Most of us were brought up with the folk wisdom that exercise is the best medicine, and often it’s true. But not for people who are suffering from long Covid and other post-viral syndromes. For them, overexertion can severely aggravate their conditions, whose symptoms may include fatigue and brain fog. There’s even a term for it: “push and crash.”
The problem is that push and crash — which the Centers for Disease Control and Prevention warns about in a bulletin to health care providers — is precisely what the American employment system is geared to cause.
Employers understandably want their people to get off sick leave or disability and come back to work as soon as possible. But providing them with needed accommodations too often falls by the wayside. And the workers themselves are eager to prove they aren’t lazy or expendable, so they may do too much and suffer a relapse.
Then there’s the American disability system. It doesn’t deal well with people suffering from long Covid and similar ailments, who can feel great one day but be incapacitated the next. The system inadvertently discourages some long Covid sufferers from returning to work — for fear that if they return, they will be considered fully recovered, which they aren’t.
A Brookings Institution study in January said absences and dropouts from the work force caused by long Covid could account for about 15 percent of the unfilled jobs in the US economy.
I was struck by the findings of a recent report that was released in conjunction with a Biden administration initiative to research and cope with the lingering aftereffects of Covid infections. The report, a part of the Solve Long Covid Initiative, estimated that from 2 percent to 4 percent of US adults are expected to suffer from some disabling symptoms of long Covid.
I spoke with the report’s three authors about the problem of “push and crash.”
“When people are forced to overexert themselves, it pushes the body into emergency mode and can cause permanent damage,” a condition known as post-exertional malaise, said Melissa Smallwood, a science and technology policy researcher.
She added, “One major risk factor for this is pressure to get back to work too soon.”
Her co-author, Emily Taylor, told me, “long Covid is not entirely new.” Taylor is vice president of advocacy and engagement at Solve M.E. (M.E. stands for myalgic encephalomyelitis, which causes chronic and debilitating fatigue.)
For people with such conditions, she said, “Numerous studies and anecdotal evidence show that the harder you as an individual push through your symptoms and trigger flare-ups or crashes, the smaller your window for recovery and the more likely your symptoms will become permanent.”
Parts of Europe have a smarter way to deal with partial and varying disability levels, said the third author, Philippa Dunne, director of outreach at Hudsonia, a nonprofit ecological research firm. The report spotlights the Netherlands and Sweden.
The Netherlands had been considered to have one of the worst disability systems in the industrialized world, then in 2002 the Dutch switched to one that “increased incentives for both employers and employees to use accommodations and rehabilitation in order to get back to work following the onset of disability,” according to the report.
The US Department of Labor maintains a list of potential accommodations for chronic fatigue syndrome, and many of them overlap with accommodations for long Covid, according to the Solve Long Covid Initiative report. For decreased stamina: scooters, periodic rest breaks. For brain fog: visual schedulers, memory software. For light sensitivity: anti-glare filters, visors. And so on.
Sufferers of long Covid who are given adequate time and help “may, over time, increase their energy envelope and accomplish an increasing number of tasks each day,” the report states. Weighing that against external or self-imposed pressure to get back on the job is, of course, the rub.
If long Covid has any silver lining, it’s that work on how to fight it and make accommodations for sufferers could benefit those experiencing related conditions such as chronic fatigue syndrome and myalgic encephalomyelitis, Taylor said. “We are learning so much.”
The New York Times
