As Long COVID takes its toll on people and the workforce, experts call for more support ⋆ Michigan Advance

In April 2020, Anna VanderLaan, a healthcare worker from Wyoming outside of Grand Rapids, began experiencing symptoms of COVID-19 at work. The next day she tested positive for the virus and within five days she was in intensive care on a ventilator.

After six weeks and a tracheotomy that allowed her to be taken off the ventilator, VanderLaan was released for inpatient rehabilitation at other hospitals.

“It was quite a journey to learn to walk again,” recalls VanderLaan.

Anna VanderLaan, a healthcare worker from West Michigan, contracted COVID-19 in April 2020. She was placed on a ventilator five days after testing positive. | Courtesy of Anna VanderLaan

In June 2020, she was discharged from inpatient rehabilitation, but still used a walker as she transitioned to outpatient therapy. She was easily fatigued and often fell asleep on her way home from therapy.

“It really felt like a slow build. There was nothing fast with the recovery,” VanderLaan said.

She would not return to full-time work until November 2021.

An estimated 16.3 million working-age Americans would have had long COVID, according to the US Census Bureau’s Household Pulse Survey for June through July 2022.

Since the start of the pandemic, 95.3 million cases have been reported in the United States and 1.06 million deaths.

The National Institutes of Health describes Long COVID as the health problems people experience within a few months of being diagnosed with COVID-19. It is the third largest neurological disorder in the country, as people suffer from symptoms such as brain fog, headaches, dizziness, loss of smell or taste, and muscle aches.

Although patient recovery experiences vary, experts predict the cost of lost wages could reach $230 billion a year. People with long-haul COVID were more likely to face financial hardship than those without, conditions that were only exacerbated in the absence of paid sick leave, insurance disability and workplace accommodations.

“The socio-economic impacts of post-acute COVID make it such a public health measure. And, quite frankly, I just don’t think there are enough programs to help these patients,” said Dr. Thomas Hordt of Grand Rapids-based Mary Free Bed Medical Group.

Road to recovery

VanderLaan’s return to his job was a gradual process. In September 2020, she was back with light duties at reduced hours. The following month, she began work-strengthening therapy, which focused on building her body’s strength and condition.

“It has never been easy; I don’t mean that,” VanderLaan said. “The therapist was telling me what he wanted me to do and I was like, ‘Well, I’ll give it a try. If I succeed, so much the better. Otherwise, we’ll back off and keep trying.

She said she was lucky. Because she contracted COVID-19 at work, she received workers’ compensation. Her employer found her things to do until she could work full time, when most people would have lost their jobs, VanderLaan said.

She is also grateful for the support of her family. When she was released from the hospital, she stayed with her mother, who helped take care of her and took her to her appointments.

Still, returning to his full-time role in November 2021 hasn’t been without its challenges. VanderLaan doesn’t know if her lungs will fully heal and she is still out of breath. She is still tired, but says it’s not as bad as before.

VanderLaan kayaks with family in Saugatuck, May 2022.| Courtesy of Anna VanderLaan

Although the story is different for every Long COVID patient, Hordt said it’s important to set appropriate expectations.

“Depending on the severity of a patient’s symptoms, I can say to them, ‘Look, I think going back to work is a good long-term goal, but we’re probably looking at about six months to a year before that. either to get depending on what you are able to do now,” Hordt said.

Some of Hordt’s patients have been out of work for six months to more than a year, placing a financial burden on families. Important other people may have to work overtime, which puts a strain on child care, creating a snowball effect, Hordt said.

“Some people improve faster, but the general theme has been that it’s slower than anyone wants it to be,” he said.

The impact of the Long COVID recovery on the country’s labor market is now in evidence.

Between 1.8 million and 4.1 million full-time equivalent workers are out of the workforce due to Long COVID projects, nonresident Brookings Institute Senior Fellow Katie Bach.

The annual cost of these lost wages is about $170 billion a year, but could be as high as $230 billion. The workforce has already been battered by COVID with nearly 100 million cases leading to absentee workers – which during spikes like the initial wave of omicron This winter, resulted in temporary business closures due to serious staffing issues.

