Nearly 500 million people and counting worldwide have contracted COVID-19 since the start of the pandemic. While some cases were reminiscent of a cold, others have led to hospitalizations and death — and those who survive may have to contend with
According to a study by the University of Michigan, more than 40% of COVID survivors have long COVID, which could involve anything from fatigue, shortness of breath, insomnia, joint pain and memory difficulties to chronic kidney disease and heart disease. The American Academy of Physical Medicine and Rehabilitation estimates that long COVID will leave 22 million Americans with disabilities.
Dr. Alice Perlowski, a long-COVID survivor and cardiologist based in Los Angeles, knows firsthand how COVID can impact one’s life and career. After first getting sick in early March of 2020, her physical and mental health have bever been the same.
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“These symptoms have affected every organ system from my head to my toes,” she says. “I definitely have post-traumatic stress — I went from being a physician on the other side to fighting for my life in the hospital.”
Dr. Perlowski is now adapting to a work world with her new disabilities, and serving as chief medical officer for long-COVID survivor advocacy nonprofit Blooming Magnolia. But the road to recovery is anything but easy. Dr. Perlowski was hospitalized four times and had two emergency surgeries. There is evidence of brain inflammation, accompanied by headaches, short-term memory loss and shortened endurance for cognitive mental activities. Dr. Perlowski also experiences new sensitivity to light and smell. For example, the once-delicious smell of a hamburger is now nauseating to her.
“I’m recovering from what is basically a traumatic brain injury,” says Dr. Perlowski. “I used to be able to work up to 16 hours without sleep and still function fully. Now I have to take frequent breaks and not push too hard so I don’t trigger my symptoms.”
The neurological effects are just half of it. Dr. Perlowski lists gastrointestinal symptoms and a decline in kidney function among her ailments, though she’s most concerned about dysautonomia. Dysautonomia, she explains, is a group of medical conditions that stem from problems with the autonomic nervous system that controls involuntary body functions like one’s heartbeat, breathing and digestion. Dr. Perlowski specifically suffers from postural orthostatic tachycardia syndrome, a blood circulation disorder that causes lightheadedness, fainting and rapid heartbeat, especially when a person stands. That’s especially troubling for a doctor.
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“My body doesn’t regulate the way it used to, and I can’t stand for prolonged periods of time,” she says. “I used to be on my feet up to 16 hours a day, and now I conduct most of my work in a seated position.”
A study published in the Therapeutic Advances in Chronic Disease reports that upon entering the central nervous system, COVID may infect the brain, causing brain inflammation. In rare cases, COVID-19 could result in life-threatening symptoms like Guillain-Barré Syndrome, where the immune system damages the nerves, leading to muscle weakness and even paralysis.
“Basically everyone who has long COVID has at least one of the things I mentioned — terrible neuropathies, crushing fatigue and aches” says Dr. Perlowski. “I didn’t know if I was going to make it [that first year], and once I realized I was going to survive, I was left with all these impairments. I was a fully functional person in a prestigious field, and to know my life was going to change forever was devastating.”
A study published in The Lancet estimates that 23% of long COVID patients couldn’t go to work because of their symptoms, while 46% had to reduce their working hours. This means employers are faced with millions of workers who are struggling to return to their lives without seriously compromising their health.
“This is definitely a conversation we are having with our clients,” says Santiago Landazuri, assistant vice president and employee benefits consultant at USI Insurance Services. “It’s important for employers to be aware, and see things like fatigue and a lack of productivity from a different perspective.”
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Landazuri is urging employers to prepare for a permanently altered workforce with symptoms that will vary in intensity and recovery time. Beyond physical recovery, workers will also be faced with depression, anxiety and post-traumatic disorder.
“How do you manage a growing group of disabled workers?” says Landazuri. “It goes back to total person health. We can’t expect employees to perform if we are not taking care of them outside of work.”
This means employees need benefits that include access to cost-effective physical and mental healthcare while encouraging employees to get annual exams and seek primary care so any health issues are identified early.
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In addition, Dr. Perlowski advises employers to offer flexibility and work-from-home options, so employees can maintain professional responsibilities without pushing themselves past their limit. Most importantly, employers have to be open to listening to their employees and learning about their specific needs, whether time off their feet or additional time to complete assignments if a decline in cognitive ability is impacting them, she explains.
“It’s crucial that employers are open to whatever new disability a person may have,” she says. “If we are supportive and empathetic, employees will feel more comfortable recovering as they go back to work.”
Since long COVID is relatively new, there is still ongoing research as the medical community tries to define the scope of its damage to survivors. However, that does not mean survivors’ needs should wait.
“COVID recovery is not uniform, and everything depends on what damage the virus did to a particular person,” says Dr. Perlowski. “I encourage employers to learn about this condition, be receptive and understand what an employee might be going through.”
