Authors: Michael E. Kanell, The Atlanta Journal-Constitution Feb 19, 2022

She suffered cardiac arrest twice and was in the hospital for three months, then came home to more than a year of kidney problems and intermittent brain fog, tingling in her hands, numbness in her right foot and a need for oxygen after even modest exertion.

“Some days, I’m all right, but I can’t tell you which days I will feel good,” she said. “It’s all very frustrating because you know what you were capable of doing before.”

She is among many people with lingering COVID-19 aftereffects who cannot work or can only work part-time. The condition has been given a name: post-acute sequelae SARS-CoV-2 infection, or PASC.

But it is commonly called long COVID.

It may be the missing piece in a pandemic puzzle: Why has the number of people in the labor force lagged? Why are there still so many unfilled job openings?

Schroederused to supervise nursing students. Lately theMcDonoughresident has been volunteering to run concessions at some high school track meets, trying to edge back toward the workplace.

“It gives me a sense of normalcy,” she said. “But after last Saturday’s meet, I was bedridden for two days.”

While more than 900,000 Americans have died from the coronavirus, the vast majority of people who contract it do survive. But many — between 10% and 30% of those who live, experts say — continue to struggle with symptoms.

That is a lot of people: up to 23 million nationwide and nearly 800,000 people in Georgia, according to estimates by the American Academy of Physical Medicine and Rehabilitation.

Some don’t work. Some are still in the labor force, but at reduced hours.

Linda Rodin, a wellness specialist at an Atlanta-area supermarket, said she came down with COVID-19 in November. “I never had a fever, but it felt like the sinus infection from hell.”

The worst of it passed, but the symptoms clung to her. At one point in December,she said she stopped at a gas station and realized she had no idea how to put gas in the car. “I went back home sobbing hysterically. Things you’ve done your whole life, like tie your shoes, and suddenly are inaccessible. It is terrifying.”

She works part-time, grateful that her employer gave her that option.

Long COVID does not appear explicitly in the labor data. But there are clues.

• The labor force in Georgia is still 28,341 below its pre-pandemic level, and the real gap is larger. At the pace of pre-pandemic growth, the labor force would be about 184,000 larger than it is today.
• The number of people with jobs but out sick averaged 50% higher last year nationally than in 2019.
• The number of people nationallywho usually work full-time but who are working part-time because of illness rose through last year. Since last summer, it has averaged 16% higher than pre-pandemic times.
• The number of people who were out of the labor force with a disability is up 5.5%, or nearly 1.3 million, from the summer of 2020.
• The Census Bureau’s most recent survey showed more than a quarter-million people in Georgia either sick or caring for someone with coronavirus symptoms.

Kathryn Bach, a research fellow at the Brookings Institution, who has studied the issue, calculated that long COVID accounts for about 1.6 million people missing from the U.S. labor force. That’s equivalent to at least 15% of the nation’s job openings. By her calculation, about 45,000 people in Georgia are missing from the labor force because of long COVID.

“You could argue that my number is too low, I want to be conservative,” Bach said. “There is simply not enough data.”

Some long-haulers stay in the labor force, but just barely.

Joy McFather, a part-time teacher in Monroe County, caught what she thought was a mild case of COVID-19 at Christmas of 2020 and hasn’t been free of it since. “It’s been a roller-coaster ride of fatigue and brain fog,” she said. “It’ll get better and some weeks I’m good, then I’ll hit the wall and it will get worse.”

She’s taken 10 to 15 days off this past year, but has avoided any extended absences so far, she said. “I’ve been able to get myself through three days and on the fourth day, I crash.”

Symptoms of long COVID include debilitating fatigue, shortness of breath, pain and a “brain fog” that makes it hard to focus.

With most federal pandemic programs expired, a COVID “long-hauler” who cannot work can apply for disability. That challenging process is even tougher for a new disease, many of whose worst symptoms — like brain fog — are invisible.

“Things you’ve done your whole life, like tie your shoes, and suddenly are inaccessible. It is terrifying.”- Linda Rodin, who says that COVID-19 symptoms have clung to her

Not everyone is convinced that long COVID is a large part of the labor shortage. Daniel Altman, chief economist at Instawork, an app for skilled hourly professionals, is among the skeptics.

He said changes in the labor force do not match up with the waves of COVID-19 in the way you’d expect if each wave pushed people out of the workplace. Still, he acknowledged, the disconnect might be because of how the data are gathered.

“We have found that the Department of Labor doesn’t do a great job of tracking people who are going into flexible work. If someone is in and out of work because of long COVID, they may not show up as part of the workforce in the official statistics,” he said.

By the numbers: COVID-19 and U.S. workers

Confirmed cases, COVID-19: 78.1 million

Working-age deaths, U.S.: about 230,000

People in labor force, compared to pre-pandemic: down 1.4 million

Workers employed, but out of work because of illness, pre-pandemic: 1.1 million

Workers employed, but out of work because of illness, current: 3.6 million

At work part-time, usually work full-time, pre-pandemic: 2.4 million

At work part-time, usually work full-time, current: 4.2 million

COVID-19, Georgia workers

Confirmed cases: 1.9 million

Working-age deaths, Georgia: about 11,400

Labor force, compared to pre-pandemic: down 28,341

Sources: Centers for Disease Control, Bureau of Labor Statistics, St. Louis Federal Reserve Bank, Census Bureau

Megan Gaskin has worked with COVID-19 cases since the pandemic’s start as a physician’s assistant at Piedmont Healthcare in Austell.

“It goes away, it comes back. It produces thousands of sick days. It is a beast,” she said.

When hit by the symptoms, about one in five can work from home, she said.

Experts say early retirement is the biggest single reason for people leaving the labor force, and long COVID is part of that, Gaskin said. She estimates long COVID accounts for about a quarter of early retirements.

More answers about the impact of long COVID are likely on the way.

A four-year National Institutes of Health study has just begun that will include about 1,000 Atlanta-area participants, said Igho Ofotokun, professor of medicine at Emory University, who is working on the study.

Long COVID is similar to some chronic diseases that doctors have seen before, and maybe in time, there will be effective treatments that send victims back to work, he said. “We don’t know enough yet to be able to tell.”

However, researchers are hoping to reach some conclusions later this year, Ofotokun said.

In the meantime, many employers struggle to find workers and many workers struggle.

Adrienne Levesque of Loganville had COVID-19 twice in 2020.

More than a year later, she still usually can’t work more than 20 or 25 hours a week.

As controller of a small, family-owned business, she must sometimes answer questions about a worker’s status, whether someone should be classified as employed and whether it’s full-time work. She looks at her own situation, someone who has larger responsibilities she often cannot fulfill, working part-time and productive in unpredictable bursts.

“How do I count myself?” she said.