SPL07 LONG COVID IMPACT ON WORKERS AND ITS MONITORING IN OCCUPATIONAL HEALTH
Authors: Morales-Camino Jorge A 
Published: July 2024

Abstract

Introduction
This paper provides an analytical connection between Long Covid syndrome, productivity, and its monitoring in occupational health. Long Covid is a medical condition affecting 10-20% of people who had Covid-19 disease.

Methods
PubMed, Google Scholar, ScienceDirect, The Lancet, NEJM, Nature, CDC Library, WHO COVID-19 research article database. Search terms: ‘Long Covid’, ‘Productivity’, ‘workers impact’.

Results
WHO defines long Covid as the continuation or development of new symptoms 3 months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least 2 months with no other explanation.
Signs and symptoms linked to Long Covid include fatigue, shortness of breath and cognitive dysfunction. Longest list includes 66 symptoms. Most mentioned symptoms are fatigue, dyspnoea, arthralgia/myalgia, cough, and headache. Some others are related to quality of life: anxiety/depression, Post Exertional Malaise (worsening of symptoms after minor physical or mental exertion), Brain Fog (neurocognitive symptoms including loss of memory and problems focusing, concentrating, and paying attention) a new study has found that these symptoms may be caused by a viral-borne brain injury, and finally sleep/mood disorders.
Long Covid medical management is focussed on: COVID-19 vaccination and administration of anti-SARS-CoV-2 monoclonal antibodies. Treatment of patients with COVID-19 with oral nirmatrelvir/ritonavir was associated with a 25% reduction of sequelae. Individuals receiving metformin had a reduced 40% incidence of long COVID.

Workers Impact
Workers with long COVID have decreased productivity, including presenteeism. In the US, 1.8 to 4.1 million workers with Long Covid were out of work. Time out was influenced by Initial infection severity, type of work, and professional categories (blue vs. white collar workers). Permanent employment loss due to long COVID was between 11%-14%. Some employees took early retirement. Persons with long COVID are less likely to employ themselves full time. Some work despite their symptoms, or RTW too early. Some reduce their workload. Working relationships are not good for workers with long COVID.
Estimated prevalence of long COVID cases in EU population is 1.7% in 2021 and 2.9% in 2022, having a negative impact on labour supply of 0.2-0.3% in 2021 and 0.3-0.5% in 2022. Long COVID reduced labour supply by 364,000–663,000 in 2021 and by 621,000-1,112,000 in 2022, with lower productivity, higher sick leaves, lower working hours, and unemployment. This range is close to a recent estimate for the US.

Discussion
Health professionals must look for preventing Long COVID becoming a disabling condition. Helping workers to stay at work or RTW. Look for work accommodations options, access to vocational rehabilitation, facing health challenges. OM physicians must help workers to manage persisting and disabling long COVID symptoms that could affect function at work. Occupational Medicine physicians often do not know how to handle long COVID cases. OM physician must be aware of the WC’s and Disability guidelines for employees with Long Covid, to identify those cases requiring support. Prevalence of long Covid is between 5 and 15%, that means we´ll continue facing a challenge to countries health and health care systems. New approaches will be required to care for patients with long Covid, and these must be based on education, research, and support. Wellbeing interventions are important to avoid work disability.