Two-and-a-half years into the pandemic, millions of Americans are still suffering from long-term effects of COVID-19, otherwise known as Long COVID. The health impacts are clear, What’s not clear is the impact on the economy and the workplace.

“I’m desperate to get back to work, but I still can’t work at a desk or talk for more than 20-30 minutes without needing to rest for hours at a time,” Charlie McCone, a 32-year-old based out of San Francisco, told Yahoo Finance. “I feel like people read things like that from Long COVID patients and think it’s an exaggeration, but I wish it were.”

That collective suffering — symptoms include fatigue, “brain fog,” heart palpitations, and autoimmune conditions — is affecting the economy: As many as 4 million individuals with Long COVID may be out of the workforce because of their symptoms, according to a new Brookings Institution report, suggesting that more than 2% of the U.S. labor force could be sidelined by Long Covid.

According to the Brookings report, “using the average U.S. wage of $1,106 per week, the estimated 3 million people out of work due to Long COVID translates to $168 billion a year in lost earnings. This is nearly 1% of the total U.S. gross domestic product. If the true number of people out of work is closer to 4 million, that is a $230 billion cost.”

Dr. Svetlana Blitshteyn, director of the Dysautonomia Clinic in Buffalo, New York, and a clinical associate professor of neurology at the University at Buffalo Jacobs School of Medicine, has seen the workplace impact first-hand. She’s been studying Long COVID patients since 2020.

“My first patient was a medical resident who couldn’t return to his hospital duties after COVID-19,” Blitshteyn told Yahoo Finance. “He told me that several of his co-workers, including a cardiologist attending, were experiencing the same symptoms.”

By December 2020, Blitshteyn’s research led her to publish a case series of 20 patients with postural orthostatic tachycardia syndrome (POTS), a condition that affects blood flow in the body, and other autonomic disorders post-COVID. Among those patients, an astounding 60% were unable to return to work. At her practice, most of her Long COVID patients have the same issue or require special accommodations like a part-time schedule or working from home in order to maintain employment.

“Obviously, by the nature of my practice, I end up seeing sicker patients, but I think Long COVID is one of the main reasons why there are shortages of workers in health care and other industries today,” she said.

Indeed, that may be partly why the August jobs report showed labor participation rate at 62.4%, below pre-pandemic levels despite more than 11.2 million open jobs as of July 29.

To better understand the impact of Long COVID, Yahoo Finance spoke with several individuals out of the workforce as they continue struggling with their illness.

‘Groundhog Day for the worst hangover you’ve had’

Charlie McCone first developed symptoms in March 2020, when he went to bed one night with chest pain and woke up the next day with a fever, fatigue, and shortness of breath.

“I was laid out for the next two weeks,” McCone said. “I went back to [remote] work on week three because I felt I had been out so long — I had never been out sick for more than 1-2 days. By week four, I thought I was shaking off the last of it so I went on a bike ride and when I got back, the symptoms came rushing back and I was laid out again for the next week. That was my first relapse.”

It’s been two-and-a-half years since McCone first got sick, and he is still battling shortness of breath. “Before I was sick, I was 30 years old with no prior health issues,” McCone said, adding that he would bike 10 miles a day and was also an active tennis player. “I’m now 32, and I’ve spent my entire 30s disabled and housebound with Long COVID.”

McCone initially worked through the illness remotely at his marketing and communications job for the first 18 months until he “essentially collapsed.” For the past year, he’s been on disability as he tries to navigate his next steps.

But the physical issues aren’t the only problem for folks like McCone, experts contend. Studies show that those battling with Long COVID are at increased risk of developing mental health issues. A British study published in BMJ found that COVID survivors are nearly twice as likely to report suicidal ideation than those who haven’t had the virus. An April 2022 BMC Psychiatry study of those with Long COVID in both Japan and Sweden found that they were also twice as likely to report depression, anxiety, or post-traumatic stress disorder.

“I really miss the simple things — going to the park, being able to breathe normally, chatting with friends, listening to music, having coffee,” McCone added. “Give me that back, and I would honestly be OK living my life half of what it used to be.”

As of July 2021, Long COVID is considered a disability under the Americans with Disabilities Act (ADA). McCone has exhausted his short-term disability and isn’t yet prepared to go back to work, which has caused him “major stress.”

“Long-term disability is not set up to deal with cases like ours,” he said. “A social worker just told me ‘don’t even bother applying.’ Right now, I’m just praying I get better before I go broke. This is the only option I’m really left with at this point: ‘Thoughts and prayers.’”

‘The fatigue was so intense’

Pamela Bishop is another Long COVID patient who had to leave the workforce due to her ongoing symptoms. Prior to developing COVID, she was a research professor and research institute director at the National Institute for STEAM Evaluation and Research at the University of Tennessee, Knoxville.

For her, it all began in December 2020 when she noticed one morning that she had lost her taste. Soon, her symptoms intensified and she experienced pain in her legs, derealization, hallucinations, heart palpitations, anxiety, shortness of breath, and chest pain.

“I thought I would die every day for three weeks,” Bishop said. By Christmas, she began feeling better and returned to remote work in January. But, the symptoms returned. “The fatigue was so intense I would have to lie down between Zoom meetings,” Bishop said. “My work day stretched out 12-14 hours because I was resting so much between tasks.”

She was eventually forced to go on leave, applying for the Family and Medical Leave Act (FMLA). The FMLA allows eligible individuals to take unpaid but job-protected leave for specified family and medical reasons with continuation of their group health insurance coverage.

Fortunately, Bishop’s university had a sick leave bank that she had bought into years prior. When it became clear she wasn’t getting better, she applied to use it when her FMLA time ran out and was approved for 90 days. She was granted it three times, the maximum amount, and her colleagues also donated some of their leave to her until she realized she wasn’t improving and decided to resign from her role.

“I would love nothing more than to return to work as my career was a huge part of my identity,” Bishop said. “I spent decades getting my education, obtaining my PhD, and then building my career in academia. My career was really taking off at the time I became ill. Unfortunately, there’s no end in sight to this illness currently, and I have no idea if I will ever be able to return to the workforce.”

What lies ahead

Katie Bach, nonresident senior fellow at the Brookings Institution and author of the Brookings report, said that there are three key ways to try to help these individuals and possibly even get them back in the workforce.

“Number one has to be treatment,” Bach told Yahoo Finance, adding: “We need to know what treatments work, which means more investment in research funding.”

The second is paid sick leave, a luxury not afforded to every American. When some individuals don’t have access to paid leave.

The third bucket: employer accommodation and understanding that Long COVID looks different in everyone.

“This administration’s been very good at saying that Long COVID can be a disability that is protected under the Americans with Disabilities Act,” she said. “I think we need more patience, and … I believe we need to get guidance to employers on how to accommodate people.”

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Adriana Belmonte is a reporter and editor covering politics and health care policy for Yahoo Finance. You can follow her on Twitter @adrianambells and reach her at [email protected].

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