Work and vocational rehabilitation for people living with long covid

• Published in: BMJ (Online) 2024-05, Vol.385, p.e076508-e076508
• Main Authors: O’Connor, Rory J, Parkin, Amy, Mir, Ghazala, Mullard, Jordan, Baley, Sareeta, Ceolta-Smith, Jenny, Rayner, Clare
• Format: Article
• Language: English
• Subjects: COVID-19; COVID-19 - rehabilitation; Employment; Health services; Humans; Labor law; Labor shortages; Pandemics; Patients; Population studies; Practice; Rehabilitation; Rehabilitation, Vocational - methods; Return to Work; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sick leave; Vocational rehabilitation
• ISSN: 1756-1833; 1756-1833
• DOI: 10.1136/bmj-2023-076508

Correspondence to R O’Connor R.J.O’[e-mail] What you need to know Support patients to assess their current abilities at work compared with what they could do previously; they don’t need to be 100% well to start the process of returning to work Going back to work too early after acute illness may be counterproductive; patients should not make hasty decisions around resignation or retirement in the early stages Use the fit note to help someone return to work, emphasising the need for flexibility to accommodate day-to-day fluctuations Long covid is a complex, highly variable, and sometimes relapsing-remitting condition that may have profound impacts on a patient’s wellbeing and ability to work.1 Many people living with long covid are attempting to return to work, or stay in work, while learning to manage an emerging long term condition.2 These challenges may be compounded by workplace burnout, fuelled by labour shortages, the psychological effects of the pandemic, widening inequalities, and global economic insecurity. 11 Among those of working age, 20% are on long term sickness absence, and 48% have reduced their working hours.7 A population based study in the canton of Zurich, Switzerland, involving 672 people of working age infected with SARS-CoV-2 early in the pandemic, reported that 5.8% of people who developed long covid experienced an impact on their work.12 These estimates may not accurately reflect the full impact of long covid on work status. In particular, people from marginalised communities are more likely to develop long covid and are less likely to be able to access health services.1314 Below, we address questions about returning to work or remaining in work, which patients might ask. Because long covid presents in many different ways, and the variety of jobs people have, no high quality evidence is available for interventions to improve people’s return to work in long covid. Patients should maintain regular contact with their employer during the early phase of illness, and request workplace support (eg, referral to occupational health services) at four weeks of sickness leave, as the health related problems with work are less likely to resolve spontaneously after six weeks of absence.8 Patients do not need to be completely fit to return to work, and setting goals around when to return can be a vital part of their rehabilitation.