New guidance on managing pandemic’s ‘sting in the tail’ of long Covid

Long Covid is the ‘sting in the tail’ of the pandemic and is increasingly being recognised as a ‘massive’ public health problem, SOM, the Society of Occupational Medicine, has argued.

In new guidance on the often-debilitating long-term post-Covid symptoms being experienced by as many as two million people, SOM has urged employers to take a more strategic, planned approach to managing long Covid in their workforce.

“There needs to be early, appropriate intervention, using occupational health input – rather than leave it to individual line managers to decide how to best manage each case,” the position paper, Long Covid and Return to Work – what works?, has argued.

The guidance distils our latest knowledge about the condition, or series of conditions. It looks at at-risk groups, its impact on ability to work, assessment of function, and what is required in terms of support and rehabilitation.

There are then a series of best practice case studies, including the UK Defence Medical Rehabilitation Centre’s Covid-19 recovery service, work being done by the Northern Ireland Department of Health, a staff long Covid service being run by Swansea Bay University Health Board, and a long Covid programme being operated by the Royal Melbourne Hospital in Australia. The guidance also looks at NHS England’s network of some 90 long Covid assessment clinics.

There are a series of appendices covering universal first-line screening assessment, ‘red flags’ and specialist referral, treatment that can help function and recovery, rehabilitation, specific fitness for work considerations, examples of workplace adjustments, prevention of infection, and workplace public health messages.

In all, the guidance is calling for equity of access to return-to-work services for people with long Covid, better education of doctors and health professionals in long Covid, and better systems for timely referral to specialists (especially cardiac, respiratory, neurological).

Crucially, the guidance emphasises the importance of employers have access to occupational health expertise to advise on managing long Covid. There is also a need for organisations to review their absence management and flexible working practices, and for line managers to receive training and guidance in sickness absence management and how best to support employees with long-term fluctuating health conditions such as long Covid.

Dr Clare Rayner, retired consultant occupational physician and long Covid expert, said of the guidance: “Occupational health professionals can support people with long Covid with their return to work and advise on improving their daily functioning.

“Early intervention can make a significant difference to the severity and length of long Covid. A one-off scan or specialist consultation in the early phase to pinpoint the key issues can mean recovery within weeks rather than months,” she added.