The impacts of COVID-19 can be felt across all aspects of our lives. There is hope for a return to a semblance of normal in the coming months. Yet, many of those who have suffered from COVID-19  will continue to experience symptoms long after the acute course of the disease, impacting their ability to return to work. These sufferers are being labelled COVID long-haulers.

“Long COVID” is a new diagnosis that attracts research attention, but there is no universally agreed-upon definition, duration, or course of treatment. Long COVID is often described as ongoing multi-system symptomology four weeks after initial diagnosis and sometimes after 12 weeks.

In one UK study of 20,000 COVID cases, 13.7% of patients continued to have symptoms for over 12 weeks1. A recent Public Health Agency of Canada study found that more than half of COVID-19 patients might experience post-COVID symptoms four weeks post infection7.

Although initially thought of as a respiratory illness, it is now considered a multi-system disease affecting multiple organs4. Symptoms can be varied, with the most common being fatigue, pain, shortness of breath,  sleep issues, and anxiety and depression. Many people have had a COVID positive test, but it is not a prerequisite and can affect any age group or population.

Due to the self-reported nature of many of the symptoms, finding a consistent and appropriate level of treatment has been a challenge. Clinical care is often specialized, and because long COVID is a multi-system disease, it requires a multi-disciplinary approach to care, focusing on a comprehensive review of symptoms and pathology. Patients were found to respond best with a bio-psychosocial and vocational approach that can include investigations, physiotherapy, respiratory physiologists, psychology,6 to name a few. Many cities and countries are also starting to establish post-COVID treatment centres.

Employers will need to work closely with their employees and disability case managers (where applicable) to coordinate the best approach to developing return to work plans. Most long-haulers will require a slow, progressive return to work plan that considers their employee’s physical and psychological health and addresses any safety issues and short-term or permanent accommodations.

Employers can consider implementing disability management products, wellness programming, and virtual care options to support employee wellness and mental health. A Deloitte study from 2019 showed for every dollar invested in mental health programs in the workplace, return on investment (ROI) after one year was 1.62 and after three years, ROI 2.188. This investment can help reduce some of the burdens that will be felt with our health care system and improve access to care.

With the right supports, treatment and return to work plans, the prognosis remains slow but good for most long-haul sufferers.

For more information on how Cowan can help employers and employees with their wellness solutions and disability management products, please reach out to your consultant or contact us.



  1. CarfìA, BernabeiR, LandiF, 3-605. doi:10.1001/jama.202Group GAC-P-ACS. Persistent Symptoms in Patients After Acute COVID-19. JAMA. Aug 2020;324(6):600.12603
  2. Garrigues E, Janvier P, KherabiY, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. Aug 2020;doi:10.1016/j.jinf.2020.08.029 -L M, H J, M W, et al. Neurologic Manifestations of
  5. Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA neurology. 06/01/2020
  8. (.PDF)