By John Mackenzie – arch.portfolio member.

Long Covid: the Hidden Pandemic?

I am writing a series of blogs on the subject of the impact of Covid-19 in the workplace.  In this blog I will explore:

(1) the causes and impact of ‘Long Covid’ and

(2) the steps that employers need to consider on behalf of their employees in light of ‘Long Covid”

(3) the future of ‘Long Covid’

Early reports in 2020 of a constellation of persistent chronic symptoms from sufferers of Covid-19 were often initially dismissed by medical professionals unable to account for the symptoms within the Covid-19 diagnosis.

However it soon emerged that so-called “Long Covid” was a real and worrying phenomenon.  Sufferers reported a wide range of symptoms which persisted past the acute phase of 1-2 weeks.  Rather than just anticipated respiratory symptoms there was a cluster of symptoms with no obvious cause.  These symptoms appear to be debilitating and serious.

Long Covid has been defined as symptoms persisting past 12 weeks, unexplained by other conditions.  The ONS record 14% of Covid-19 sufferers in the UK report symptoms meeting this definition.   1.5% of working age adults have reported symptoms of Long Covid.

It presents a huge problem for sufferers, primary care, and for the economy as a whole.  Long Covid – also known as ‘Post Covid Syndrome’ – presents a particular challenge for employers given the sheer number of people affected.  Worryingly it affects many young, employed people in otherwise good health.  Some young people may have been less cautious in Covid-19 hygiene procedures as they were perceived as low risk of death. Long Covid appears to be less age-dependent in its effects than Covid-19 itself.

Long Covid presents differently to other post-viral syndromes but does share some features with Chronic Fatigue Syndrome caused by ME.  Interestingly, in contrast to other post-viral syndromes there is a wide variety of symptoms.  Any one individual will typically suffer a cluster of several different symptoms.  These fall broadly into problems in three categories:

  1. Exercise intolerance – eg breathlessness, fatigue
  2. Cognitive complaints – eg ‘brain fog’
  3. Autonomic nervous system eg palpitations, dizziness


Sufferers typically can have several different symptoms at once which can last for weeks or months.  The variety of symptoms suggests a problem in several organs.  Because of the variety of symptoms, experts consider that the potential cause may lie in one of the following origins:

  1. Persistent viral infection (ie Covid-19 has not cleared )
  2. Autoimmune disorder
  3. Chronic inflammatory response

However, to date no cause has been proven.  On account of the lack of a defined cause, there remains no definitive treatment or cure.  More medical research is required if we are to combat this condition.  It is unclear whether this will be a transient or permanent condition although many sufferers do report improvement over time.


This disease represents a particular challenge for employers in dealing with affected employees.  A significant cohort of the employed population has been affected.  The variety in presentation of symptoms between individuals would not mean a ‘one-size-fits-all’ solution for reintegration into the workplace.  Employers will need to consider how best to accommodate employees who may suffer with several different symptoms and often pre-existing conditions.

  • Employers will need to consider amongst other things a phased return to work
  • Employers will need to understand how symptoms impact on function – which may vary
  • Employers will have to identify those employees with symptoms and establish whether they are ‘disabled’ under the Equality Act 2010. If so, employers will need to consider and put in place “reasonable adjustments” to allow those employees to work.

The Future

Some commentators assert that Covid-19 is a disease that we shall have to live with for years to come- the vaccine notwithstanding. There is a significant proportion of the population opposed to vaccines which may compromise herd immunity.  Variants may continue to be reimported until the disease is eradicated worldwide.  If for example the acute cases are prevented or mitigated but chronic cases (Long-Covid) persist, then this disease may be an insidious problem.  If that is correct then Long-Covid remains of great concern because of its capability to disable part of the workforce.

Employers may well be on the receiving end of claims for Long Covid arising out of workplace exposures.  I will consider the potential avenues available for these claims in my next blog.

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