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Is Long COVID Part Of The Historically Tight Labor Market? Signs Point to Yes.

Long COVID Has Likely Taken Millions of Americans Out of the Workforce

Amanda Finley got interested in archeology when her third grade teacher spent the school year on it. “I just loved it,” she said. Finley decided then that she wanted to become an archeologist, and she did.

It’s a demanding job. Most people are hired on a contract basis; the digs last a few weeks to a month and require being out in a field, often in hot conditions, bending over to dig a shovel test every 10 to 30 meters to look for artifacts or other signs that the area is worth excavating further. “It’ll be like 100 degrees and you’re out there digging holes in a field all day and you’ll ask yourself, ‘Why was this my dream job?’” she said.

Still, it was her dream job, and she loved it. To earn enough money between gigs, Finely delivered food and groceries on apps. “I worked my tail off,” she said. “Just in order to keep afloat I was working like 80, 90 hours a week.”

But Finley hasn’t been able to go out on a single dig, or even a delivery, since early 2020. She contracted COVID that March, in the first wave of the pandemic, and nearly three years later her symptoms still haven’t resolved. Other than a short contract job in 2021 she’s remained unemployed.

Data suggests that millions of Americans now find themselves in a similar situation, but it’s tricky to know exactly how widespread long COVID is, or how it is affecting America’s workforce. Somewhere between 10 and 30 percent of people who get COVID develop long COVID, according to the Government Accountability Office, or between 7.7 million and 23 million Americans. While symptoms vary, long COVID typically involves fatigue, cognitive issues like “brain fog,” muscle or joint pain, organ damage, heart issues, shortness of breath, and/or mood changes.

Like Finley, some sufferers have been left so impaired that they’re no longer able to work, or at least not in the same job or under the same conditions that they used to. And yet we still don’t know for sure just how many people have been affected this way or what the impact on the economy has been. As data continues to roll in, however, it seems quite likely that long COVID is a significant part of why the labor market is currently so tight: it has forced people out of the workforce, plunging them into financial turmoil, which is making it harder for employers to find workers.

One international online study of nearly 4,000 long COVID patients found that 22 percent had left the workforce due to their symptoms. Here in the United States, economists have been trying to pinpoint a more robust answer with different datasets. One is the Census Bureau’s Current Population Survey. It’s a well-respected dataset: it’s nationally representative, and it also has a long history, allowing researchers to compare trends over time.

In a recent paper, Gopi Shah Goda, deputy director of the Stanford Institute for Economic Policy Research, and Evan Soltas, a PhD economics student at MIT, looked at how many more health related work absences were reported in the CPS in the pandemic compared to the years before, using that as a proxy for people who got COVID. They found that workers who had to miss work for at least a week when they got COVID were 7 percentage points less likely to be in the labor force a year later compared to those who hadn’t had such a disruption.

It seems quite likely that long COVID is a significant part of why the labor market is currently so tight: it has forced people out of the workforce, plunging them into financial turmoil, which is making it harder for employers to find workers.

Thus, they concluded, COVID illness had reduced the labor force participation rate by 0.2 percentage points by June, meaning there were about 500,000 fewer people working. “That does explain a pretty substantial chunk of the reduction in labor force participation since the beginning of the pandemic,” Shah Goda noted, and could be a big reason for why the labor market is so tight. “It’s maybe not the whole story, but it’s still something that’s relatively substantial.” The labor force losses will cost the economy about $62 billion a year, they calculate. “COVID is basically half as costly to the U.S. economy as diabetes or all cancers,” Soltas noted.

But not all of what they observed could be attributed to long COVID: their findings include those who got sick with COVID and quickly recovered, but perhaps lost their job when they had to take time off or saw it as a good catalyst to retire, as well as those whose symptoms lingered. “Long COVID is certainly, we think, in the mix here,” Soltas said. But it’s not the only phenomenon they measured.

A different analysis has come to a different conclusion. In a recent report, Louise Sheiner, senior fellow at the Brookings Institution, and Nasiha Salwati, senior research assistant, found an extra 3 million people reported having a disability in the CPS during the pandemic as compared to 2017-2019. They then compared the labor force participation rate of those with disabilities to what it would have been had the pandemic never happened. They found a much smaller impact: that there were somewhere between 281,000 and 562,000 people with disabilities who left the labor force during the pandemic, or a reduction of somewhere between 0.2 and 0.4 percent. And, of course, not all of those people have long COVID — so that particular impact may be smaller.

There are drawbacks to Sheiner and Salwati’s approach. CPS disability rates tend to be 20 to 30 percent lower than disability rates in other surveys. Another peek into what might be going on with long COVID comes from the Census’s Household Pulse Survey, launched in the pandemic. It has limitations, mainly that it’s brand new and is conducted through the internet. It’s gotten some things wrong, such as measuring an increase in hunger that wasn’t actually reflected in higher quality data.

But it’s also able to more quickly start asking new questions. Beginning in the September 2022 wave of the survey, it started asking adults who report having long COVID if their symptoms are limiting their daily activities and by how much. In the first week that the survey included these questions, 2 percent of adult respondents, which translates to 4.4 million people and about a quarter of those with long COVID, said their current symptoms reduced their ability to carry out everyday activities a lot, while another 9.9 million were slightly impaired. In all, about 81 percent of people with long COVID say it’s hampering their daily lives. The numbers didn’t change significantly in the next week’s survey.

“It’s pretty clear-cut that the people who say their daily activities are limited a lot are the ones who are likely to have their employment affected,” said Hayley Brown, research associate at the Center for Economic and Policy Research. In the survey, those who say their symptoms are limiting are also more likely to not be employed as well as to say they recently lost employment income.

