Long COVID-Challenges in diagnosis and managing return-to-work

Abstract

Objectives: Long COVID may be a public health concern resulting in a hidden toll of the pandemic years later, on workers and their work ability in the workforce. We illustrate the challenges in diagnosing long COVID in a patient, its associated psychological impact on work and how return-to-work can be better managed and supported from an occupational health perspective.

Methods: An Occupational Health trainee working as a government public health officer experienced persistent fatigue, decreased effort tolerance, and difficulties in concentration after contracting COVID-19. There were unintended psychological effects arising from the functional limitations that were not explained with a proper diagnosis. This was further complicated with a lack of access to occupational health services for return-to-work.

Results: He developed his own rehabilitation plan to improve his physical tolerance. Progressive efforts to build up his physical fitness complemented with workplace adjustments helped to overcome his functional limitations and allowed him to effectively return-to-work.

Conclusion: Diagnosing long COVID continues to remain challenging due to a lack of consensus on a definitive diagnostic criterion. This may give rise to unintended mental and psychological impact. Workers with long COVID symptoms can return-to-work, involving a complex individualized approach to the symptoms' impact on work, and workplace adjustments and job modifications available. The psychological toll on the worker must also be addressed. Occupational health professionals are best placed to facilitate these workers in their journey to return-to-work, with multi-disciplinary delivery models providing return to work services.

Keywords: COVID-19; fitness to work; long COVID; return to work.