Long COVID Is a Mass Disability. The Labor Market Is in Denial

commentary

Dec 7, 2022

Kathy Spencer sorts the dozens of pills she must take since contracting COVID-19 in November 2020, in Kensington, Connecticut, January 11, 2022, photo by Mark Mirko/TNS/ABACA via Reuters Connect

Kathy Spencer sorts the dozens of pills she must take since contracting COVID-19 in November 2020, in Kensington, Connecticut, January 11, 2022

Photo by Mark Mirko/TNS/ABACA via Reuters Connect

This commentary originally appeared on Bloomberg on December 7, 2022.

Forget the work-from-home revolution or quiet quitting: The COVID-19 pandemic's biggest impact on the U.S. labor market will be as a mass disability event. It's a shock that the economy is not well prepared to handle.

An estimated 1 in 4 COVID-19 patients experience symptoms lasting months. In principle, not all of them should have to leave the labor force. First, they should be able to call in sick. If work-impairing symptoms persist beyond a week or two, they should have the option of requesting reduced hours or claiming short-term disability benefits. Only in severe cases, lasting several months or more, should they have to transition to long-term disability insurance.

Unfortunately, that's not how things operate in practice. Almost a quarter of U.S. private-sector workers can't take any paid sick days. More than half have no access to short-term disability insurance, and those who do must fight to get long-COVID claims approved. Affected workers have a right to request workplace accommodations such as part-time schedules, but employers have ample leeway to deny such requests as unreasonable.

Long COVID is keeping the equivalent of as many as 4 million working-age adults away from work.

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Keeping one's job isn't guaranteed, either. Under at-will rules, employees can be fired for missing work, even if due to illness (rather than disability). Although federal law guarantees up to 12 weeks of job protection to people who are ill or caring for a newborn or seriously sick family member, it covers only those who have been on payroll for 12 months—which, as of 2018, was just 56 percent (PDF) of workers.

Figure 1: Employed, Not at Work, Own Illness. Seasonally Unadjusted Data and Lagging 12-Month Moving Average

