Long COVID a driver of unemployment

Long COVID may have contributed to reduced participation in the UK labour market, a cohort study suggests.

“The main finding of our study is that reporting long COVID after SARS-CoV-2 infection is associated with increased odds of labour market inactivity and long-term absence compared with pre-infection, with the period of greatest excess risk being 30 to <40 weeks post-infection for inactivity and 18 to <30 weeks post-infection for absence,” said the researchers, led by Daniel Ayoubkhani, PhD student at the University of Leicester in the UK.

Inactivity

Compared with pre-infection, labour market inactivity (excluding retirement, ie, neither working nor actively looking for work, and not retired) was higher among participants reporting long COVID 30 to <40 weeks (adjusted odds ratio [aOR], 1.45) or 40 to <52 weeks post-infection (aOR, 1.34). [Eur J Public Health 2024:doi:10.1093/eurpub/ckae034]

The waning effect after 40 weeks may have been driven by individuals who later returned to work after leaving the workforce when they were experiencing long COVID, the researchers explained.

“Combining with official statistics on long COVID prevalence, and assuming a correct statistical model, our estimates translate to 27,000 working-age adults in the UK being inactive because of long COVID in July 2022,” they added.

Workplace absence

Compared with pre-infection, SARS-CoV-2 infection <12 weeks prior was associated with an increased likelihood of long-term workplace absence (≥4 weeks for any reason whilst employed; aOR, 1.09), as was reporting long COVID 18 to <24 weeks (aOR, 1.40) or 24 to <30 weeks post-infection (aOR, 1.45).

“[T]he risk of absence levels off after 30 weeks post-infection, [and this] may partly reflect people returning to work (including those with persistent illness) upon completion of their 28-week period of statutory sick pay,” the researchers explained.

Not the main driver

The team used longitudinal data from a large community-based sample in the UK. The study cohort comprised 206,299 participants (mean age 45 years, 54 percent women). Of these, 15 percent were ever labour market inactive during follow-up. Of those employed from October 1, 2021 (n=147,895), 10 percent ever reported long-term absence.

Among those who tested positive for SARS-CoV-2 during follow-up (n=97,751), 8,440 (8.6 percent) reported long COVID ≥12 weeks post-infection.

“This research reveals a significant association between the challenges of returning to work and the lingering effects of long COVID,” commented study co-author Professor Kamlesh Khunti, also from the University of Leicester, in a press release. [https://le.ac.uk/news/2024/march/covid-working]

The researchers added that the reduced working capacity, as well as its downstream effects on income and living conditions, could negatively impact the physical and mental wellbeing of affected individuals.

“[The study] underscores the need for a compassionate and supportive approach to those grappling with this extended illness … Understanding the intersection of health and employment is crucial in navigating the complexities of long COVID and fostering a more inclusive recovery for all,” Khunti added.

While the findings underpin the role of long COVID in the reduced participation in the UK labour market, it is unlikely to have been the sole – or even main – driver, the researchers noted. The number of working-age adults who became inactive owing to ill health had been gradually on the rise since early 2019 – before the pandemic even started. [https://www.ons.gov.uk/employmentandlabourmarket/peoplenotinwork/economicinactivity/articles/halfamillionmorepeopleareoutofthelabourforcebecauseoflongtermsickness/2022-11-10]

“The contribution of factors besides long COVID to reduced labour market participation, such as indirect health effects of the pandemic and extended healthcare waiting lists, remains unknown, and further research is required,” the researchers said.