Long COVID has impacted up to 23 million Americans and counting, many of whom exhibit declines in cognitive function, memory, concentration and communication. As employers and
Researchers at Washington University School of Medicine in St. Louis found that people who have COVID-19 are at an increased risk for developing neurological conditions within the first year of infection. Avivit Ben-Aharon, a speech therapist and the founder and clinical director of virtual speech therapy platform Great Speech, has seen her clients struggle to do once-mindless tasks, like remembering the word "table" or responding to simple questions about the weather.
"We're definitely seeing more patients who are reporting all sorts of symptoms that seem to correlate to COVID — it's affecting their ability to process and interpret the information," says Ben-Aharon. "As a result, speech is impacted by a slow response time, affecting the ability to successfully communicate."
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Caryn Foster Fitzgerald, a clinical nurse instructor based in New Jersey, knows this struggle firsthand. Fitzgerald was a nurse practitioner in palliative care before long COVID made it too difficult to continue. After battling COVID in September 2021, she sought a speech therapist with Great Speech to help her manage her symptoms. Fitzgerald saw significant improvements, but came down with COVID again in January 2022 and was out of work for an entire year. She turned to teaching after deciding she didn't feel safe nursing anymore.
"I couldn't think of words. I couldn't express myself," says Fitzgerald. "I was stuttering. If you go ask me something that requires new thought or higher level things, I still start to get all gobbly gook in my speech."
Ben-Aharon notes that Fitzgerald's experience is not unique. She has seen patients lose focus in the middle of a sentence, develop a stutter and unconsciously leave out parts of words or sentences. Multilingual patients have even reported that they have stronger accents or speak more in their native language despite improvements or fluency they have gained in their second language.
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Ben-Aharon theorizes that short-term memory is especially affected by long COVID — but there are ways to work around it. One common exercise Ben-Aharon practices with patients is word retrieval.
"If you're trying to think of the word 'table', it may help to associate it with a bunch of other words like 'chair' and 'pencil' to make it easier to retrieve," she says. "We try to help our members map words in their brain so they can have an easier time remembering it."
Essentially, by grouping words together, there's a higher chance you can recall one word that reminds you of the word you need. Speech therapists also help patients increase the amount of words they can retain in a short time span. For example, a therapist may tell a patient two words they have to recall later on during their session. The therapist will slowly increase the number of words so the patient can improve their memory.
Fitzgerald's therapist helped her manage the constant stuttering — a skill Fitzgerald is grateful for as someone who now spends her time teaching the next generation of nurses.
"I would try to force my way through the stutter, but now I pause and allow time for my brain to send the words to mouth," she says. "There might be breaks in my speech because I'm trying not to stutter."
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While Fitzgerald underlines that speech exercises have helped her work with her symptoms, it does not disappear overnight. She is still advised to write scripts to prepare for classes or formal conversations.
Beyond that, Fitzgerald still has a list of other long COVID symptoms such as head tremors when there is too much stimulation in her environment, poor balance and worsened tinnitus or ringing in her ears.
Ben-Aharon advises employers to be aware of which employees are experiencing long COVID and be patient with their recovery. This means offering workers more time to complete tasks and projects, extended sick leave and if possible, the ability to work from home. Ben-Aharon predicts more employers will have to incorporate healthcare benefits that help employees manage long COVID as well. She suggests re-evaluating benefits sooner rather than later.
"This is not something that somebody is making up, but a documented result of COVID," she says. "A big percentage of the population has been affected to some degree or another by COVID. It will not be uncommon for us to have multiple employees from the same organization struggling with similar issues."
These issues are ongoing, if not indefinite. Employers may have to consider permanent changes to their work culture and policies if they want their employees to succeed. Fitzgerald admits that she is still struggling and does not feel comfortable returning to nursing. However, speech therapy has helped her regain the confidence to enter the world again.
"My husband and I are so grateful for what [my therapist] has done for me," says Fitzgerald. "At least I can say I am working and contributing something to society and my profession."