Date Employment Level Employed—with a job, not at work, Own illness
Jan
2003
135907 1124 0.8%
Feb
2003
136433 1155 0.8%
Mar
2003
136783 1107 0.8%
Apr
2003
137424 1061 0.8%
May
2003
137567 1025 0.7%
Jun
2003
138468 972 0.7%
Jul
2003
138503 969 0.7%
Aug
2003
138137 1080 0.8%
Sep
2003
137731 1168 0.8%
Oct
2003
138619 1125 0.8%
Nov
2003
138700 1092 0.8%
Dec
2003
138556 1207 0.9%
Jan
2004
136924 1177 0.9%
Feb
2004
137384 1116 0.8%
Mar
2004
137691 1127 0.8%
Apr
2004
138423 1001 0.7%
May
2004
138867 1093 0.8%
Jun
2004
139861 1035 0.7%
Jul
2004
140700 1018 0.7%
Aug
2004
140226 1019 0.7%
Sep
2004
139641 1049 0.8%
Oct
2004
140447 1036 0.7%
Nov
2004
140581 1009 0.7%
Dec
2004
140278 1022 0.7%
Jan
2005
138682 1245 0.9%
Feb
2005
139100 1239 0.9%
Mar
2005
139759 1120 0.8%
Apr
2005
140939 1051 0.7%
May
2005
141591 1029 0.7%
Jun
2005
142456 1074 0.8%
Jul
2005
143283 998 0.7%
Aug
2005
143142 1060 0.7%
Sep
2005
142579 1070 0.8%
Oct
2005
143340 993 0.7%
Nov
2005
142968 1074 0.8%
Dec
2005
142918 1098 0.8%
Jan
2006
141481 1163 0.8%
Feb
2006
141994 1214 0.9%
Mar
2006
142772 1300 0.9%
Apr
2006
143405 1116 0.8%
May
2006
144041 1034 0.7%
Jun
2006
145216 1006 0.7%
Jul
2006
145606 1001 0.7%
Aug
2006
145379 1073 0.7%
Sep
2006
145010 1094 0.8%
Oct
2006
146125 1036 0.7%
Nov
2006
146014 1048 0.7%
Dec
2006
146081 1065 0.7%
Jan
2007
144275 1122 0.8%
Feb
2007
144479 1178 0.8%
Mar
2007
145323 1213 0.8%
Apr
2007
145297 1018 0.7%
May
2007
145864 1034 0.7%
Jun
2007
146958 957 0.7%
Jul
2007
147315 1061 0.7%
Aug
2007
146406 973 0.7%
Sep
2007
146448 1044 0.7%
Oct
2007
146743 1007 0.7%
Nov
2007
147118 1015 0.7%
Dec
2007
146334 1141 0.8%
Jan
2008
144607 1019 0.7%
Feb
2008
144550 1314 0.9%
Mar
2008
145108 1073 0.7%
Apr
2008
145921 927 0.6%
May
2008
145927 978 0.7%
Jun
2008
146649 904 0.6%
Jul
2008
146867 928 0.6%
Aug
2008
145909 1004 0.7%
Sep
2008
145310 1039 0.7%
Oct
2008
145543 1001 0.7%
Nov
2008
144609 1092 0.8%
Dec
2008
143350 1035 0.7%
Jan
2009
140436 1040 0.7%
Feb
2009
140105 1076 0.8%
Mar
2009
139833 1014 0.7%
Apr
2009
140586 981 0.7%
May
2009
140363 971 0.7%
Jun
2009
140826 927 0.7%
Jul
2009
141055 923 0.7%
Aug
2009
140074 910 0.6%
Sep
2009
139079 988 0.7%
Oct
2009
139088 1041 0.7%
Nov
2009
139132 989 0.7%
Dec
2009
137953 1052 0.8%
Jan
2010
136809 1008 0.7%
Feb
2010
137203 1038 0.8%
Mar
2010
137983 1023 0.7%
Apr
2010
139302 990 0.7%
May
2010
139497 974 0.7%
Jun
2010
139882 814 0.6%
Jul
2010
140134 882 0.6%
Aug
2010
139919 907 0.6%
Sep
2010
139715 901 0.6%
Oct
2010
139749 944 0.7%
Nov
2010
139415 891 0.6%
Dec
2010
139159 925 0.7%
Jan
2011
137599 953 0.7%
Feb
2011
138093 1070 0.8%
Mar
2011
138962 1014 0.7%
Apr
2011
139661 985 0.7%
May
2011
140028 862 0.6%
Jun
2011
140129 810 0.6%
Jul
2011
140384 806 0.6%
Aug
2011
140335 893 0.6%
Sep
2011
140502 906 0.6%
Oct
2011
140987 941 0.7%
Nov
2011
141070 849 0.6%
Dec
2011
140681 958 0.7%
Jan
2012
139944 930 0.7%
Feb
2012
140684 986 0.7%
Mar
2012
141412 917 0.6%
Apr
2012
141995 911 0.6%
May
2012
142727 934 0.7%
Jun
2012
143202 900 0.6%
Jul
2012
143126 863 0.6%
Aug
2012
142558 822 0.6%
Sep
2012
143333 882 0.6%
Oct
2012
