Associations between SARS-CoV-2 infection and subsequent economic inactivity and employment status: pooled analyses of five linked longitudinal surveys
Authors: Shaw Richard J , Rhead Rebecca , Silverwood Richard J , Wels Jacques , Zhu Jingmin , Hamilton Olivia KL , Gessa Giorgio Di , Bowyer Ruth CE , Moltrecht Bettina , Green Michael J , Demou Evangelia , Pattaro Serena , Zaninotto Paola , Boyd Andy , Greaves Felix , Chaturvedi Nish , Ploubidis George B. , Katikireddi Srinivasa Vittal 
Published: August 2023

Introduction

Following the acute phase of the COVID-19 pandemic, record numbers of people became economically inactive (i.e., neither working nor looking for work), or non-employed (including unemployed job seekers and economically inactive people). A possible explanation is people leaving the workforce after contracting COVID-19. We investigated whether testing positive for SARS-CoV-2 is related to subsequent economic inactivity and non-employment, among people employed pre-pandemic.

Methods

The data came from five UK longitudinal population studies held by both the UK Longitudinal Linkage Collaboration (UK LLC; primary analyses) and the UK Data Service (UKDS; secondary analyses). We pooled data from five long established studies (1970 British Cohort Study, English Longitudinal Study of Ageing, 1958 National Child Development Study, Next Steps, and Understanding Society). The study population were aged 25-65 years between March 2020 to March 2021 and employed pre-pandemic. Outcomes were economic inactivity and non-employment measured at the time of the last follow-up survey (November 2020 to March 2021, depending on study). For the UK LLC sample (n=8,174), COVID-19 infection was indicated by a positive SARS-CoV-2 test in NHS England records. For the UKDS sample we used self-reported measures of COVID-19 infection (n=13,881). Logistic regression models estimated odds ratios (ORs) with 95% confidence intervals (95%CIs) adjusting for potential confounders including sociodemographic variables, pre-pandemic health and occupational class.

Rebsults

Testing positive for SARS-CoV-2 was very weakly associated with economic inactivity (OR 1.08 95%CI 0.68-1.73) and non-employment status (OR 1.09. 95%CI 0.77-1.55) in the primary analyses. In secondary analyses, self-reported test-confirmed COVID-19 was not associated with either economic inactivity (OR 1.01 95%CI 0.70-1.44) or non-employment status (OR 1.03 95%CI 0.79-1.35).

Conclusions

Among people employed pre-pandemic, testing positive for SARS-CoV-2 was either weakly or not associated with increased economic inactivity or non-employment. Research on the recent increases in economic inactivity should focus on other potential causes.

Key messages

What is already known on this topic

Economic inactivity has increased following the pandemic.

Infection with SARS-CoV-2 has the potential to lead to post-COVID-19 condition, which is associated with reduced working capacity and absences from work.

It is unclear if infection with SARS-CoV-2 leads to economic inactivity among those who were initially in employment just before the pandemic.

What this study adds

Infection is only very weakly or not associated with economic inactivity and non-employment in people who were in employment just prior to the pandemic.

How this study might affect research, practice or policy

Alternative explanations for the rise in economic inactivity need to be investigated such as long-term sickness.

Possible biases introduced by linkage consent need considering when using linked healthcare data.