Working with long COVID: Guide for managers to support employees with long COVID

An increasing number of people are experiencing ongoing symptoms from COVID-19 known as post-COVIDsyndrome or ‘long COVID’, which is a significant long-term health condition for some employees. 

As a new, serious health condition, many people with long COVID face a period of great uncertainty as they wait for a diagnosis and an effective management plan. Many individuals often return to work too quickly. Consequently, their return to work is less likely to be sustainable and there are longer-term health risks. This has significant implications for sickness absence, return to work and ongoing work.  

Having a long-term health condition like long COVID can have an impact on an individual’s productivity at work, and their ability to stay in work. However, this impact can be lessened when work is designed and managed in a supportive and flexible way.  

Supporting people’s health and wellbeing is the right thing to do and part of ensuring that people feel safe and valued at work. If an employee is given the support they need to manage their long COVID symptoms, they are more likely to perform at their best and help to achieve the team’s objectives. 

Long COVID is defined by the National Institute for Health and Care Excellence in the UK (NICE) as ‘signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for more than 12 weeks and are not explained by an alternative diagnosis’. 

Research by the Office for National Statistics (ONS) found that the commonly reported symptoms of long COVID include: 

• Fatigue 

• Breathlessness 

• Brain fog and poor concentration 

• Short-term memory loss 

• Slurred speech 

• Chest pain 

• Muscle and joint pain 

• Headaches 

• Sore throat 

• Vertigo 

• Hair loss and changes 

• Digestive difficulties 

• Autoimmune conditions 

• Insomnia 

• Heart rate changes 

• Blood pressure changes 

• Loss of taste  

• Loss of smell  

• Menstrual changes/early menopause  

• Poor skin  

• Depression  

• Anxiety 

Symptoms can be unpredictable and fluctuate over time, so your team member may have a period of recovery followed by a sudden relapse, sometimes with new or different symptoms. A relapse is most likely when people push themselves to perform to the level they did before they were ill. Long COVID symptoms can last for many months, and recovery can be very slow. To find out more about long COVID, see our report Working with Long COVID. 

It’s important when managing someone with an ongoing, fluctuating health condition to take a flexible, individualised and compassionate approach. This relates closely to the behavioural area Building and sustaining relationships. Exercise 5 offers advice on how to develop these behaviours. 

The IGLOO framework for thriving at work, developed by the University of Sheffield and Affinity Health at Work, outlines the different resources at the individual level, the group level, the leader/line manager level and the organisational level that can help an employee when managing a long-term health condition such as long COVID. 

As a manager you can help employees access the work adjustments and support that they need to manage their health and work safely and effectively. What you do and how you behave can affect:  

• whether the employee feels able to take steps to manage their condition in work  

• how early action is taken to help prevent symptoms worsening or recurring  

• ultimately, whether someone is able to stay in work.  

It’s important to understand what your role is for supporting and managing people with a health condition such as long COVID. This also means maintaining clear boundaries. For example, you are there to provide support, but you are not a medical expert or counsellor. This means helping someone with the work aspects of the situation and ensuring that work is not part of the problem. It also means signposting to specialist sources of support, such as occupational health or an employee assistance programme if available.  

Supporting someone with an ongoing health condition can be challenging for you as a manager. It is worth considering what specific support is available within your organisation, like expert advice from HR on people management policies or from occupational health on medical issues if available. Debrief sessions with your own manager might also be helpful (with confidentiality and no specific case details) as well as regular wellbeing conversations and catch-ups.

Related manager behaviour 

This relates closely to the behaviour area Being open, fair and consistent. Look at Exercise 1 for advice on how to develop this area.

Exercise 4 offers advice on Providing knowledge, clarity and guidance. 

Remember that once aware of an employee’s health or disability information, an employer also has a legal duty to consider making reasonable adjustments. 

The behavioural area that will be particularly helpful in this context is: Being open, fair and consistent. Exercises 1 and 2 offer advice on how to develop these behaviours. 

Make sure you understand your organisation’s framework for managing and supporting employees with a long-term health condition like long COVID. This includes health and people management policies, procedures for making workplace adjustments and managing sickness absence, and the support available such as occupational health or an employee assistance programme.

Related manager behaviour 

This relates closely to the behaviour area Providing knowledge, clarity and guidance. Look at Exercise 4 for advice on how to develop this area. 

If your team member is returning to work after a period of absence, they are likely to be experiencing mixed feelings. They might be looking forward to returning to a sense of normality, but may also feel apprehensive about how they will manage their work and whether they will be able to maintain their health when back at work. Many people with long COVID need to return to work slowly, gradually building up their work hours and tasks, sometimes over a period of months.  