And with more than one million Americans dying of COVID since 2020, it’s also had a profound impact on families and the workforce.

In order to limit the long-term impact of COVID on the workforce, we need political action and a better understanding of the disease and its impact on specific industries, said Jonathan Tsao, research and evaluation project leader for the Center for Health and Research Transformation.

The Michigan COVID-19 Recovery Surveillance Study (MICReSS) released in June found that of 2,703 responses, 21.4% indicated they had 90-day COVID. It was more prevalent among women, Hispanics, and poorer people as well as people over 75. People with pre-existing conditions, including emphysema, cancer, heart disease and chronic obstructive pulmonary disease (COPD), also reported a higher prevalence of the condition. .

“The impact of Long COVID has been overlooked for a long time,” said Nancy Fleischer, associate professor of epidemiology at the University of Michigan and principal investigator of the survey.

“Even though we as a society may be moving away from high levels of day-to-day anxiety around COVID infection, many people continue to suffer from ongoing struggles with Long COVID,” Fleischer said. .

Brookings Institute graph on Long COVID

A need for more data

Another survey by the Center for Health and Research Transformation (CHRT) puts the financial toll of people with Long COVID into perspective.

It revealed that 63% of participants said they had struggled to earn money for as long as needed in the past year, compared to 31% of people who had COVID-19 but no symptoms Long COVID and 37% people who had not contracted the virus.

In the center’s Cover Michigan Survey, 138 people out of 1,000 responses reported a diagnosis of COVID-19. Of those people, about 1 in 3 identified themselves as COVID long-haulers.

Still, measuring the impact of Long COVID on the workforce is difficult with sparse data, Tsao said.

Because Long COVID has only been around for about two years, experts haven’t studied the disease for long. And more research requires more resources and funding. As the National Institutes of Health opens up funding sources, it will take time to get better numbers, Tsao said.

Bach also acknowledged the limitations of the available data in his own report, noting that the census household pulse survey had a low response rate.

The socio-economic impacts of post-acute COVID make it such a public health measure. And, quite frankly, I don’t think there are enough programs to help these patients.

– Dr. Thomas Hordt of the Grand Rapids-based Mary Free Bed Medical Group.

She suggested adding questions about the impact of Long COVID on work to the Household Pulse Survey, as well as the current demographic survey released by the US Census Bureau and Bureau of Labor Statistics.

Bach also recommended partnerships with researchers from the National Institutes of Health and Long COVID patient advocacy programs to focus questions on information policymakers need to know.

Creating support for patients, such as expanding paid sick leave and access to Social Security disability insurance, will be key to making recommendations to employers on improving employee accommodations. .

“My point on this is sort of twofold. One, we know enough to know [the impact is] big. We have to start doing something about it. We don’t need more evidence that this is a problem,” Bach said. “But we live in a society with limited resources, and we actually need to know the cost of things. So we need to collect better data.”

In Michigan, Governor Gretchen Whitmer’s new Data Analytics Center in the Department of Technology, Management and Budget could serve as a one-stop solution, bringing together data from multiple sources under one roof, said Melissa Riba, director of research and evaluation of the center.

“I think what COVID has shown us is that this is really a cross-sector issue. It’s not just for a State Department or an area like health care to consider,” Riba said.

Brookings Institute graph on Long COVID

Tsao noted the importance of cross-industry partnerships in promoting acceptance of Long COVID as a disability. According to the US Department of Health and Human Services, Long COVID may qualify as a disability under the Americans with Disabilities Act of 1990.

Housing can still be hard to come by in some areas, Bach said, citing low-wage service jobs and certified nursing assistants as examples.

While workplace accommodations and perks can be hard to come by, Hordt said he faced less resistance from employers than expected.

“I have no problem or qualms with imposing very specific restrictions when patients begin to return to work. So, you know, it can be reduced hours, it can be reduced hours and days, it can be limited duties,” Hordt said.

“I can get super hyper focused with my referrals and in my communication with patient employers,” he said. “I don’t really remember [a moment] on the top of my head where I was banging my head against the wall because an employer was so resistant.

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Michael A. Bynum