Reflections on 12 months of supporting people back to work post-Covid-19.

Our Careers and Employment Specialist shares her experience

As with everything since the pandemic started, the process of supporting people returning to work has been a steep learning curve. We asked our specialist Career and Employment Consultant for some reflections on her work with post-Covid clients over the last year.

I have worked as a Career and Employment Consultant for Vitality360 for five years, supporting people with persistent fatigue and pain to either return to or remain in work. Starting to work with clients with Long Covid felt daunting because of how new the condition was, and how little knowledge we had about the long term effects and prognosis.  88% of our Long Covid clients reported that they were employed when they first approached us, and of those 69% were off work and on sick leave, 14% were working reduced hours and 4% were struggling to sustain their contracted hours.  Vitality360 is a multidisciplinary team, so whilst my clinician colleagues were helping clients to improve their health, my role was to ensure that even if they weren’t ready to return to work by the end of the programme, they had the tools to enable them to do so when they had recovered sufficiently. 

Clients would often say at their first meeting that they didn’t feel they would ever be well enough to return to work. However, the good news is that in our experience the majority of the people we have worked with have managed to either go back to work, or feel that they know how to return to work sustainably when they are well enough to do so. We don’t yet have enough data to provide any in-depth analysis about this cohort in relation to work, but my own reflection on this has led me to wonder whether this could be in part because we have been able to provide early interventions for our Long Covid clients. Although they have felt as though they have been unwell for significant lengths of time, this has been shorter than many of our pain and fatigue clients. Although the diagnostic criteria of Long Covid and ME/CFS of experiencing symptoms for 12 weeks (or 3 months) has become more aligned, historically this period has been longer for people with ME/CFS. In addition, Long Covid usually follows an obvious onset of infection, whereas this isn’t always as clear cut for people with ME/CFS.

Clearly everyone we see with Long Covid has a range of different symptoms that have an impact on their ability to work. Even from the early stages of research into Long Covid we were aware that for many people their primary long-term symptom was fatigue – especially cognitive fatigue. Most of the people I have worked with over the last 12 months have identified this as one of their biggest concerns when it comes to contemplating their return to work. Our ability to think quickly, take in lots of information, or simply to communicate with colleagues is a large part of how we perceive our identity at work. When this becomes challenging, it is tempting to think that we can’t do our job anymore. I always remind people that they are just as capable as they always have been, but their capacity has changed – so it might be necessary to take more breaks, or a task takes a little longer and you need fewer distractions. Our clinicians work with people to help them improve their cognitive capacity but there are also strategies and adaptions that can be made at work that we discussed in our recent blog about cognitive fatigue.

Many people have taken one of two approaches to their return to work: either going back before they were ready, or trying to wait until they felt 100% better. As we know from other post-viral conditions, it is essential to increase activity slowly and that includes the speed at which you return to work. We recommend an extended phased return (usually over 12 weeks) and that not only are the hours worked increased gradually but also the intensity and complexity of the tasks at work. It might be that beyond that time it is still useful to have some adjustments made, either on a temporary basis or permanently. These can include simple things like allowing someone to continue to work some of their days from home, or adjusting times to avoid rush hour. Doing this increases the likelihood of a sustainable return to work.

Unfortunately, it doesn’t look like the number of Long Covid cases is abating, but taking forward the lessons learnt over the last twelve months gives me the confidence that people’s health can improve and they can return to work in a sustainable and productive way.