After graduating in the spring of 2020, Clare Banaszewski landed her dream job as a nurse practitioner in a maternity ward at a hospital in Omaha, Nebraska.
That winter, Banaszewski, 24, contracted the coronavirus. It was a mild case, and she bounced back after two weeks. But it wasn’t long before she started feeling new symptoms: She was overcome with fatigue, struggling to make it through her 12-hour shifts, which used to fly by. She felt heart palpitations, suffered from cognitive problems and had severe headaches — telltale symptoms of a condition known as “long COVID.”
She took three months of medical leave and started back with shortened, six-hour shifts. Even those were too much. Her manager was understanding, but she eventually told Banaszewski that the hospital would need to hire a replacement. Banaszewski resigned six months ago. She has been unemployed since.
“It’s scary,” she said. “I have a lot of student loans I’m trying to figure out how I’m going to pay off. I don’t really have much to fall back on.”
Banaszewski is one of at least 7 million people in the United States, by one estimate, who are unable to work full time or who have had to scale back their work because of long COVID-19, which is defined as when COVID-19 symptoms persist weeks, months or even years after the initial onset of an infection.
Some research has shown that lingering COVID-19 symptoms are more prevalent in people in their 30s and 40s — when workers are often in the prime of their careers. That’s according to a British government study, published this month, that found that the ailment was also most prevalent in women, people living in deprived areas and those working in social care, teaching or health care or having another disability.
“We’ve got to, as a nation, recognize that the majority of people will be of working age, and we need to facilitate these guys working in an environment that allows them to recover while working,” said Fauzia Begum, an occupational health doctor for Britain’s National Health Service and the medical head of a countywide long COVID-19 program in Derbyshire, England. “If you don’t do that, you end up in a position where you have a lot of people who are off work.”
Begum and her colleagues have seen firsthand how patients who overexert themselves in the early stages of recovery can end up prolonging their symptoms.
Nisa Malli, a labor researcher who has long COVID-19, said she returned to work too soon and later needed to take off a long period to recover. Malli, who said she feels 90% better two years after contracting the virus, added that she was lucky that her employer allowed her to work remotely and offered a phased return to work.
Other types of workers, however, such as chefs who lost their sense of smell or software developers who could not remember codes they wrote before they were sick, may have to change careers and need support for retraining programs, said Malli, a member of the Patient-Led Research Collaborative, a group of long COVID-19 patients who are researching the disease.
The key difference between long COVID-19 and other disabilities is that the virus is airborne and transmitted in the workplace and during commutes, Malli said. It is also different because of the numbers of people it has affected.
“We’ve never had a post-viral illness at this scale,” she said, “where a medium-sized employer is going to see multiple workers getting COVID initially and have long-term complications.”
A study published in January by the Brookings Institution found that long COVID-19 could account for 15% of the millions of unfilled jobs in the United States.
Lucy Bailey, a 34-year-old with long COVID-19, said she felt as if she was trying to figure out her career options without any support.
She has found some solace in online support groups that connect her with others who are trying to navigate recovery and career changes, she said.
“I drop a lot of balls all the time that I never used to,” said Bailey, whose work as a campaigns coordinator for a charity in London was not renewed last year after her contract ended. “I don’t really know where to go next. I can’t do the jobs I loved before.”
Some countries in Western Europe have robust policies to protect those with disabilities, said Philippa Dunne, one of the authors of a report published by the Solve Long COVID Initiative, a nonprofit research and advocacy group.
In the United States, however, there are fewer protections. Since people who are unvaccinated may be at a higher risk for developing long COVID-19, according to the Centers for Disease Control and Prevention, companies in regions with low vaccination rates, like the South, may have more worker shortages than those in regions with higher vaccination rates, Dunne said.
“It’s going to be another unequal burden,” Dunne said. “The South already has a much higher rate of people on disability than the Northeast and the Midwest. That also is going to be made worse.”
A major logistical hurdle for U.S. employees with long COVID-19 is qualifying for unemployment benefits. There is no single test for diagnosing it, and it is only vaguely defined, with so much still unknown. That can make it harder for people to be diagnosed and gain access to disability benefits. It can also complicate responses from employers, who are still navigating how to handle coronavirus-related work issues, including the fraught issue of whether COVID-19 vaccinations should be mandatory for workers.
Katie Brennan, an adviser for the Society for Human Resource Management, said employers must consider their legal obligations to employees under the federal Family and Medical Leave Act and the Americans With Disabilities Act. With FMLA, eligible employees are entitled up to 12 weeks off, and state protections may also be in place, she said.
Beyond the legal guidelines, companies can support and retain employees with long COVID-19 by providing flexibility and a gradual return to work option. It’s crucial that people with long COVID-19 avoid returning to work without the adjustments they need to manage fatigue, according to a guide by the Royal College of Occupational Therapists.
According to guidelines published by the European Union’s workplace safety agency, “returning to work too soon or to a full workload can cause relapse.” Some employees may feel guilty and find it hard to take a break when they need to, the agency’s guidelines say. Encourage them to rest and recuperate, and focus on asking about their health rather than when they will be returning.