how Occupational Health can assist

For many people, the acute stage of the COVID infection lasts a couple of days although it is common for the symptoms to last between 2-4 weeks. This is referred to as ‘acute’ COVID. ‘Long COVID’, however, is a term which is used after four weeks if a person’s symptoms continue and prevent the person from doing normal activities. Symptoms can last for many weeks and months. It is important to note that it is not necessary for the person to have had a positive test for COVID when they were acutely ill to meet the definition of long COVID – this is because tests were not always accessible, or indeed accessed, by many of those who are now affected. Long COVID affects people of all ages and even those with mild initial symptoms. Current best estimates are that between 5-10% of people who get COVID will develop Long COVID. It is not yet known how long it takes for lingering symptoms (most commonly fatigue) to resolve but for some people there will be significant lasting effects such as permanent organ damage.

Long COVID is associated with many different symptoms and often these symptoms can fluctuate over time. A majority of patients experience fatigue, headache, feeling unwell after exercise and respiratory symptoms such as shortness of breath, sore throat and persistent cough. Some experience symptoms such as continuing fever, gastrointestinal problems, a fast heart rate or palpitations and neurological problems such as loss of concentration or “brain fog”, ringing in the ears or loss of feeling in their extremities. There is also evidence showing that some people are developing new diagnoses, including diabetes, heart disease and liver disease. Clearly medical attention is needed to help treat and manage the symptoms and new specialised centres and services are being set up throughout the UK to help those with Long COVID to recover.

A word of reassurance though: although recovery from COVID-19 can be slow, many people are improving with time and treatments are improving as more is known.

Returning to work is an important part of the overall recovery process even if it initially it needs to be on a flexible or phased return.

What should Managers do when the worker is off sick?

There are a number of measures managers can take when a worker is off sick including:

• keeping in contact with the worker when they are off, even if it’s just a telephone call agreed between worker and manager, to ask how they are and if there is anything the manager can do to help. This helps keep the worker connected to the workplace
• offering support – not only by asking how the worker is, but also by checking that they are accessing the medical assistance they need and acknowledging that they have been having a difficult time
• discussing what a return to work may look like when the time is right and what support/adjustments may be needed to facilitate this.

Short–term adjustments to a worker’s work pattern and duties can help enormously with their return to work and there are many options which can be considered. This is where the advice of experienced Occupational Health Practitioners can be helpful: to assess the impact existing symptoms are having on the person’s ability to function and work, and to identify appropriate adjustments and restrictions to allow for a safe and controlled return to work, for management consideration.

As Occupational Health Practitioners, we recognise that the duration of the illness can be long and that whilst a return to work can be an important part of the road to recovery, early return has the possibility to cause a relapse, if people overexert themselves too soon. Occupational Health can therefore:

• carry out an individualised health assessment and evaluate the impact of symptoms on functioning and advise on fitness to work, with adjustments
• advise on the external help and support available and signpost the person to the available services to aid their recovery
• advise on an individualised workplace/task risk assessment with the worker and line manager
• consider the safety of the worker and co-workers
• advise on rehabilitation programmes and likely timescales.

Examples of adjustments Occupational Health may recommend to facilitate a return include:

• alteration to timings (starts, finishes and breaks)
• altered hours e.g. shorter days, days off between work days
• alteration to workload e.g. fewer tasks than normal within a time or more time to complete usual tasks
• adjustment to patterns of working e.g. need for regular breaks
• temporary changes to duties or tasks
• support with a clear line of supervision – someone to ask or check in with
• time off for healthcare appointments
• not working in isolation
• working from home part of the time
• equipment adjustments e.g. voice activated software, ergonomic office chairs, enhanced moving/handling equipment.

Please click here for guidance and advice from both the NHS and the Chartered Society of Physiotherapy to support a person with their recovery from COVID-19, including activity tips, downloadable resources and an overview of what to expect.

For advice as to how to make a referral for an Occupational Health assessment please contact Katie Eastwell or download our management referral form .