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"Long COVID" and Implications for Workplace Mental Health Support

The Philippines hit an all time high of 49% COVID-19 testing positivity rate during the early weeks of January 2022, owing mostly to the many social gatherings during the Christmas season and the Omicron variant being more infectious than those that came before it. Thankfully, many have already completed their vaccination and booster shots, helping ensure that most infected (tested or otherwise) experience just mild to moderate symptoms, if at all.

But while this would make the latest surge seem like just a bad flu season, there is one crucial difference: COVID-19 symptoms don't always go away in a few days; some stay on for weeks --- even months --- after getting infected.

"Long COVID” refers to symptoms that continue after the initial acute COVID-19 infection period is over. Common symptoms reported include breathing difficulties, chest or throat pain, fatigue, shortness of breath, "brain fog", loss of taste or smell, headaches and muscle pains. The symptoms may be new onset, starting after initial recovery and after getting a negative COVID test result. Others persist from the initial illness. Still others may be of delayed onset, occurring 2-3 months after recovery. Symptoms may also fluctuate or relapse over time.

Long COVID appears to be more prevalent among those who had severe COVID-19 infections, especially those who had to get hospital care. But it can also be felt by those who are in the mild to moderate category, including those vaccinated.

What does Long COVID mean for champions of mental health at work?

Return-to-Work Support and Accommodation for Recovered COVID-19 Employees

Often, the fitness to return to work of a person who tested positive for COVID is indicated solely by a negative test result. Assumption is, after being cleared of the virus and completing isolation, an employee can continue working and performing as before.

But long COVID symptoms can affect work performance. Bouts of fatigue can make long shifts difficult to sustain. Cognitive symptoms like "brain fog" will make analytical and creative tasks more challenging. In a work culture where there is high pressure to perform and "excuses" are not tolerated, the impact of these symptoms may easily be misinterpreted as laziness or lack of skill.

It is important to open conversation for employees to share about any infection after-effects they may be experiencing, and what accommodations they need to successfully transition back to the full swing of things. Ask employees what they need to better adjust. A gradual easing-in period can be provided for those whose just returning back to work; work time and work load adjustments can be given for those visited by symptom at variable times. What is important is that the reality of long COVID is recognized so that return to work is a positive experience. Many of the Long COVID symptoms are manageable, but dismissive attitudes at work can create more stress.

Watching Out for Anxiety and Depression

The experience of any long illness can take its toll on a person's mental health. Long illness affects a person's quality of life, can delay plans or personal goals, can demand adjustments in routine, and impact relationships. Long illness can also spark fears about the uncertainty of recovery or the gravity of illness. With COVID-19 in particular, since no cure still exists or not all medicines are readily available, questions like "when will this end?" or "will get better?" can create mounting frustration.

Some preliminary studies suggest an increase in depression, anxiety , and traumatic stress among the "long haulers" of COVID-19. It is unclear whether the virus itself creates psychiatric and neurologic symptoms, or the illness experience triggers mental health concerns. With the stigma surrounding mental health disclosure at work still high, it is important that managers and peers remain on the look-out for warning signs of mental health problems in their team, even past the initial date of infection. Persons who experience good social support, minimal disruptions to their life, and access to health care do tend to do better despite long illness.

Information is Key

As with any battle, the more we know about the enemy, the more confident and effective our response. Mental Health support for persons with Long COVID shouldn't just come in the form of socio-emotional care, but should be via relevant illness education as well.

Connect employees who tested positive to information about COVID-19 post-infection care. Knowing what to expect can mitigate the stress of the long illness. Share how it typically tapers off after 3-6 months, and provide tips on how to boost one's immune system or how to temporarily compensate while waiting for recovery. For example, those with lingering memory issues can create lists or reminders so they can work around memory gaps.

Most importantly, teach how to practice self-compassion during this time. COVID is an illness that we can try to protect ourselves from, yes, but catching it can be no one's fault. It is really hard to cover all possible entry points of an infection during a pandemic.

We may have learned to live with COVID-19 by now, but it doesn't mean it is still something to be taken lightly. With evidence for Long COVID, avoiding infection remains a priority. More so, supporting COVID-19 survivors' mental health and wellbeing should be considered as cause for continuing care.

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