Employers are rethinking sick leave, work from home policies to protect COVID-19 'long haulers'

By Dr. Alexis E. Carrington & Dr. Jay Bhatt

As the COVID-19 pandemic continues to devastate the United States, many employers are reevaluating their sick leave, work from home and disability policies to accommodate their employees, especially those now known as COVID-19 "long haulers."

Working from home has become the de facto policy of many white-collar job employers, but employees in blue-collar or essential jobs may still be required to show up in person. This has brought up complex and thorny questions about how employers should best protect their workers while on the job.

The novel coronavirus has also brought up concerns about companies' traditional sick leave policies. At this time, if employees do get sick with the virus, they could turn out to be asymptomatic, they could get sick and then quickly recover or they could experience aggressive symptoms and need further care. Some may need more time to recuperate than the standard two weeks of paid sick leave allows.

Some people could experience symptoms for weeks or months, and could end up needing long-term disability coverage; these people are the ones now being referred to as COVID-19 long haulers.

"The first concern of all employers should be for the health and safety of their employees," said Dr. Sachin Jain, an internal medicine physician, the CEO of SCAN Health Plan and the former CEO of CareMore. "Employees who return to work too soon put both their own health and the health of their co-workers at risk."

Different companies are choosing to manage these COVID-19 complications in different ways, and many are reconsidering their in-person work setups.

"Companies should encourage employees to track their symptoms, share that information with their physicians and take [medical] leave as appropriate," said Dr. Asha S. Collins, the U.S. country head for country clinical operations at Genentech. "We still have a lot to learn about this virus."

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When an employee becomes a COVID-19 long hauler, employers should encourage him or her to stay home in isolation, so as to protect his or her colleagues and family members.

"If an employee has symptoms of COVID-19, their employer should work with them to ensure that they have the time and space they need to recover from their illness before they return to the office," said Jain.

According to some experts, COVID-19 could be considered a chronic illness if a person has persistent symptoms.

"[They] fall into the same category as any chronic illness with lingering requirements to have persistent care," said Dr. Ken Abrams, the managing director and chief medical officer at Deloitte.

Employers should be prepared for this, and -- if they don't already -- make sure they have policies in place to ensure that those with chronic illness are not discriminated against, Abrams said.

"It is important for us to promote the importance of recognizing the difference between infectious versus recovered, and should not be discriminating against someone that has persistent symptoms," Abrams said.

Employers are still thinking of ways to make life easier for employees recovering from COVID-19.

Some solutions could include establishing sick leave policies, giving employees access to support services and creating hybrid work environments. Because many COVID-19 patients don't have any symptoms, it may be safer to start implementing widespread testing rather than rely on symptom-based stay-at-home policies.

Medical professionals often wait until people with severe cases of COVID-19, those who have been hospitalized for the virus and those with underlying conditions who were infected, test negative twice before allowing them to stop self-isolating. And now, companies aiming to open their doors are coming up with their own guidelines.

"Adopting testing-based strategies for return to work, instead of symptom-based approaches, may be an option for COVID-19 recovered employees," said Dr. Peter Lee, the global medical director for General Electric. "While these individuals are not considered infectious post-recovery, we still want to be sensitive to all employees and the potential concerns of being around others who may continue to exhibit symptoms."

Nine months into the pandemic, many employees are demanding clear and consistent return-to-work policies from their companies.

"Any company reopening for business should ensure they have robust protocols in place to protect the health and safety of both their employees and customers," said Jain. "Toward that end, employers should stress that sick employees should not come to work."

Some experts believe that COVID-19 could raise questions regarding disability claims for the long haulers, and employers across the country are still determining whether chronic COVID-19 symptoms should qualify for disability claims.

Some companies, however, have not seen any changes in the number of employees filing for disability claims.

"[Deloitte] has not seen a lot regarding disability claims as of yet," said Abrams.

Collins, who heads up U.S. clinical operations at the biotech company Genentec, shared similar observations.

"At this point, I haven't had to include these considerations into our recovery plans," Collins said. "However, we are ensuring that people are being provided the flexibility to arrange their work schedules in non-traditional ways that will allow them (and their team members) to work as effectively as possible during this pandemic."

Still, not all sick employees require disability claims, and making that choice could require a physician's assessment. "Not everything requires disability insurance claim," said Abrams, "but may require adjustment to the work environments to support them through illness."

All in all, employers and employees should be prepared to be flexible when it comes to their work lives.

"We will need to identify clear protocols and parameters and give companies space to adapt as we learn more about coronavirus when it comes to supporting employees recovered from COVID-19," said Dr. David Shulkin, the former U.S. secretary of veteran affairs.

In the meantime, some employers are doing what they can to encourage their employees to get the flu vaccine as we move into the colder months. "I worry about -- as I sit here and think of cold climates -- I worry most about is getting the flu on top of COVID-19," said Abrams.

As a possible "twindemic" approaches, some immediate precautions can be taken by everyone to possibly reduce the effect of the flu and of COVID-19.

"We strongly encourage people to get the flu vaccine. We believe it is beneficial, lifesaving, in many cases," said Abrams.

Alexis E. Carrington, M.D., is a dermatology research fellow at the University of California, Davis, and a contributor to the ABC News Medical Unit. Jay Bhatt, D.O., is an internist, adjunct faculty at the UIC School of Public Health and an ABC News contributor.