Long COVID Might be Taking Toll on Health Care Workforce

Long COVID might be exacerbating the labor shortage in the United States as a whole and in health care in particular, according to recent data about both problems. This doesn’t surprise Linda Spaulding, RN-BC, CIC, CHEC, CHOP, an infection prevention consultant and a member of Infection Control Today^®’s (ICT^®’s) Editorial Advisory Board (EAB). Spaulding contends that hospitals want heath care professionals complaining of long COVID symptoms to return to work nonetheless. “They’re not always listened to or told ‘it’s all in your head’,” says Spaulding. “We are going to see more and more of this because no one knows how to treat or care for people with long COVID because it’s a condition that we haven’t dealt with in the past. Some medical professionals and hospital management just don’t want to hear the compliant. They just want you to return to work to care for the patients. No one is caring for the health care workers.”

Katie Bach, MBA, a nonresident senior fellow at the Brookings Institution, estimates that “31 million long Covid patients stayed sick for an average of three months. That means that about 4.5 million may have been sick at any given time over the past 20 months.”

A study in the The Lancet suggests that many workers may also be dealing with long COVID by reducing the number of hours that they’re on the job. The Lancet looks at data from 3762 individuals who’ve complained of having long COVID symptoms. The study states that “for those who returned to their job, respondents reported experiencing relapses triggered by the mental exertion and stress of work, often needing to go back on leave. This emphasizes the importance of all patients having adequate time off to recover, being able to qualify for disability benefits if long-term assistance is needed, and receiving accommodations at work including telecommuting, flexible hours, and phased returns.”

Recent data from the United Kingdom says that of all occupations, health care worker is the third most likely to report symptoms of long COVID. The UK’s Office for National Statistics states that “as a proportion of the UK population, prevalence of self-reported long COVID was greatest in people aged 35 to 69 years, females, people living in more deprived areas, those working in health care, social care, or teaching and education….”

The health care system lost 20% of its workforce over the course of the pandemic, according to the US Bureau of Labor Statistics. The combination of wave after wave of COVID-19 and understaffing at hospitals have resulted—as Spaulding and other experts have told ICT^®—in widespread burnout and fatigue among frontline health care professionals still on the job.

Nurses in intensive care units and non-clinical workers are especially vulnerable to getting COVID-19, according to a recent study in the American Journal of Infection Control.

Rebecca Leach, RN, BSN, MPH, CIC, another ICT^® EAB member, predicts that the health care system will feel the effects of long COVID for many years to come. Many nurses are baby boomers and this may be what pushes them into retirement, which will force hospitals to make systemic changes. Leach says hospitals will “look at alternative care methodologies; things like team nursing and allowing non-nursing clinical staff to practice at expanded roles. Cross-training like we do for free-standing EDs, for example, where you have limited staff, and everyone has to help out with other tasks.”

One good thing that Leach hopes comes out of this is more oversight of traveling nurse pay, saying that there should be “regulation on how much those companies price gouge during these types of emergencies.”

Monica Verduzco-Gutierrez, MD, director of the COVID Recovery Clinic at University Health in Texas, testified before the House Ways and Means Committee on February 3 about the problem with long COVID. Verduzco-Gutierrez tells Axios this morning that cancer patients have said that “their COVID-related fatigue was 100 times worse than when they had cancer and were going through chemotherapy.”

Spaulding warns that “we haven’t seen the worst of staffing shortage yet. I predict that as soon as this current spike tapers off more health care workers will leave their job for other careers and the next spike in cases will be unbearable because of the lack of health care workers. Health care workers deserve better care and respect. Not being pushed back to work too soon just so the unvaccinated have someone to care for them. This is a shortage that will last for a very long time.”

Long COVID might overlap with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). In a recent interview with ICT^®, Jamie Seltzer, the director of scientific and medical outreach for #MEAction, a patient advocacy organization for people suffering from ME/CFS, stated that long COVID could quadruple the number of people in the US with ME/CFS. The Lancet study also points to that possibility. Investigators asked participants whether they experienced worsening symptoms after mental or physical exertion, which is 1 of 3 required symptoms for an ME/CFS diagnosis.

“We found PEM [Post-Exertional Malaise] to be highly represented in this cohort (89.1% at any time during the course of illness, 72.2% at month 7),” the study states. “Intriguingly, among those still experiencing symptoms at month 6 with no PEM (n = 707, 28.8%), fatigue was still the most common symptom.”

Spaulding points to the practical implications of dealing with long COVID and/or ME/CFS. “Many health care workers are single moms who have to leave the workforce to care for their children who get COVID or are sent home from school because of an exposure. Where is their assistance? Who is standing up to help them? The unvaccinated sure aren’t.”