Intended for healthcare professionals


How can I support my colleague returning to work with long covid?

BMJ 2023; 382 doi: (Published 12 September 2023) Cite this as: BMJ 2023;382:p1997
  1. Abi Rimmer
  1. The BMJ

There are things you can do to ease a colleague’s return to work when they are living with long covid, Abi Rimmer hears

Don’t let it be the elephant in the room

Rachel Duncan, clinical lead for the Brighton and Hove memory assessment service, GP, and someone with lived experience of long covid, says, “Firstly, it’s important that you acknowledge and validate their illness and experience. This colleague may well have been off work for some time and you don’t want long covid to be the elephant in the room. Openly mentioning it in an appropriate and supportive way can be helpful.

“They may not look unwell, but don’t let this mislead you—when attempting a return to work your colleague will be putting everything they have into making it a success.

“Your colleague is likely to have a structured return to work plan that has been made with occupational health or their line manager’s input. Please respect these boundaries and do not try to navigate around them. There is often a ‘go low and go slow’ approach which can look different to recovery from other conditions. Remember that no two people with long covid will be the same in terms of their challenges, so the approach to returning to work needs to be bespoke and may look different to others.

“There may be bumps in the road so expect your colleague to need the occasional sick day in order to keep their recovery trajectory going in the right direction. This will be hard for them but can be vital to their recovery so please be understanding.

“If friends or family have had similar illnesses then mention it—your colleague will realise you have a better understanding of the impact of long covid and similar conditions. I found this very helpful as I felt that I didn’t need to explain everything in great detail. Share recovery stories of others that you know of in a sensitive and positive way as this can be inspiring and give them hope for the future.”

Ask how to help—and listen

Natalie Nokes, third year specialty trainee in emergency medicine, says, “Everyone’s experience with long covid is different. I believe the best way you can support your colleagues is to do three things: listen, empathise, and offer appropriate support.

“On one of my rotations, it came up in conversation that I had post-covid fatigue or long covid. I explained that one of the hardest things to manage at work was having to stand for long periods of time. As I explained this, three of my colleagues were sat on chairs and I was stood up. No one offered me their chair. I remember thinking that they seemed to be listening and they’d asked questions, but they hadn’t offered me support or understanding.

“Understanding is important because there’s a background anxiety that many people feel about not being believed or being thought of as a fraud. I acknowledge it’s difficult. Until I experienced it, I couldn’t comprehend the overwhelming fatigue long covid causes and the impact it would have on my life.

“Coming to work requires preparation. Before a twilight shift I’ll spend the morning in bed, despite having had a good night’s sleep. Turning down the chance to play football with my kids the day before a shift, for example, is difficult but I know the knock-on effect it could have. I’ve had to miss social events because I need to have enough energy to complete my shift the following day and then be safe to drive home.

“This condition has had a profound impact on my life yet I consider myself one of the lucky ones. Some people haven’t made it back to work. The people who have returned have most likely had a battle to be there.

“When you empathise with what that person is going through you can figure out how best to support them. And sometimes that support might be something as simple as offering your chair.”

Allow extra time for rest and appointments

Ravi Prakash, older adults psychiatry specialty doctor, Oxleas NHS Foundation Trust, says, “Please listen and accept your colleagues’ concerns when they return to work with long covid symptoms. The Memorial Sloan Kettering Cancer Center Library is a good resource for information on the long term health consequences of covid.1

“They could be worried about their health and how they will meet their own and their colleagues’ expectations while suffering from fluctuating fatigue, myalgia, and breathlessness.

“Do gently ask how to help and, if you can, assist them by avoiding excess physical exertion and planning rest periods into their working day.

“While doctors are used to intense activity and pressure at work, doctors with long covid need to avoid an excessive workload and stress or they risk worsening their symptoms.

“To avoid and prevent serious exacerbations of their long covid symptoms your organisation should consider making allowances for longer recovery periods after non-covid related illnesses or medical procedures. It is also important to recognise that long covid can activate other illnesses such as autoimmune conditions.

“Consider that your colleague might need time to attend appointments and understand delays that occur with these appointments, investigations, and treatments. Long covid services vary by area, which can result in different waiting times.

“Emphasise that everyone’s ability to tolerate ambiguity and uncertainty was quite taxed, even before the pandemic, and this can be made worse by long covid. These uncertainties continue as new information about long covid continues to emerge.

“Finally, if you feel it is appropriate, you can signpost your colleague towards sources of confidential stress support, either through their GP or through national services such as the Practitioner Health Programme.2