Absence and return to work are often managed as a one-off event, but many employees with long COVID will need to take multiple absences as their condition fluctuates over time.  

Taking a flexible, compassionate and individualised approach to sickness absence can help prevent unhealthy presenteeism (working when unwell). 

The CIPD guide Managing a Return to Work after Long-term Absence sets out guiding principles to follow when navigating an effective return to work:  

1. maintaining communication while absent  

2. preparing for a return to work  

3. supporting the employee during the immediate return  

4. supporting the employee on an ongoing basis on return.  

Employees are more likely to return to work safely and productively following a period of sickness absence if they are well supported during their absence and on their return. How you manage these situations will make a difference to whether the individual returns effectively and sustainably to work. 

Related manager behaviour 

The behavioural areas that are particularly important in this context are:  

Building and sustaining relationships: see Exercise 5.

Being open, fair and consistent: see Exercises 1 and 2.

Providing knowledge, clarity and guidance: see Exercise 4.

Some employees may require adjustments to their job role, work environment or work schedule to manage their long COVID symptoms while working. Ensuring employees have access to work adjustments can help them to continue to be productive at work.  

The type of adjustment(s) will differ depending on many factors, including the nature of the employee’s job and their unique needs. As the symptoms of long COVID can be many and varied and also fluctuate over time, different work adjustments may be needed at different times.  

It’s important to recognise that you do not need to be an expert on long COVID – it’s a new and complex condition that even health professionals are still learning about. It’s more important to show good people management skills, including sensitivity, empathy and understanding.  

Many people with a long-term health condition like long COVID learn over time about the most effective ways to manage their symptoms. This means the employee is often in the best position to know what adjustments or support can help them in their job. This could be particularly challenging for people with long COVID, however, because they could experience unpredictable or new symptoms. 

You should discuss and agree any adjustments with the employee. CIPD research on working with long COVID identifies a number of work adjustments or conditions that have helped employees with long COVID to stay in work. These include: 

• home or hybrid working 

• flexible working times 

• reduced or off-peak commuting time 

• making work tasks physically, mentally or cognitively less demanding 

• a wellbeing room for downtime during the working day 

• a supportive organisational culture.

Many people find it challenging to tell others about their health. For someone with long COVID, this could be even more challenging because they may not be able to obtain a clear diagnosis or treatment pathway.  

Everyone’s experience of long COVID and potential symptoms is unique and individual to them. Symptoms can vary from mild to severe and some require changes to their job or working pattern. Conversations will help to identify what workplace support is needed to help the employee to manage their symptoms and carry on working.  

A regular catch-up or one-to-one is an opportunity to continue to show your support for someone when they have returned to work. Remember, recovery from long COVID can be slow and unpredictable, and some people may need ongoing support. Ask simple, open and non-judgemental questions to give the employee ample opportunity to explain their health situation in their own words. Developing your capacity to build and sustain relationships, particularly around showing concern for people and interacting with them in a friendly way, can help with this.  

Listening, treating people with respect and bringing kindness and consistency will help you provide this support, as will your capacity to build and sustain relationships, while skill at handling conflict and people management issues may also be needed. 

The CIPD People Managers’ Guide to Mental Health has useful tips and a conversation checklist that can be followed when having a conversation about someone’s health and its impact on their work. 

Related manager behaviour 

This relates closely to the behaviour area Being open, fair and consistent. Look at Exercise 1 for advice on how to develop this area. 

When people are unwell or have a health condition that requires ongoing management, there are certain things that can help them manage their health and work. 

CIPD research working with long COVID identifies a number of recommendations. These include:  

• Individual actions  

• Group actions by their colleagues 

• Line manager actions  

• Actions taken by their Organisation 

• Help and support from Outside their organisation.  

We call this the IGLOO for working with long COVID.  

Download the checklist to see what you can do to help your team members with long COVID. Read the statements in the ‘Do I…’ column, answering ‘yes’, ‘no’ or ‘sometimes’ and marking your answer in the column provided. 

You can also share the checklists for employees with long COVID and for colleagues to help your team in supporting those with long COVID. 

• NHS advice on long COVID  

• NHS: Your COVID Recovery  

• Society of Occupational Medicine COVID-19 return to work guide for recovering workers 

This guide has been developed by Affinity Health at Work, the University of Sheffield and the CIPD, and outlines practical recommendations developed from the CIPD Working with long COVID research. It draws on evidence and research with returning workers, line managers, occupational health, employment advisers, and rehabilitation professionals as well as HR professionals and the Long Covid Support group.