Long COVID & Returning to Work

What exactly is Long COVID?

COVID-19 has had a tremendous impact on the world, affecting millions of people globally. While many people recover from the virus in a few weeks, some people experience persistent symptoms that can last for several months after they have contracted COVID-19. This condition is known as ‘Long COVID,’ or Post-Acute Sequelae of SARS-CoV-2 Infection’ (PASC). 

Studies of the occurrence of long COVID have only recently gathered momentum, however from the limited data available, current prevalence estimates of Long COVID (defined as >12 weeks) in Australia range from 5% to 10% of COVID-19 cases. This means that Long COVID is becoming increasingly common and may become a significant contributing factor to long-term disability for Australians. 

The symptoms of Long COVID can vary widely, but common ones include fatigue, difficulty with memory and concentration (brain fog), shortness of breath, muscle and joint pain, and headaches. Some people also report heart palpitations, chest pain, and gastrointestinal symptoms. Experiencing any number of these symptoms on a persistent basis can significantly impact daily life and can make it challenging to return to work at a pre-illness capacity. 

Long COVID & Returning to Work

Long COVID symptoms that seem to have the greatest impact on work and return to work are fatigue, and cognitive dysfunction (difficulty with concentrating and memory loss). However returning to work after COVID-19 can be challenging for not only those experiencing Long COVID symptoms, but for their employers too. People may need to take a phased return to work approach; starting with shorter hours, fewer days, or adapted tasks in order to avoid overwhelming their bodies. It is essential to have an open dialogue between employers and co-workers to discuss accommodations and adjustments that can be made to support the employee’s return to work.

Returning to work for an individual with Long COVID often needs involvement of several stakeholders: the recovering worker, employer, line manager, and health professionals. Occupational Physicians can play an important role in bridging between these groups.

The primary goal should be a progressive, adaptive, and appropriate return to work, as well as support at work, as working is generally viewed as being beneficial for overall health.

Multidisciplinary Treatment Strategies 

Multidisciplinary treatment strategies can be helpful in managing Long COVID symptoms and supporting a successful return to work. Treatment should be tailored to the individual’s symptoms and needs and may involve a combination of the following:

1. Rest and pacing: It is important to avoid overexertion and to balance activity with rest to manage symptoms such as fatigue and muscle pain.
2. Counselling can be helpful in managing anxiety, depression, and other mental health issues that may arise as a result of Long COVID.
3. Exercise and physical therapy can help improve strength and flexibility and manage pain and fatigue. 
4. Medication management: medications such as painkillers, anti-inflammatory drugs, and antidepressants may be prescribed to manage symptoms.
5. Nutritional support: A balanced diet with adequate nutrition is essential in supporting the body’s recovery and managing symptoms.

Long COVID Rehabilitation Clinics 

There are several clinics in Australia that are dedicated to the rehabilitation of patients with long COVID. These include;

• St Vincent’s Hospital Post-COVID Recovery Clinic in Sydney provides multidisciplinary care for patients with long COVID, including medical assessment, physiotherapy, occupational therapy, psychology, and dietetics. Patients can be referred to the clinic by their GP or specialist, or they can self-refer.
• The Victorian Rehabilitation Centre in Melbourne have developed a fully supervised reconditioning outpatient program for patients suffering from Long COVID, designed to support their graded return to activity and educate on the management of common symptoms. Its supervised evidence-based patient recovery program includes support from physiotherapists, occupational therapists, psychologists and dieticians.
• The Wesley Hospital Long COVID Clinic in Brisbane provides medical assessment, physiotherapy, occupational therapy, psychology, and dietetics. The clinic aims to address the multifactorial effects the illness can have on a person’s long-term health.  

The goal of long COVID clinics in Australia is to provide a comprehensive and coordinated approach to the rehabilitation of patients with long COVID. The clinics bring together a range of health professionals to provide a holistic approach to patient care, with the aim of improving the patient’s quality of life and helping them to manage their symptoms of Long COVID.