accompanied by other symptoms which can vary to allow an individual to one day feel better and manage some routine activities, only to then be incapacitated by overwhelming symptoms on a subsequent day.
More specifically, the limited evidence to-date around Long Covid suggests it can present with clusters of symptoms which can fluctuate with time and impact a wide variety of body systems.
According to NHS England these symptoms can include, but are not limited to, breathing difficulties, persistent tiredness, impaired muscle function, generalised pain, headaches, gastrointestinal issues, ongoing fever, mental health implications such as post-traumatic stress disorder, anxiety and depression, and a generally reduced capacity to perform everyday tasks.
Who is at risk?
Evidence shows that those at an older age, male and with underlying health conditions appear to be at a higher risk of severe ill health from a Covid-19 infection. However, results from recent research at King’s College London now seem to suggest that while Long Covid can affect anyone, some factors do also seem to raise the risks.3
The number of symptoms which present during the initial Covid-19 infection appears relevant, with five or more different symptoms in the first week showing as a key risk factor for going on to develop Long Covid. This research has also shown that being female is a risk factor, as is having a higher BMI or being an asthma sufferer. Risks are also increased for those in the over 50 age group.
Life and work impact
General guidance from research so far suggests a slow return to normal activity after a Covid-19 infection, as too much too soon can be a significant risk factor for longer term physical and mental health implications.
More specifically, the advice to-date states that people should only very gradually try to increase any physical activity back to levels prior to a Covid-19 infection, whilst carefully monitoring their bodily responses to this along the way.
In line with this advice, a phased return to work duties is recommended, to avoid feelings of being physically or mentally overwhelmed.
What can employers do to support employees?
0 – 6 weeks
- Existing wellbeing support services: Take a look at what services are already at your disposal, particularly any embedded services within your group income protection policy such as an Employee Assistance Programme, second medical opinion services – include mental health second medical opinions – perhaps eldercare support services for those juggling the demands of work and caring responsibilities. But most importantly stay in regular contact.
- NHS Your Covid Recovery: An online resource for families, friends and carers impacted by Covid-19, with information on everything from what to expect from a stay in hospital to ongoing self-care and where to go to access further advice and support (NHS mental health helplines and charity services): https://www.yourcovidrecovery.nhs.uk/your-wellbeing/family-friends-and-carers/
6 – 8 weeks
- If the employee is absent from work, now is the time to consider notifying your group income protection insurer. Your provider will help you access specialist rehabilitation programmes to help support your employee. Generali UK works with Vitality360, whose specialist clinicians will help employees anchor and stabilise their symptoms. They will explore the factors that individuals can control and create step-by-step support plans.
- Where employees don’t have income protection cover, speak to your insurer about the possibility of self-funding rehabilitation directly with their wellbeing partners. Or signpost to local NHS Covid-19 clinics: https://www.nhs.uk/conditions/coronavirus-covid-19/social-distancing/using-the-nhs-and-other-health-services/
Sources:
1 NCBI, SARS – Lessons from Toronto, https://www.ncbi.nlm.nih.gov/books/NBK92467/
2 Against COVID-19 Post-Acute Care Study Group, Persistent symptoms in patients after acute covid-19 https://jamanetwork.com/journals/jama/fullarticle/2768351/
3 Covid symptom Study, How long does Covid last? https://covid.joinzoe.com/post/covid-long-term
4 British Medical Journal, Covid 19: What do we know about “long covid”? https://www.bmj.com/content/370/bmj.m2815