Before the pandemic, Imogen Phelan started work as a nanny at 7am. Her mornings would fly by in a flurry of preparing breakfasts, packed lunches and school runs for her own two children and those she cared for.
During the day, 42-year-old Phelan did domestic work for her employer before school pick-up time rolled around. Homework and cooking dinner followed, before she finally left for home at about 8.30pm.
Two years later, Phelan can do at most an hour of paperwork, sitting down, a day — and some days not even that. She caught Covid-19 in March 2020 and has never fully recovered. She still experiences intense fatigue, cognitive issues, chest pain, joint inflammation and chronic tinnitus.
Phelan, who lives in Winchester, is one of the roughly 2 million people in the UK suffering from Long Covid, according to estimates by the Office for National Statistics, based on the people self-reporting symptoms four weeks or more after first contracting the virus.
“Your future is just stripped from you overnight,” said Phelan, who has had to quit nannying after 15 years.
Initially dismissed as a quirk of some infections, Long Covid has developed into a major puzzle for doctors, employers and officials — one that threatens to have long-lasting consequences for the UK’s thinly stretched economy.
Over two years on from the outbreak of the pandemic, this new and as yet little understood condition is adding to Britain’s labour market crisis, contributing to the highest number of people out of work because of long-term sickness in almost two decades.
Data from the Office for National Statistics shows a rise of 450,000 in the number of people currently “economically inactive” in the UK since the pandemic: not seeking work or available for work. This has been dubbed the “great resignation”, and its causes are baffling economists. But sickness — and perhaps Long Covid — appear to be major factors.
There has been a rise of 225,000 in those described as inactive because of long-term illness. Economic inactivity due to long-term ill health is now at its highest for 20 years, according to the Institute for Employment Studies (IES).
In the eurozone, the number of “inactive” people has fallen by 1.75 million since the fourth quarter of 2019, according to Capital Economics, although the Eurostat agency’s data on illness being a reason for inactivity — which appears to have risen — does not provide a clear picture of the situation.
Tony Wilson, director of the IES, said: “The crisis that we all prepared for isn’t the one we’ve got. We were anticipating mass unemployment coming out of Covid. In reality, we haven’t got an unemployment crisis, we have a participation crisis — and long-term ill health definitely appears to be one of the big drivers of that.” Long Covid, he said, was likely to be contributing.
Ruth Gregory, senior economist at Capital Economics, said waves of higher rates of people out of work due to long-term illness were common after major economic shocks, but that this time the effect may be more severe than usual. “It’s too soon really to tell whether the changes will persist. But we have been struck by the sheer extent of the rise in long-term sickness this time round.”
Research by the Chartered Institute of Personnel and Development (CIPD) earlier this year found that almost half of more than 800 employers surveyed had staff who had experienced Long Covid in the past year.
More than a quarter of the organisations, who together employ 4.3 million people, said Long Covid was among their main causes of long-term sickness absence.
“There has never been a [comparable] event in our lifetimes where so many people in the workforce are affected,” said Clare Rayner, an occupational health physician who has been involved in research into Long Covid, including with the World Health Organisation.
Long Covid is a particular challenge for employers because while sufferers believe that they have the illness, many may not yet have an official diagnosis. Pressures on the NHS means that it can take months to see a specialist, and there is no single test to diagnose the condition — doctors typically run tests to rule out other causes.
Little surprise, then, that some managers are privately sceptical about some employees’ claims. “Everyone’s flying blind,” said Rayner. “The big block in the road is the lack of access to healthcare — and the savvy employers, which tend to be the big ones, are realising this.”
Rachel Suff of the CIPD said: “Managers and HR are used to supporting people with illnesses, but that will often be based on someone having a diagnosis and a treatment plan.”
She added that employers should take a “symptom led” approach to support staff as needed: being flexible about their work depending on how they are feeling, rather than focusing on whether a worker has an official diagnosis or not. But for some with the condition, even adaptations of workplaces and a supportive employer are not enough to make a return to work feasible.
Having gone back to the office part-time after an initially mild case of Covid in March 2020, a communications chief at a FTSE 100 firm increasingly struggled with severe fatigue. Although her employer supported her working extremely reduced hours, she eventually decided that she would have to leave her job to focus on her recovery.
“I realised over a number of months that while I was making progress, work was really hard for me — and not only from the physical side. Emotionally it was really challenging, because you feel like you can’t achieve what you had been able to previously and just feel incompetent. I had a team that I wasn’t able to manage effectively,” she said.
One of the most contentious areas surrounding Long Covid and work is whether the condition should be legally treated as a disability. Under UK legislation, a person is considered to be disabled if they have a physical or mental impairment that has a substantial impact on their ability to do their normal daily activities and will last for at least 12 months.
The definition is important because equalities legislation prohibits employers from discriminating against staff due to disability, and requires them to make reasonable adjustments to avoid disabled employees being put at a disadvantage in the workplace.
In a landmark employment tribunal ruling last week, a panel determined that Long Covid can indeed be considered a disability. Terence Burke, who was dismissed from his role at a charity, was granted permission to bring a disability discrimination case against his former employer. The ruling is widely expected to lead to a flurry of further claims.
Acas, the public body that mediates workplace disputes, said it was regularly receiving calls from employees with Long Covid. They seek advice on issues including asking for adjustments to their role or flexible working, or are concerned about being dismissed by their employer because they cannot commit to returning to work on a set date.
But what can people do to help those with Long Covid remain in, or re-enter, the workforce?
For Wilson at the Institute of Employment Studies, one answer would be better government support — both for people with Long Covid and their employers. He wants to see more state help to adapt jobs and advise businesses on how to tailor roles to an individual’s needs.
“There’s a whole ton of stuff we could do — we just don’t. We largely expect employers to pick it up,” he said.
Tightness in the labour market is now providing an additional incentive for employers to work hard to retain staff with Long Covid as they cannot be sure they can easily be replaced, he added.
Now that nannying seems beyond her, Phelan is not yet sure what type of job she can do, but the financial imperative to return to work is pressing.
She has been doing ad hoc administrative work for her husband’s construction business when she feels well enough, but the lack of a second income has hit her family hard. She is looking into applying for benefits.
“I’m sure there are people who are worse off than me, but we have completely stripped back on what we eat, what we do. We’re really worried about October, when the heating comes on again,” she said.
How to deal with staff with Long Covid
• Be aware symptoms can fluctuate. Note that the usual rules for absence due to sickness and sick pay apply.
• Agree how and when to make contact with any employees off sick, and make sure their work is covered and shared out appropriately.
• Discuss how you can support them once they return to work.
• Arrange an occupational health assessment when they return to work, and make reasonable adjustments as needed. These could include a phased return to work, flexible working, or shorter hours.
Source: Acas