144039 899 0.6%
Nov
2012
143549 880 0.6%
Dec
2012
143060 944 0.7%
Jan
2013
141614 1202 0.8%
Feb
2013
142228 1079 0.8%
Mar
2013
142698 1027 0.7%
Apr
2013
143724 913 0.6%
May
2013
144432 947 0.7%
Jun
2013
144841 897 0.6%
Jul
2013
145113 862 0.6%
Aug
2013
144509 838 0.6%
Sep
2013
144651 874 0.6%
Oct
2013
144144 891 0.6%
Nov
2013
144775 888 0.6%
Dec
2013
144423 869 0.6%
Jan
2014
143526 1006 0.7%
Feb
2014
144134 974 0.7%
Mar
2014
145090 1034 0.7%
Apr
2014
145767 1046 0.7%
May
2014
146398 873 0.6%
Jun
2014
147104 882 0.6%
Jul
2014
147265 823 0.6%
Aug
2014
146647 864 0.6%
Sep
2014
146941 931 0.6%
Oct
2014
147936 936 0.6%
Nov
2014
147666 1026 0.7%
Dec
2014
147190 1048 0.7%
Jan
2015
146552 989 0.7%
Feb
2015
147118 1000 0.7%
Mar
2015
147635 1032 0.7%
Apr
2015
148587 919 0.6%
May
2015
149349 948 0.6%
Jun
2015
149645 860 0.6%
Jul
2015
149722 864 0.6%
Aug
2015
149228 791 0.5%
Sep
2015
148980 889 0.6%
Oct
2015
149716 795 0.5%
Nov
2015
149766 874 0.6%
Dec
2015
149703 924 0.6%
Jan
2016
149037 1003 0.7%
Feb
2016
150060 1033 0.7%
Mar
2016
150738 1020 0.7%
Apr
2016
151075 1045 0.7%
May
2016
151594 1062 0.7%
Jun
2016
151990 972 0.6%
Jul
2016
152437 986 0.6%
Aug
2016
151804 1005 0.7%
Sep
2016
151977 996 0.7%
Oct
2016
152335 986 0.6%
Nov
2016
152385 1009 0.7%
Dec
2016
151798 891 0.6%
Jan
2017
150527 1075 0.7%
Feb
2017
151594 1078 0.7%
Mar
2017
152628 1065 0.7%
Apr
2017
153262 1065 0.7%
May
2017
153407 903 0.6%
Jun
2017
154086 892 0.6%
Jul
2017
154470 908 0.6%
Aug
2017
153576 851 0.6%
Sep
2017
154494 805 0.5%
Oct
2017
154223 859 0.6%
Nov
2017
154180 897 0.6%
Dec
2017
153602 1020 0.7%
Jan
2018
152848 1283 0.8%
Feb
2018
154403 1184 0.8%
Mar
2018
154877 1098 0.7%
Apr
2018
155348 981 0.6%
May
2018
156009 861 0.6%
Jun
2018
156465 970 0.6%
Jul
2018
157004 801 0.5%
Aug
2018
155539 845 0.5%
Sep
2018
156191 884 0.6%
Oct
2018
156952 892 0.6%
Nov
2018
157015 984 0.6%
Dec
2018
156481 990 0.6%
Jan
2019
154964 1063 0.7%
Feb
2019
156167 1113 0.7%
Mar
2019
156441 978 0.6%
Apr
2019
156710 912 0.6%
May
2019
157152 902 0.6%
Jun
2019
157828 962 0.6%
Jul
2019
158385 862 0.5%
Aug
2019
157816 866 0.5%
Sep
2019
158478 893 0.6%
Oct
2019
159067 973 0.6%
Nov
2019
158945 875 0.6%
Dec
2019
158504 1119 0.7%
Jan
2020
156994 1071 0.7%
Feb
2020
158017 1088 0.7%
Mar
2020
155167 1340 0.9%
Apr
2020
133326 2010 1.5%
May
2020
137461 1534 1.1%
Jun
2020
142811 1228 0.9%
Jul
2020
144492 1695 1.2%
Aug
2020
147224 1331 0.9%
Sep
2020
147796 1258 0.9%
Oct
2020
150433 1315 0.9%
Nov
2020
150203 1778 1.2%
Dec
2020
149613 1902 1.3%
Jan
2021
148383 1955 1.3%
Feb
2021
149522 1414 0.9%
Mar
2021
150493 1203 0.8%
Apr
2021
151160 1507 1.0%
May
2021
151778 1244 0.8%
Jun
2021
152283 1046 0.7%
Jul
2021
153596 1290 0.8%
Aug
2021
153232 1470 1.0%
Sep
2021
154026 1532 1.0%
Oct
2021
154966 1378 0.9%
Nov
2021
155797 1513 1.0%
Dec
2021
155732 1679 1.1%
Jan
2022
155618 3616 2.3%
Feb
2022
156942 1573 1.0%
Mar
2022
158106 1081 0.7%
Apr
2022
157991 1181 0.7%
May
2022
158609 1350 0.9%
Jun
2022
158678 1472 0.9%
Jul
2022
159067 1518 1.0%
Aug
2022
158714 1529 1.0%
Sep
2022
159003 1237 0.8%
Oct
2022
159144 1331 0.8%

