By Myrna Sachs, head of Alexander Forbes Health Management Solutions

Lingering after effects of Covid-19 which persist for more than six weeks have been deemed “Long Covid” by the World Health Organization – and those holding down jobs need to manage their symptoms while being expected to return to work.

While Long Covid is not common knowledge, we can gauge its prevalence from a December 2020 article in the Lancet medical journal. One in five people who had Covid-19 had persisting symptoms for more than five weeks and one in ten had symptoms for longer than12 weeks.

Over the past six months South African insurers have noted that sickness benefits or income replacement benefits have increased year on year.

Fatigue and headaches are the most prevalent symptoms. Other symptoms include:

• extreme tiredness (fatigue)
• shortness of breath
• chest pain or tightness
• memory and concentration problems (brain fog)
• difficulty sleeping (insomnia)
• heart palpitations
• dizziness
• pins and needles
• joint pain
• depression and anxiety
• ringing or buzzing in the ears (tinnitus) or earache
• diarrhoea
• stomach aches
• high temperature
• sore throat
• loss of sense of smell (anosmia)
• rashes

The symptoms may be constant, fluctuate, or appear and be replaced by symptoms relating to other symptoms with varying frequency.

Long Covid-19 may linger three months or more after Covid isolation, even up to 12 months. This may affect overall work performance, resulting in extended medical incapacity, a disability claim or both.

Return-to-work process for employees

Companies need to take a holistic approach according to Alexander Forbes Health Management Solutions’ (AFHMS) experience with clients. Include all intervention service providers such as occupational health, health risk managers, employee assistance programme providers and the wellness team to support the employee through a graded return to work and work accommodation.

Telephonic contact with the individual has proved to be successful in understanding the symptoms, the impact it has on productivity. accommodations in place and follow-up appointments with the treating doctor

AFHMS follows this process with some clients:

1. Human resources submits a consent form signed by the employee and provides contact details of the individual and a family member to the health risk manager.
2. The health risk manager contacts the individual or family member to establish the nature of the medical condition (hospitalisation, self-isolation, symptoms). They also conduct regular follow-ups with the individual on the progress made with their medical condition and determine whether any reasonable accommodations are required during reintegration
3. With Long Covid-19 cases, a referral for an incapacity investigation is initiated to determine whether the individual can fully perform the duties of their own occupation (contact with the treating doctor, specialist and physiotherapist may be necessary).
4. Depending on the outcome, further referrals could be made to extend sick leave, assist with a disability application, chronic disease management with medical aid, conduct a fitness-for-work assessment, join a return-to-work programme or assist with ergonomic assessments.

Using Covid-19 sick leave data to make correct interventions

If employees have taken more than 18 days leave for Covid-19, this could signal possible Long Covid-19 risk.

Employees who are on the high-risk register could show an aberrant sick leave pattern that warrants closer management through the appropriate channels. This should be a parallel process to the Long Covid incident and questionnaire, and assist in understanding the ongoing symptoms that the employee presents with.

Our experience with Long Covid-19 cases has taught us that each case may vary due to the various symptoms that individuals present with. For this reason, there cannot be a one-size-fits-all approach.

ENDS/