Long Covid is keeping millions out of work – and worsening labor shortage in the US | Fiona Lowenstein and Ryan Prior

We’ve all seen the headlines about labor shortages, worker attrition, or – as many mainstream media outlets refer to it – “the Great Resignation”.

It’s true: since 2020, a record number of people have quit their jobs. The trend is ongoing, and some argue quitting is contagious. But, there’s another contagion that’s probably causing people to leave the workforce in droves.

Since 2020, there have been more than 95m recorded US Covid-19 cases, 1 million deaths and ongoing reports of Covid-induced chronic illness and disability, known as long Covid. A recent study by the Centers for Disease Control and Prevention estimated that long Covid affects one in five people infected with Sars-CoV-2. A recent Brookings Institution analysis found that as many as 2 to 4 million people may be out of work as a result. With more than 11m US jobs vacant, it’s plausible that up to one-third of current labor shortages are due to long Covid.

In other words, the Great Resignation may be a symptom of a mass disabling event.

So, why aren’t we talking more about quitting and long Covid? Instead of investigating the impact of continuing pandemic harms on the workforce, many have been quick to frame the Great Resignation through stories of white-collar workers seeking better work-life balance. For a society supposedly eager to move on from the pandemic, long Covid is an inconvenient truth. Its potential impact on the workforce is even more inconvenient, since governments frequently cite economic trouble as justification for dropping Covid-19 mitigation efforts.

Despite a widespread media focus on white-collar workers who have quit, pandemic worker attrition is most obvious in “essential” industries that require in-person work. Many states face drastic teacher shortages and healthcare workers continue to quit. The restaurant and food service industry still experiences severe pandemic-related labor shortages today. These workers faced higher rates of infection than those working remotely, and probably experience higher rates of long Covid – both because preventing infection is the only way to prevent long Covid and because reinfection may increase risk.

It stands to reason that long Covid may be driving shortages in these industries. A 2021 study by scientists at the University of California San Francisco indicated that line cooks faced the highest risk of mortality from Covid-19. One in five educators are long-haulers, and healthcare workers with long Covid say workplace pressures make it difficult to retain employment.

As two people personally affected by post-viral illnesses, we understand the difficult choices facing long-haulers who can’t survive financially without working. We both rely on remote work and flexible schedules to manage our health – privileges many with long Covid lack. Our symptoms are also milder than many, allowing us to work at all. More severely sick long-haulers face major barriers accessing social security disability benefits. Those who do qualify will receive a mere $1,358 on average each month.

When Tracey Thompson became too sick to stand, it was clear she couldn’t return to her former job as a chef. More than two years later, Thompson is unemployed and disabled, with cognitive dysfunction and “overwhelming fatigue”. She recently regained enough strength to lift a single frying pan, but remains housebound and mostly bed-bound. “A lot of the normal avenues of work – like physical labor or mental labor – are cut off for me,” she explained. “You can’t cook remotely.”

Since getting sick, Thompson has connected with other long-haulers who are similarly out-of-work. “There’s a lot of people that are just barely hanging on … by a thread,” she said. “And there are people who have definitely been going to work unwell.” Unfortunately, pushing through long Covid symptoms to continue working can result in worsened health. But, as Thompson explains, “people can’t afford to take time off”.

Leigh, a physical therapist in Ohio who prefers to be identified by just her first name, is one such long-hauler. She sometimes finds herself forgetting interactions with patients and rarely has time to care for herself. If she could retain healthcare benefits while working less, she’d do it. “I’m so sick of being tired all the time,” she said. “I don’t want to let anyone down, but I am … struggling. And I’m not sure I want people to know how much.”

While long-haulers fight to maintain employment, a TikTok video about “quiet quitting” set off a flurry of news coverage describing workers who are saying no to hustle culture. As with the Great Resignation, most discussions of “quiet quitting” fail to address the impact of pandemic harms, focusing instead on perceived generational divides. To borrow a phrase often attributed to Mark Twain, it’s as though a TikTok meme went halfway around the world before the truth had time to put its shoes on.

“Quiet quitting” and resignations may also be driven by recent removals of remote work options, mask mandates and quarantine requirements. Some long-haulers who can work part- or full-time are now sidelined due to increased risk of reinfection. These people are joined by millions of other high-risk individuals who have been increasingly marginalized from society, and now must fend for themselves.

The connection between workplace safety, chronic illness and labor is not new. For decades, health justice activists have urged policymakers to respond to rising rates of disabled poverty, demanding better workplace accommodations and disability benefits. However, policymakers continually fail to adequately address these issues. Erasing disease is easier in a world where chronically ill people often seem to vanish from society altogether.

Since we started covering long Covid in spring 2020, the patients we have spoken to have consistently detailed drastic financial issues. Yet little has been done to help. Instead, long-haulers burn through savings accounts, lose their homes and trudge back and forth to jobs they can no longer safely perform. Some might call this a Great Resignation, or “quiet quitting”. To us, it’s an example of government negligence in the face of a public health crisis, and the impossible choices facing chronically ill and high-risk workers today.

Fixing the labor shortage means treating, accommodating and mitigating long Covid. It also requires building a society in which disabled people can participate.

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