New research reveals the hidden economic burden of long COVID on the workforce, showing millions of missed workdays and costing the economy billions.
Study: Long-COVID is associated with increased absenteeism from work. Image credit: PeopleImages.com - Yuri A/Shutterstock.com
Researchers at the University of Utah, USA, and Hannam University, South Korea, investigated the rate of absenteeism among employees with long COVID. They found a significant loss of productive workdays due to persistent health complications. The study is published in PLOS ONE.
Background
The coronavirus disease 2019 (COVID-19) pandemic has put an unprecedented burden on the healthcare system worldwide. A large proportion of individuals who suffered COVID-19 have experienced persistent health consequences requiring comprehensive medical care, commonly known as long COVID.
Long COVID is a chronic condition associated with COVID-19 that develops following an acute infection and persists for at least three months. In this study, long COVID was defined by self-reported symptoms lasting three months or more that were not present before the COVID-19 infection and were present at the time of the survey.
The most common symptoms of long COVID are post-exertional malaise, fatigue, cognitive difficulties, dizziness, gastrointestinal problems, and heart complications.
According to the 2024 US national survey report, approximately 18% of adults reported ever having experienced long COVID, with 7.5% reporting currently experiencing long COVID symptoms. These estimates suggest that about 60 million people in the United States could have been affected by long COVID.
Considering its novel etiology, several studies have investigated the short-term and long-term health consequences of long COVID. However, there remains a gap in research regarding the economic impact of long COVID.
In the current study, researchers investigated whether employees with long COVID experience higher missed days in the workplace than those without the condition. Their objective was to provide insights into the potential impact of long COVID on the labor market.
The study
The researchers analyzed data from a nationally representative sample of 131,685,516 adult full-time employees aged 18-64 from the 2022 Full-Year Population Characteristics file of the Medical Expenditure Panel Survey. The survey sample represents the civilian non-institutionalized population on a national scale.
They used appropriate statistical models to assess absenteeism rates in adult employees with long COVID, a history of COVID-19, or no COVID-19 infection. The analysis is adjusted for age, sex, race/ethnicity, income, insurance, marital status, and pre-existing health conditions.
A two-part statistical model accounted for many individuals who reported zero missed workdays. The survey relied on self-reported responses, introducing the potential for recall bias, which could influence the findings.
The study also notes that its cross-sectional design means it can only observe associations and cannot establish that long COVID directly causes absenteeism. Additionally, the survey did not specify whether respondents worked remotely or in person, which could impact the number of reported missed workdays.
Study findings
The prevalence of long COVID in the full-time employed study population was 7%, with women having a significantly higher prevalence than men. The risk of long COVID was also significantly higher among employees with pre-existing health conditions, such as hypertension, diabetes, asthma, arthritis, physical limitations, and cognitive limitations.
The absenteeism rate among employees with long COVID was, on average, eight days within a calendar year. In contrast, the employees without long COVID had only four missed workdays during the same period.
Compared to employees without long COVID, those with long COVID experienced an additional 2.54 missed workdays, with women experiencing 1.45 more missed workdays than men.
Various health conditions, such as asthma and arthritis, were associated with an additional 1.52 and 2.11 missed workdays, respectively. Similarly, pre-existing physical and cognitive limitations were associated with an additional 2.52 and 2.54 missed workdays, respectively.
Compared to employees who never had COVID-19, employees with a history of COVID-19 and those with long COVID experienced 1.90 and 4.05 more missed workdays, respectively. A sensitivity analysis including COVID-19 vaccine status found no significant difference in absenteeism rates between vaccinated and unvaccinated groups.
These findings are based on self-reported data and a cross-sectional analysis. The reliance on self-reported data introduces limitations, such as potential recall bias, so the study cannot determine causality.
Study significance
The study reveals that individuals with long COVID experience significantly higher absenteeism in the workplace within a calendar year compared to those without the condition. These findings highlight the significant negative impact of long COVID on workplace productivity and the overall economic system.
Individuals with long COVID histories often experience difficulties resuming work or maintaining their pre-pandemic productivity at the workplace. While not all affected individuals require it, many may need to reduce or adjust their workload, resulting in reduced income, job loss, and financial hardship.
The workplace challenges associated with long COVID are particularly high in service industries such as healthcare, social care, and retail. Labor shortages in these sectors have resulted in increased wages and prices in the United States, contributing to the recent inflationary pressures observed in the country.
Existing evidence suggests that the risk of long COVID is higher among females, older adults, and those with health conditions. The current study findings also support these demographic characteristics of long COVID and highlight the need for prompt, targeted interventions to manage these high-risk populations.
According to the study findings, approximately 9.2 million US employees with long COVID had about 2.5 more missed workdays, accounting for a total work loss of 23 million days a year. Based on the average daily income in the United States, the estimated additional workplace productivity loss costs due to long COVID could be around 6.4 billion USD.
These estimates highlight the significant public health and economic impact of long COVID and provide economic rationale for increased investment in long COVID treatment for employers and policymakers.
The researchers suggest that remote work facilities, flexible work schedules, or shorter workdays could be practical arrangements for employees experiencing activity limitations due to long COVID.
The authors also note that support systems, such as improved healthcare coverage, disability benefits, and rehabilitation programs, may be necessary to help affected individuals return to work and reduce the overall economic burden.
The study also points out that differences in return-to-work rates and social security system support may exist internationally, with US and Chinese workers generally returning to work faster than their European counterparts.
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