COVID-19 Healthcare Workers Are Becoming Long-Haulers

A growing number of frontline healthcare workers are joining the cohort of people who have developed COVID-19 “long-hauler” symptoms, according to Massachusetts General Hospital. Long-hauler symptoms are those that linger for many months after a person has recovered from COVID-19.

Experts say hospital systems have a moral obligation to care for COVID-19 long-haulers, including their own healthcare workers who’ve put their lives on the line during the pandemic.

“They’re the ones who have saved lives,” Natalie Lambert, PhD, associate research professor of medicine at Indiana University School of Medicine, tells Verywell. “And in doing so, they were exposed. So, to me, the service that they’re giving the world, and also the risk that they underwent, if they’re now experiencing these long-term health impacts, we have to support them.”

Lasting Symptoms

About 10% of people who’ve had COVID-19 develop long-term symptoms, according to a recent article in JAMA. And Massachusetts General Hospital reports that 3% to 4% of healthcare workers are expected to have prolonged symptoms lasting for many months or longer.

Lambert, in conjunction with a grassroots effort called Survivor Corps, surveyed more than 1,500 individuals with long-term COVID-19. Her research compiles a list of 98 symptoms long-haulers report experiencing. Some of the ailments are consistent with those common during initial infection, such as body aches or coughing. Others, like hair loss or vision issues, aren’t as typical.

Now, Lambert has taken her research a step further by tracking long-hauler symptom impact and is preparing her findings for publication. She’s charted the duration and intensity of symptoms, along with the level of job impairment, to find which symptoms are hindering people the most. 

“They’re like the supervillains,” she says. “They’re the ones lasting a long time and making it hard for people to work.” Those symptoms include extreme pressure at the base of the head or occipital nerve, brain pressure, fatigue, and drastic personality changes, to name a few.  But not every long-hauler experiences the same set of symptoms, severity, or the same impact on their lives.

Lambert, who spends time learning about people’s COVID-19 journeys through the Survivor Corps group, says there are healthcare workers worried about long-hauler symptoms. “There are lots of nurses saying that they’re going back to work,” she says. “But they still have that crushing fatigue or they have such terrible brain fog or difficulty concentrating that they’re terrified of treating patients. They’re terrified of making a mistake.”

The Importance of Long-Hauler Recovery

Lambert says going back to work too early with long-hauler symptoms may be counterintuitive to a person’s recovery. Her recent survey asked people what helped for each of their symptoms.

“For almost every single one, people said rest,” she says. “They’re not getting the rest they need to recover if they’re going back too early. It’s also very common that if people push themselves too hard, they’ll have a relapse of symptoms.”

Lambert says workplace policies need to change to allow people time off without the risk of losing their job or benefits. 

“Progress has been made in understanding COVID-19,” she says. “Where I think we need to see progress is we need to see health policies for these long-haulers. There are so many people who are long-haulers now, and there are so many more who are going to become long-haulers.”

In addition to policy changes at the federal level and at the workplace level, Lambert says we need treatment plans for people with long-term COVID-19, and we need more post-COVID care centers. Some hospitals and research centers—including Mount Sinai, the University of Colorado, UC Davis Health, and more—have set up clinics that specialize in treating long-hauler symptoms. 

Barriers to Care

The need for specialization has become clear as long-haulers face barriers to care. One barrier includes not having proof of having had COVID-19, Lambert explains. COVID-19 tests were scarce early on, and that’s just one reason why someone might not have a positive test in their records. They also could have been tested too early or too late in the course of their illness.

But a lack of a positive test result might lead to difficulty in getting time off from work for a longer recovery period or convincing a doctor that symptoms are related to COVID-19, Lambert adds.

When a healthcare provider attempts to investigate what might be causing someone’s unusual symptoms, Lambert says initial routine tests and scans may appear normal.

“COVID-19 will cause damage to the smallest capillaries or to the smallest airways in your lungs,” she explains. “So with more sophisticated scanning, we can see this damage. But you can imagine someone who is a long-hauler, the doctor runs all these tests and they all come back normal, but the person is still clearly very ill. So they’re up against all these problems.”

The Healthcare System Is Feeling the Strain

The COVID-19 pandemic has placed a huge burden on the healthcare system. More than 100,000 people are currently hospitalized with severe symptoms, according to the University of Minnesota’s COVID-19 Hospitalization Tracking Project. 

So when healthcare workers themselves become sick with COVID-19 or develop long-term COVID-19 symptoms, that places an additional strain on the healthcare system. 

“When you have staff that can’t come back to work, you’re going to have a problem because you’re going to have a supply-demand issue,” Anne Dabrow Woods, DNP, RN, CRNP, the chief nurse of Health, Learning, Research and Practice at Wolters Kluwer, tells Verywell. 

Dabrow Woods emphasizes the importance of cross-training a hospital’s workforce, especially training nurses across specialties. “So basically what you’re building is a multifunctional nurse who can go in many different areas of the hospital to work,” she says. “And then that allows your workforce to have work agility and efficiency. Really, you’re upskilling all the nursing staff and others.” 

Dabrow Woods says cross-training eliminates the need to furlough staff when elective procedures are temporarily cut. And it helps fill gaps when staff is out long-term, easing pressure for people to return before they’re recovered if they have long-hauler symptoms.

Echoing Lambert, Dabrow Woods says the need for post-COVID clinics at hospitals is paramount so that healthcare workers and other individuals with long-term symptoms can seek recovery services, including physical therapy, occupational therapy, cardiopulmonary rehab, and even mental health services. “It’s really looking at hospital systems understanding they need to care for the community,” Dabrow Woods says. “And healthcare workers in their system are part of that community.” 

Lambert worries that without more support, healthcare workers will leave the field permanently. “I’ve seen a scary number of healthcare workers saying that they’re going to look for a different career because it is just more than they can bear,” she says. “Healthcare workers in particular—we have to show them that we care.”

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