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Support Coronavirus 'Long Haulers' in Your Healthcare Workforce

Analysis  |  By Christopher Cheney  
   January 26, 2021

Healthcare workers who experience long-term symptoms after their acute COVID-19 illness can struggle to do their jobs.

Employers should put measures in place to support healthcare workers who suffer from long-term symptoms after experiencing acute COVID-19 illness, a recent journal article says.

Gary Rogg, MD, an attending physician in internal medicine and co-director of the Post-COVID-19 Recovery Program at Westchester Medical Center in Valhalla, New York, says coronavirus "long haulers" can have a range of long-term symptoms. Those symptoms include cough, shortness of breath, anxiety and depression, cardiac issues, constitutional symptoms such as numbness and tingling, deconditioning, and hair loss.

As of Jan. 21, there had been more than 373,000 COVID-19 cases among U.S. healthcare workers, according to the Centers for Disease Control and Prevention.

The recent journal article, which was published by The Lancet Respiratory Medicine, says healthcare worker coronavirus long haulers can experience symptoms that interfere with the ability to do their jobs. "The barriers to returning to work are often low energy, cognitive symptoms, and affective symptoms. For example, a middle-aged, critical care nurse with years of both clinical and academic experience described having poor focus during patient encounters, forgetting names of essential medications, and debilitating fatigue after a typical workday," the co-authors wrote.

Recommendations to help healthcare worker coronavirus long haulers

A multidisciplinary team should be created to develop return-to-work strategies for healthcare worker coronavirus long haulers, the co-authors wrote. "This team might include individuals with specialism in neurology, psychiatry, psychology, pulmonology, physiatry, and other subspecialties, in collaboration with primary care staff."

Employers can take several actions to support coronavirus long haulers in their workforces, the co-authors wrote. "Examples include reintroduction into the workforce in phases, limiting shift schedules that disrupt natural circadian rhythms, mandating breaks to avoid post-exertional neurological symptoms, partnering with other workers to facilitate oversight while multitasking, and gradually increasing responsibility and workloads. Although these measures might be costly in the short term, they might also allow for a previously healthy, skilled healthcare professional to continue working long term."

Shift changes and easing workloads are effective strategies to get healthcare worker coronavirus long haulers back to work, the lead author of the journal article told HealthLeaders.

"In our experience, it does seem that reduced work hours and a flexible schedule avoiding night shifts to promote rest and recovery works best to prevent debilitating post-exertional fatigue. The creation of a backup or supervision system for employees returning to work might also be useful to avoid coverage gaps in the event of post-exertional fatigue while work hours are being gradually increased. Most importantly, we recommend dialogue between employers, employees, and occupational health about what is helpful on an individual basis," said Nathan Praschan, MD, MPH, a senior resident at Massachusetts General Hospital/McLean Hospital Adult Psychiatry Residency.

Employers should support healthcare worker coronavirus long haulers to help ensure adequate staffing during the pandemic, he said. "We think supporting healthcare workers struggling with long-term sequelae of COVID-19 as they return to work will help maintain the workforce as it continues to handle the pandemic. Not only that but also failing to do so would amount to moral injury among healthcare workers and contribute to burnout."

Related: Cedars-Sinai Launches Heart Clinic for Coronavirus 'Long Haulers'

Christopher Cheney is the senior clinical care​ editor at HealthLeaders.


Coronavirus "long haulers" experience a range of long-term symptoms, including cough, shortness of breath, anxiety and depression, cardiac issues, deconditioning, and hair loss.

Employers can support healthcare worker coronavirus long haulers through multiple measures such as gradually increasing workloads and avoiding night shifts.

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