Source: Bureau of Labor Statistics

All this adds up to a big potential hit to the nation's productive capacity. Estimates based on Census data suggest that long COVID is keeping the equivalent of as many as 4 million working-age adults away from work—roughly the number of disabled veterans in the United States. There's no indication that the number of affected workers is decreasing as people recover: The share of employees officially out sick or working part-time due to illness, for example, keeps rising.

Figure 2: Employed, At Work Part Time, Usually Full Time, Because of Illness. Seasonally Unadjusted Data and Lagging 12-Month Moving Average

Date Employment Level Number At work part-time, usually work full-time Illness All industries 1-34 hours
Jan
2003
135907 2291 1.7%
Feb
2003
136433 2597 1.9%
Mar
2003
136783 2286 1.7%
Apr
2003
137424 1890 1.4%
May
2003
137567 1765 1.3%
Jun
2003
138468 1603 1.2%
Jul
2003
138503 1324 1.0%
Aug
2003
138137 1362 1.0%
Sep
2003
137731 1848 1.3%
Oct
2003
138619 1833 1.3%
Nov
2003
138700 1909 1.4%
Dec
2003
138556 2905 2.1%
Jan
2004
136924 2271 1.7%
Feb
2004
137384 2453 1.8%
Mar
2004
137691 2092 1.5%
Apr
2004
138423 1794 1.3%
May
2004
138867 1620 1.2%
Jun
2004
139861 1407 1.0%
Jul
2004
140700 1530 1.1%
Aug
2004
140226 1623 1.2%
Sep
2004
139641 1785 1.3%
Oct
2004
140447 1775 1.3%
Nov
2004
140581 1872 1.3%
Dec
2004
140278 2419 1.7%
Jan
2005
138682 2708 2.0%
Feb
2005
139100 3116 2.2%
Mar
2005
139759 2588 1.9%
Apr
2005
140939 2144 1.5%
May
2005
141591 2042 1.4%
Jun
2005
142456 1664 1.2%
Jul
2005
143283 1572 1.1%
Aug
2005
143142 1508 1.1%
Sep
2005
142579 1909 1.3%
Oct
2005
143340 1929 1.3%
Nov
2005
142968 1817 1.3%
Dec
2005
142918 2306 1.6%
Jan
2006
141481 2589 1.8%
Feb
2006
141994 2863 2.0%
Mar
2006
142772 2387 1.7%
Apr
2006
143405 1669 1.2%
May
2006
144041 1848 1.3%
Jun
2006
145216 1624 1.1%
Jul
2006
145606 1452 1.0%
Aug
2006
145379 1462 1.0%
Sep
2006
145010 1794 1.2%
Oct
2006
146125 1843 1.3%
Nov
2006
146014 1866 1.3%
Dec
2006
146081 2514 1.7%
Jan
2007
144275 2403 1.7%
Feb
2007
144479 2389 1.7%
Mar
2007
145323 2291 1.6%
Apr
2007
145297 2028 1.4%
May
2007
145864 1760 1.2%
Jun
2007
146958 1573 1.1%
Jul
2007
147315 1393 0.9%
Aug
2007
146406 1492 1.0%
Sep
2007
146448 1805 1.2%
Oct
2007
146743 1815 1.2%
Nov
2007
147118 2106 1.4%
Dec
2007
146334 2388 1.6%
Jan
2008
144607 2505 1.7%
Feb
2008
144550 3257 2.3%
Mar
2008
145108 2462 1.7%
Apr
2008
145921 2137 1.5%
May
2008
145927 1754 1.2%
Jun
2008
146649 1555 1.1%
Jul
2008
146867 1406 1.0%
Aug
2008
145909 1543 1.1%
Sep
2008
145310 1797 1.2%
Oct
2008
