Unemployment: A side effect of long COVID

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A study from The Ohio State University analyzed the impact that long COVID has on employment and overall well-being, offering a glimpse into the struggles faced by those navigating the chronic condition, in which symptoms following COVID-19 infection persist for at least three months. Although past research has established a connection between long COVID and higher rates of unemployment, this new study provides an increasingly nuanced understanding of the personal and financial toll experienced by those affected by the condition.

The research, published in the Journal of General Internal Medicine, is based on interviews conducted in 2022 with 21 patients who were receiving care at the post-COVID recovery clinic at Ohio State’s Wexner Medical Center. The study’s participants, aged 19 to 68, had all experienced lingering COVID-19 symptoms for at least three months following their initial infection. Most of them had been first infected with the SARS-CoV-2 virus in 2020 and three-fourths of them were women.

“For many individuals we talked to, their lives have been completely changed because of this chronic condition,” said Sarah MacEwan, the study’s lead author and an assistant professor of general internal medicine at Ohio State’s College of Medicine. “That’s really changed how they see themselves, how they experience life, how they interact with their families, how they provide for their families. In some cases, incredible financial instability has upended their lives. They’re facing extremely difficult choices and also trying to take care of themselves. It’s so important that we hear from them so we can improve the ways we can support them.”

Participants reported several debilitating symptoms, including brain fog, fatigue, weakness and headaches, which often interfered with work responsibilities, disrupting the balance between their professional and personal lives. “Some quit their jobs because they just couldn’t handle working anymore. Some reduced their hours. And then some were involuntarily terminated from their jobs because of their symptoms,” MacEwan explained.

The financial consequences of these employment disruptions were significant. Many participants reported lost income for a variety of related reasons, and that lost income often coincided with increased medical expenses and changes in insurance coverage, resulting in significant financial instability. Some participants reported that transitioning to lower-paying jobs or losing employer-sponsored insurance forced them to pay more for less comprehensive coverage at a time when they needed more medical care than ever.

The emotional toll of long COVID was equally substantial, as participants described feelings of loss of identity tied to their professional and personal roles. They also expressed fear of stigma and judgement at work and in their social circles, which emphasized their emotional distress. In certain cases, this extended to interactions with health care providers.

“One thing we’ve uncovered through this work is people not being believed by their providers about their symptoms or being brushed off or pushed into other diagnoses that they feel don’t reflect their experience,” MacEwan said. “It’s a real question of whether they are getting what they need from the providers they’re able to reach where they are.”

The study highlighted how patients have adapted to their new reality, with many of them developing coping strategies to manage daily tasks, taking frequent breaks, minimizing possible distractions, creating task lists and using visual prompts on whiteboards or talking themselves through tasks. Some participants were encouraged by health care providers to seek short- or long-term disability benefits or possible workplace accommodations like remote or hybrid work, although they reported that initial support from employers eventually waned.

Long COVID is recognized as a potential disability under federal law, offering some employment protections. However, the authors of the study emphasized the need for a more holistic approach to care. MacEwan suggested that clinicians could play a key role in supporting patients by connecting them to financial resources, expediting workplace accommodation requests and addressing mental health concerns.

“It’s important that we use lived experience to understand the needs of the population and not make assumptions. There are a lot of good ideas already out there, and people with other chronic conditions have solutions for some of these problems,” MacEwan explained. “So, maybe we don’t need to reinvent the wheel, but we certainly need to identify the needs and take steps to fill those gaps.”