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

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.

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.

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.

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.

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