145543 1703 1.2%
Nov
2008
144609 1881 1.3%
Dec
2008
143350 2254 1.6%
Jan
2009
140436 2262 1.6%
Feb
2009
140105 2592 1.9%
Mar
2009
139833 2213 1.6%
Apr
2009
140586 1722 1.2%
May
2009
140363 1754 1.2%
Jun
2009
140826 1586 1.1%
Jul
2009
141055 1436 1.0%
Aug
2009
140074 1357 1.0%
Sep
2009
139079 1053 0.8%
Oct
2009
139088 2009 1.4%
Nov
2009
139132 1809 1.3%
Dec
2009
137953 2086 1.5%
Jan
2010
136809 2306 1.7%
Feb
2010
137203 1951 1.4%
Mar
2010
137983 2006 1.5%
Apr
2010
139302 1688 1.2%
May
2010
139497 1945 1.4%
Jun
2010
139882 1577 1.1%
Jul
2010
140134 1309 0.9%
Aug
2010
139919 1331 1.0%
Sep
2010
139715 1796 1.3%
Oct
2010
139749 1641 1.2%
Nov
2010
139415 1592 1.1%
Dec
2010
139159 2047 1.5%
Jan
2011
137599 1762 1.3%
Feb
2011
138093 2485 1.8%
Mar
2011
138962 2040 1.5%
Apr
2011
139661 1731 1.2%
May
2011
140028 1761 1.3%
Jun
2011
140129 1421 1.0%
Jul
2011
140384 1298 0.9%
Aug
2011
140335 1283 0.9%
Sep
2011
140502 1664 1.2%
Oct
2011
140987 1611 1.1%
Nov
2011
141070 1544 1.1%
Dec
2011
140681 2212 1.6%
Jan
2012
139944 2164 1.5%
Feb
2012
140684 2314 1.6%
Mar
2012
141412 2070 1.5%
Apr
2012
141995 1680 1.2%
May
2012
142727 1766 1.2%
Jun
2012
143202 1441 1.0%
Jul
2012
143126 1220 0.9%
Aug
2012
142558 1460 1.0%
Sep
2012
143333 1614 1.1%
Oct
2012
144039 1544 1.1%
Nov
2012
143549 1729 1.2%
Dec
2012
143060 2063 1.4%
Jan
2013
141614 2853 2.0%
Feb
2013
142228 2130 1.5%
Mar
2013
142698 2112 1.5%
Apr
2013
143724 1912 1.3%
May
2013
144432 1574 1.1%
Jun
2013
144841 1312 0.9%
Jul
2013
145113 1166 0.8%
Aug
2013
144509 1180 0.8%
Sep
2013
144651 1611 1.1%
Oct
2013
144144 1263 0.9%
Nov
2013
144775 1557 1.1%
Dec
2013
144423 1647 1.1%
Jan
2014
143526 2365 1.6%
Feb
2014
144134 1771 1.2%
Mar
2014
145090 1916 1.3%
Apr
2014
145767 1743 1.2%
May
2014
146398 1587 1.1%
Jun
2014
147104 1311 0.9%
Jul
2014
147265 1089 0.7%
Aug
2014
146647 1409 1.0%
Sep
2014
146941 1604 1.1%
Oct
2014
147936 1719 1.2%
Nov
2014
147666 1636 1.1%
Dec
2014
147190 2281 1.5%
Jan
2015
146552 2488 1.7%
Feb
2015
147118 2118 1.4%
Mar
2015
147635 2116 1.4%
Apr
2015
148587 1846 1.2%
May
2015
149349 1514 1.0%
Jun
2015
149645 1353 0.9%
Jul
2015
149722 1350 0.9%
Aug
2015
149228 1344 0.9%
Sep
2015
148980 974 0.7%
Oct
2015
149716 1575 1.1%
Nov
2015
149766 1513 1.0%
Dec
2015
149703 2114 1.4%
Jan
2016
149037 1885 1.3%
Feb
2016
150060 2098 1.4%
Mar
2016
150738 2062 1.4%
Apr
2016
151075 1852 1.2%
May
2016
151594 1693 1.1%
Jun
2016
151990 1410 0.9%
Jul
2016
152437 1160 0.8%
Aug
2016
151804 1402 0.9%
Sep
2016
151977 1672 1.1%
Oct
2016
152335 1601 1.1%
Nov
2016
152385 1325 0.9%
Dec
2016
151798 2209 1.5%
Jan
