More than two years after Georgia Linders first fell ill with COVID, her heart is still racing randomly.
She is often exhausted. She cannot digest certain foods.
Most days she has a fever, and when the temperature rises above a certain point, her brain feels like it’s tough, she says.
These are commonly reported symptoms of prolonged covid.
Linders really noticed problems with her brain when she returned to work in the spring and summer of 2020. Her job required her to be on the phone all day, coordinating with health clinics that serve the military. There was a lot of multitasking, which she excelled at before COVID.
After COVID, the brain fog and fatigue slowed her down tremendously. In autumn 2020, she was put on probation. After 30 days, she believed her performance had improved. She had certainly felt busy.
“But my supervisor picked up on my productivity, which was about a quarter of what my colleagues were doing,” she says.
It was demoralizing. Her symptoms worsened. She was given a new probationary period of 90 days, but she decided to take sick leave. On 2 June 2021, Linders was dismissed.
She submitted a discrimination complaint to the government, but it was rejected. She could have sued, but didn’t make enough money to hire a lawyer.
Survey data suggests millions of people are out of work due to prolonged COVID
As the number of people with post-COVID-19 symptoms rises, researchers and government officials are trying to get a handle on how long the impact of COVID-19 is having on the American workforce. It is an urgent question, given the fragile state of the economy. For more than a year, employers have faced staffing problems, with jobs going unfilled month after month.
Now, millions of people could be sidelined from their jobs due to prolonged COVID. Katie Bach, a senior fellow at the Brookings Institution, drew on survey data from the Census Bureau, the Federal Reserve Bank of Minneapolis and the Lancet to come up with what she says is a conservative estimate: 4 million full-time equivalent workers out of work due to prolonged COVID.
“It’s just a shocking number,” says Bach. “That’s 2.4% of the US working population.”
Long-term COVID can be a disability under federal law
The Biden administration has already taken some steps to try to protect workers and keep them on the job, issuing guidance that makes clear that as long as COVID can be a disability and relevant laws will apply. Under the Americans with Disabilities Act, for example, employers must provide accommodations to workers with disabilities unless doing so would create an undue burden.
Linders now thinks back to what she should have asked after she returned to work. She was already working from home due to the pandemic, but perhaps she could have been given a lighter workload. Perhaps her supervisor could have taken disciplinary action.
“Maybe I wouldn’t have gotten as sick as I did because I wouldn’t have pushed myself to do the things I knew I couldn’t do, but I kept trying and trying,” she says.
Dr. Monica Verduzco-Gutierrez, a professor of rehabilitation medicine at the University of Texas Health Science Center in San Antonio, has seen COVID play out in similar ways in other patients.
“If someone has to go back 100% when they start feeling a little bit better, they’re going to crash and burn quickly,” she says.
Finding accommodations for prolonged COVID can be complicated
The problem with coming up with long-term COVID accommodations is that there are so many unknowns. The duration and severity of symptoms varies greatly from person to person.
Gutierrez is struck dumb by questions about disability forms that ask how long a person can be out or how long the illness can last.
“This is a new condition,” she says. “We do not know.”
Accommodations in the workplace can include flexibility in where someone works, extended leave or a new role in a different department. The goal is to get workers back on track, says Roberta Etcheverry, CEO of Diversified Management Group, a disability consulting firm.
But with long COVID, it is difficult to measure whether an employee is actually on the way back.
“This is not a sprain or strain where someone turns an ankle and we know in x number of months they’re going to be at this point,” she says. “It’s not—someone was helping to move a patient, and they hurt their back, and they can’t do that kind of work anymore. They have to do something else.”
With prolonged covid, symptoms come and go, and new symptoms may appear.
The Ministry of Labor encourages employers not to rule out accommodation for employees who do not receive an official long-term covid diagnosis.
“Rather than determining whether an employee has a disability, you should focus on the employee’s limitations and whether there are effective accommodations that will enable the employee to perform essential job functions,” the Department of Labor says in its lengthy COVID guidance for employers .
Accommodation may be more difficult to obtain in some jobs
However, not all employers have the means to offer the type of accommodation an employee may need given their symptoms.
Bilal Qizilbash believes he would have been fired a long time ago if he had not been the boss of his own company.
“Most of my team has no idea that I work from bed most of the time,” says Qizilbash, a long-haul COVID carrier who suffers from chronic pain that he likens to wasp stings.
As the CEO of a small business that manufactures dietary supplements, Qizilbash says he tries to be compassionate while being ruthlessly efficient. Having one employee whose productivity is seriously compromised can end up negatively affecting the entire company, he says.
In other professions, it can be challenging to find accommodation that works, no matter how generous it is.
In South Florida, Karyn Bishof was a new recruit with the Palm Beach Gardens Fire Rescue team in 2020 when she contracted COVID, likely in a training session, she says. She comes from a family of firefighters and it was her lifelong dream to follow. But for a long time, COVID has left her with profound brain fog, fatigue, lightheadedness and a host of other symptoms incompatible with firefighting.
“I couldn’t run into a burning building if I can’t regulate the temperature,” she says. “If I can’t control having hypertension, I can’t lift a patient up or I’m going to pass out.”
Bishof was terminated from his job for failing to meet performance-related probation standards and has since become an advocate for COVID long-haul carriers.
The Ministry of Labor is collecting ideas for how to keep workers in work
Taryn Williams, Assistant Secretary of Labor for Disability Policy, wants to hear from workers and employers. Through mid-August, the Ministry of Labor is holding an online dialogue, asking for input on guidelines that can help with workplace challenges as a result of prolonged covid.
“We want to be responsive,” says Williams. “We are considering how we can support these workers at what is a transformative time in their lives.”
She says that the government has encountered situations in the past when there was a sudden increase in the number of people who needed facilitation at work. For example, a significant number of service members returned from Iraq and Afghanistan with traumatic brain injuries. Williams says that such times have led to changes in disability policy in the United States
From her home in La Crosse, Wisconsin, Linders has contributed a number of comments to the Department of Labor’s online dialogue. Like Bishof, she also spends a lot of time helping other COVID long-haul carriers navigate what she’s been through, including qualifying for Social Security disability insurance.
Her advocate helps her feel like she’s contributing to society, even if it’s not the life she wanted.
“I don’t want to become disabled. I don’t want to take money from the state,” she says. “I’m only 45. I was going to work for at least another 20 years.”