Still, the survey doesn’t ask directly whether long COVID symptoms are keeping people from being able to work. “It would be great if they would add this question so we could answer this directly,” Brown said.

Long COVID is “very clearly playing some role” in the tight labor market, said Richard Deitz, an economic research advisor in the Federal Reserve Bank of New York’s Research and Statistics Group who also researched the issue. “But it’s not clear the magnitude.”

A completely different survey has also indicated that long COVID is impacting the labor force. Looking at data from the Understanding America Study, a longitudinal survey of about 9,500 nationally representative households at the University of Southern California, Dasom Ham, a research assistant at the Federal Reserve Bank of Minneapolis, found that about a quarter of people with long COVID said it had affected their employment or work hours. Those people are 10 percentage points less likely to be working and, if they are working, put in half as many hours as people who haven’t had COVID.

Long COVID is “very clearly playing some role” in the tight labor market, said Richard Deitz, an economic research advisor in the Federal Reserve Bank of New York’s Research and Statistics Group who also researched the issue. “But it’s not clear the magnitude.”

It’s clear that long COVID is taking an individual toll, though. Shah Goda and Soltas found people who got sick with COVID also decreased their working hours and/or switched jobs to something that paid less — perhaps in an attempt to shield themselves from more exposed occupations. The international study of people with long COVID found 45 percent had to cut back their work hours. Shah Goda and Soltas found that, all told, getting sick with COVID for a week ended up costing someone an average of at least $9,000, 90 percent of which was due to job loss, fewer hours, or lower pay.

Finley started to feel sick on March 6, 2020, long before much was known about COVID. At first she wasn’t sure what it was, but then she put two and two together: It felt worse than any respiratory disease she had ever had, even with her asthma.

Her symptoms lingered, and she’s still struggling. Her blood pressure is sky-high and she frequently feels short of breath while her heart races. It’s exhausting to go down her stairs, let alone out on a dig. “With asthma, you use an inhaler and poof, you can breathe. But you can’t do that with cardiac symptoms,” she said. “When your heartrate gets that high you can’t think, you can’t focus on anything. It’s immobilizing.” After her second bout of COVID—she believes she’s had it at least three times—she started having neurological symptoms, so she doesn’t drive anymore, either.

She’s tried to work. She was a contract tracer for a while, a job she could do from home, but it ended in early 2021. She nearly tried to go on an archeology dig this summer but it didn’t work out, and she’s glad. “I’d have wound up in the hospital trying to do that,” she said. She thinks it’s unlikely she’ll work in archeology again.

In the summer of 2021, Finley’s landlord didn’t renew her lease and she found herself homeless, first staying with friends and then eventually living out of a tent in Kansas City, Missouri. When it got cold she moved in with a friend in Minnesota and then, in May of this year, eventually found her current apartment in Kansas City with the financial assistance of friends.

“If you don’t have paid sick leave, people may be tempted to try and push through,” Deitz noted, which “can often turn out very badly and make long COVID worse.”

Finley and other long haulers could, in theory, turn to support systems. But they are poorly suited to helping those who suffer from an affliction that remains poorly understood. The Americans with Disabilities Act requires employers to offer disabled workers reasonable accommodations. But it requires a medical diagnosis, and there is currently no clinical diagnostic criteria for long COVID. “If you’re going to get an accommodation, you typically need proof from a physician that you have this condition,” Deitz said. “Because long COVID is so new, people may not be getting an accurate diagnosis.” Worse, people who got COVID in the early months of the pandemic, before testing was widely available, may have no way to prove that their symptoms stem from the infection. But even with a diagnosis, the kinds of impairments that tend to come with long COVID, such as brain fog or fatigue, are ones that can be harder to get accommodations for, such as a flexible schedule or working from home.

The country doesn’t guarantee paid family and medical leave nor paid sick leave, although 11 states and Washington, D.C. guarantee the former and 13 states and Washington, D.C. ensure the latter. Outside of those states, it’ll be hard for someone dealing with long COVID to take time away from work to visit the doctor or deal with symptom flares. “If you don’t have paid sick leave, people may be tempted to try and push through,” Deitz noted, which “can often turn out very badly and make long COVID worse.”

If a disability is severe enough, Americans can apply for Supplemental Security Income, a program that’s part of Social Security meant to help disabled people who have little to no income, and Social Security Disability Insurance, a longer-term program. For Disability Insurance, an applicant has to prove that their ability to work has been substantially limited and that it will last more than 12 months. An initial determination typically takes five months, and two-thirds of applications get denied on average. It requires resources and support to keep making the case. “It’s a process that is set up in many ways to assume that you’re not really having these problems,” said Shawn Fremsted, senior policy fellow at the Center for Economic and Policy Research.

These systems are complex to navigate even for someone at the top of their health. For someone with disabling long COVID, particularly neurological issues, it’s going to be far harder. Finley is working on trying to get SSI and SSDI, but her symptoms have made it harder to get the paperwork completed. “When your brain doesn’t work the way it used to it’s frustrating,” she said.

In late October, Finley had a stroke of good luck — she received a job offer working remotely in travel services for a credit card company. But the job doesn’t start until mid-December, and her lease is up that month. She’s not sure if she’ll be able to stay in it.

“I hope I’m able to do the job,” she said. She’s always had a long list of backup plans given the unpredictable nature of archeological work. “I’m out of backup plans right now,” she said. “I’m not sure what else to do if this doesn’t pan out.”

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