2017
150527 2455 1.6%
Feb
2017
151594 2639 1.7%
Mar
2017
152628 1842 1.2%
Apr
2017
153262 1438 0.9%
May
2017
153407 1660 1.1%
Jun
2017
154086 1442 0.9%
Jul
2017
154470 1191 0.8%
Aug
2017
153576 1182 0.8%
Sep
2017
154494 1637 1.1%
Oct
2017
154223 1555 1.0%
Nov
2017
154180 1506 1.0%
Dec
2017
153602 2123 1.4%
Jan
2018
152848 2871 1.9%
Feb
2018
154403 2522 1.6%
Mar
2018
154877 1948 1.3%
Apr
2018
155348 1793 1.2%
May
2018
156009 1620 1.0%
Jun
2018
156465 1523 1.0%
Jul
2018
157004 1191 0.8%
Aug
2018
155539 1416 0.9%
Sep
2018
156191 1670 1.1%
Oct
2018
156952 1527 1.0%
Nov
2018
157015 1860 1.2%
Dec
2018
156481 2144 1.4%
Jan
2019
154964 2322 1.5%
Feb
2019
156167 2436 1.6%
Mar
2019
156441 2361 1.5%
Apr
2019
156710 1705 1.1%
May
2019
157152 1735 1.1%
Jun
2019
157828 1457 0.9%
Jul
2019
158385 1274 0.8%
Aug
2019
157816 1352 0.9%
Sep
2019
158478 1785 1.1%
Oct
2019
159067 1764 1.1%
Nov
2019
158945 1866 1.2%
Dec
2019
158504 2108 1.3%
Jan
2020
156994 2370 1.5%
Feb
2020
158017 2384 1.5%
Mar
2020
155167 2168 1.4%
Apr
2020
133326 963 0.7%
May
2020
137461 969 0.7%
Jun
2020
142811 964 0.7%
Jul
2020
144492 1354 0.9%
Aug
2020
147224 1255 0.9%
Sep
2020
147796 876 0.6%
Oct
2020
150433 1334 0.9%
Nov
2020
150203 1591 1.1%
Dec
2020
149613 1875 1.3%
Jan
2021
148383 1781 1.2%
Feb
2021
149522 1593 1.1%
Mar
2021
150493 1734 1.2%
Apr
2021
151160 2051 1.4%
May
2021
151778 1605 1.1%
Jun
2021
152283 1517 1.0%
Jul
2021
153596 1442 0.9%
Aug
2021
153232 1674 1.1%
Sep
2021
154026 1841 1.2%
Oct
2021
154966 1569 1.0%
Nov
2021
155797 1855 1.2%
Dec
2021
155732 2436 1.6%
Jan
2022
155618 4230 2.7%
Feb
2022
156942 2099 1.3%
Mar
2022
158106 2065 1.3%
Apr
2022
157991 1797 1.1%
May
2022
158609 2245 1.4%
Jun
2022
158678 1675 1.1%
Jul
2022
159067 2020 1.3%
Aug
2022
158714 1845 1.2%
Sep
2022
159003 2160 1.4%
Oct
2022
159144 2133 1.3%

Source: Bureau of Labor Statistics

More COVID-19 is coming, both short and long. The Centers for Disease Control estimates 300,000 new cases a week, and hospitalizations are again on the rise. People will keep getting sick for reasons beyond their control. And given the policies the United States lacks—including universal access to paid sick days, short-term disability, job protection, and part-time accommodation—many will lose earnings and jobs, or end up out of the labor force completely. Given the challenges the economy already faces, that's a loss the country can ill afford.


Kathryn Anne Edwards is an economist at the RAND Corporation and a professor at the Pardee RAND Graduate School.

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