Long COVID is a condition where individuals experience persistent or new symptoms that last for months or years after the acute phase of COVID-19. Common symptoms include severe fatigue, shortness of breath, brain dysfunction and others which have an impact on everyday functioning, including the ability to work. These symptoms may exhibit fluctuations or experience relapses over time.
When discussing their symptoms, one patient told the British Heart Foundation: “It felt as if I had a constant brick on my chest, it was so heavy. If I went up a flight of stairs my heart would start racing, and it would stay like that for minutes on end. And I was tired all the time.”
The mental health impacts of Long COVID can also not be ignored. One study found that 34% of people suffered from mood disorders or anxiety six months after their initial COVID-19 infection, with the Royal College of Nursing’s Professional Lead for Mental Health asserting: “There’s a link between increased rates of mental and emotional struggles with any long-term debilitating condition…Although long COVID is not yet clearly defined, generally people who experience the longer-term effects of contracting COVID-19 are also experiencing mental health struggles as they come to terms with increased isolation, anxiety and renewed fears of what will happen to them.”
The World Health Organisation asserts that more than 17 million people across the WHO European Region may have experienced long COVID during the first two years of the pandemic. In the UK, the latest figures suggest approximately 2 million people living in the UK (3.1% of the population) were experiencing self-reported long COVID symptoms in January 2023. Furthermore, US data shows that 40% of adults in the United States reported having COVID-19 in the past, and nearly one in five of those (19%) are currently still having symptoms of “long COVID.” The prevalence of the condition means it has become a consideration and a concern for employers.
The neurodiverse community including individuals who have conditions such as ASC, ADHD, dyslexia, and other neurological differences may face additional challenges as long COVID symptoms can exacerbate these difficulties, making it more challenging for individuals to manage their environment and engage in daily activities.
Recent research has shown that neurodivergent individuals are most likely to experience health problems that are characterised by central sensitisation. This research further asserts that long COVID can also be described as a heightened response to internal stimuli and as such found that higher autistic traits predicted COVID-19 symptoms that lasted more than 12 weeks regardless of formal autism diagnosis. Similarly, there is research that suggests people with ADHD experience long COVID more distinctly than the average neurotypical person.
Brain fog, memory problems, and difficulties with concentration and executive functioning are common symptoms of long COVID. These cognitive impairments can compound existing challenges for individuals with neurodivergent conditions, affecting their ability to focus, organise tasks, and communicate effectively.
Issues with executive functioning and concentration are typical symptoms of ADHD and with long COVID heightening these symptoms further, it’s clear people with ADHD may need further support in returning to work or requiring additional time to recover.
Furthermore, symptoms of COVID-19 can be more pronounced in people with ADHD, with further research reporting that ADHD was associated with greater COVID-19 symptom severity and rates of hospitalisation.
Many of the neurological symptoms of long COVID mimic those of ADHD or other cognitive disorders so people with ADHD may find their symptoms further exacerbated due to the condition.
Some research has found that some treatments originally developed for ADHD can help in managing the “brain fog” associated with long COVID, with Yale School of Medicine assistant professor of psychiatry and of neurology Arman Fesharaki-Zadeh explaining:
“There’s a paucity of treatment out there for long COVID brain fog, so when I kept seeing the benefits of this treatment in patients, I felt a sense of urgency to disseminate this information.”
Leading employment organisations including ACAS have published guidance for employers supporting employees with long COVID. Employers need to recognise the effects of long COVID can fluctuate and an employee’s needs will fluctuate similarly. Their symptoms may worsen meaning they cannot work on some days but can on others.
Managing employees with long COVID in addition to ADHD requires real focus and a commitment to recognising and understanding their needs as an individual. If an employee chooses to disclose their long COVID symptoms, then employers should work with them to define the right level of work and any reasonable adjustments necessary to help in their recovery.
The prevalence and potential of long COVID to affect many people means it makes sense for employers to explore their approach to reasonable adjustments. Throughout the pandemic most organisations had to convert to remote working, for example, and for people living with long COVID symptoms, this may be a preference so they can still actively work but not have the difficulty of the commute.
Employers may also consider allowing employees additional breaks, flexible hours to attend medical appointments and adapt their working practices to suit employees with long COVID. If employees are unable to work, employers could also consider a phased return to help them assess how much they can manage and work to their full potential.
The pandemic taught employers the benefit of being agile and adaptive. To adequately support individuals affected by long COVID and create workplaces that are more suitable, in general, for a wider spectrum of people and their individual needs, it is important to maintain this agile and flexible approach.
From a practical perspective, employers could look at flexible and remote working, role-sharing options and putting in place robust well-being initiatives to support the whole workforce. Investing in diversity awareness and neurodiversity training can also be valuable in widening awareness of neurodivergence within the workplace and helping your employees to recognise there is help available.