For many Americans it feels like everyone is out sick right now. But there is a good reason: work absences from illness are at an all-time annual high in the US and show few signs of relenting. And it’s not just acute illness and caregiving duties keeping workers away.
About 1.5 million Americans missed work because of sickness in December. Each month, more than a million people have called out sick for the past three years. In June 2022, about 7% of adult Americans had long Covid, which can affect productivity and ability to work, according to data from the Centers for Disease Control and Prevention (CDC).
The last time the absentee number dipped below a million Americans was in November 2019.
Last year, the trend accelerated rather than returning to normal. In 2022, workers had the most sickness-related absences of the pandemic, and the highest number since record-keeping began in 1976.
In 2022, the average was 1.58 million per month, for a total of 19 million absences for the year. The largest spike was in January 2022, when 3.6 million people were absent due to illness, about triple the pre-pandemic number for that month.
Parents and caregivers also saw the highest rates of childcare-related absences of the entire pandemic in October 2022 as illnesses surged amid relaxed precautions and lower vaccination rates among children.
Patterns in absenteeism correspond with rises and falls in the spread of Covid. But long Covid is probably contributing to sick leave rates as well.
One analysis in New York found that 71% of long Covid patients who filed for worker’s compensation still had symptoms requiring medical attention or were unable to work completely for at least six months. Two in five returned to work within two months, but still needed medical treatment. Nearly one in five (18%) of claimants with long Covid could not return to work for a year or longer after first getting sick. The majority were under the age of 60.
Workforce participation has dropped by about 500,000 people because of Covid, according to one study that looked over time at workers who were out sick for a week. But the actual number could be higher, because not all workers are able to take time off during their illnesses, Bach said.
“It’s likely that long Covid is keeping somewhere around 500,000 to a million full-time-equivalent workers out of work,” said Katie Bach, a nonresident senior fellow at the Brookings Institution.
Some affected by long Covid have reduced their hours, while others have left the workforce temporarily or permanently – a metric not captured by work absence data, but calculated in labor participation statistics.
Patients who are very sick with long Covid often “try to work for some amount of time and then eventually they drop out”, Bach said.
Between death and disability, the workforce has been reduced by as much as 2.6% during the pandemic, with 1bn days of work lost, McKinsey recently reported.
Those who stay in their jobs may need more sick leave than before because of new chronic illnesses.
“People who are on the less-sick end of long Covid, maybe they can keep working, but every now and then they might need a day or two off just because they have overdone it or something happened that triggered a symptom flare,” Bach said.
Much more research still needs to be done on the causes of and treatments for long Covid, the researchers said. Some patients do eventually recover, for instance, but it’s not clear why or how long they will be sick.
“We don’t know how long it’s taking them to recover. There’s a lot of uncertainty there,” said Alice Burns, associate director of the program on Medicaid and the uninsured at the Kaiser Family Foundation.
The more immunity people have, from vaccines and recovery from prior cases, the less likely they are to get sick in the first place, which reduces the risk of developing long Covid. But it is still possible to have long Covid even after mild or asymptomatic infection.
All of this means the US may continue to see higher-than-normal workplace absences.
“Some people just really need flexibility from their employers,” Burns said. That can include telework, unscheduled leave, flexible schedules and reduced hours.
“The challenge with that is, those supports are a lot more likely to be available to workers who have office jobs, higher-paying jobs, who are pretty well-established in the labor market,” Burns said.
“Covid in general, and long Covid too, are more likely to affect people who are minorities, who have lower levels of education, [who have] likely lower levels of income. So there may be, for many people, a mismatch between the people who need some of these employment-related supports and the types of jobs they are in.”
Employers can adjust to this new normal by offering as many accommodations as possible, both for those suffering initial bouts of Covid infection and those experiencing longer-term symptoms, Bach said. Again, some of the jobs where people are most at risk might be the least accommodating – it’s usually easier for office workers to telecommute than it is for fast-food workers – but there are still steps employers can take.
“Companies have to get creative, like: can we offer more frequent breaks?” Bach said. “Can we as a society convince Medicare and Medicaid to reimburse a little bit more where companies are employing people with long Covid? What memory aids can we put together?”
If long Covid continues to affect 7% of the country, that’s 23 million people at any given time who may require accommodations under laws like the Americans with Disabilities Act.
“But there isn’t a lot of clarity about what is a reasonable accommodation” under the law when it comes to Covid and long Covid, Burns said.
While Covid has thrown the country into disarray in every realm, including work, it is also shining a more intense light on the ways chronic illness affects productivity and workforce participation – a change that disability and chronic illness activists say is long overdue, Bach pointed out.
“My hope is that it’s big enough that we can rethink how we research and treat these diseases, and how we approach workplace accommodation,” Bach said. “In a world where any of your workers could suddenly become disabled, I think you have to be more flexible.”
• This article was amended on 31 January 2023 to reflect that cited CDC data on long Covid was published in June 2022 and referred to adults only.
