Over the last fifteen months the number of people affected by COVID-19 is unprecedented. Since 31 December 2019 and as of October 2021, 120 million cases of COVID-19 have been reported worldwide, including 2.66 million deaths (1). The medical research into Covid-19 over this same period has made great progress, both in relation to symptoms and treatment, with the development of the various vaccines that are now been administered around the world. Knowledge however, about the lasting effects of COVID-19, referred to as “long COVID”, is still in its early phase.
Months after a severe infection with Covid-19, a significant number of people are still battling crushing fatigue, the consequences of damage to their lungs, heart, immune system, or brain as well as other symptoms of long COVID. An analysis by researchers at King’s College London shows that one in 20 people with COVID-19 are likely to suffer symptoms for 8 weeks or more (so-called Long COVID) (2).
As organisations’ consider reopening offices, factories, retail centres following the vaccination roll out they need to think carefully about what steps they need to take to maintain safety (real and perceived) as the return to work momentum builds up. The key questions for employers to address are:
Ultimately, a return-to-work strategy must balance employee health and welfare, legal requirements, and operational considerations. The organisational choices will be driven by the business values and needs. What is clear that there will be an on-going need for health and well-being support for all employees long into the future.
About long COVID
How long it takes to recover from coronavirus is different for everybody. Many people feel better in a few days or weeks and most will make a full recovery within 12 weeks. But for some people, symptoms can last longer. The chances of having long-term symptoms does not seem to be linked to how ill you are when you first get coronavirus. People who had mild symptoms at first can still have long-term problems (2).
The damage can be partially traced back to side effects of intensive treatments such as intubation, but there is also evidence suggesting that the conditions are linked to the virus itself. Either way, preliminary studies and existing research into other coronaviruses suggest that the virus can injure multiple organs and cause some surprising symptoms.
COVID-19 often affects the lungs first, but in many cases, the lungs are not the worst-affected organ. An infection can leave patients with a weakened immune system, but it can also cause parts of the immune system to become overactive and trigger harmful inflammation throughout the body.
Patients with long COVID can show a wide range of symptoms, including breathlessness, a cough that won’t go away, joint pain, muscle aches, hearing and eyesight problems, headaches, loss of smell and taste as well as damage to the heart, lungs, kidneys and gut. Mental health problems have also been reported including depression, anxiety and struggling to think clearly.
Researchers are still trying to understand the long-term conditions COVID-19 can cause. While most severe COVID-19 infections often produce the worst long-term impacts, mild cases can still have life-changing effects such as a severe fatigue syndrome, arguably the most difficult to understand among the long-term symptoms.
While the scale of long COVID is still unclear, the insurance industry has started to prepare for it in terms of the products they provide to employee benefit programmes. The insurance areas particularly affected are private medical insurance, life insurance and group income protection. The impact of COVID-19 will take time to reflect on insurers’ books, but it could lead to a hardening of policy rates as well as changes in terms and conditions.
Can an employer demand that staff get vaccinated?
There are two aspects to this question that apply to employment contracts, those for new staff and those for existing staff. Making new joiners get vaccinated could, in theory, be possible if it were written into their employment contracts and they agreed to it. However, it was very unlikely that employers can make existing workers have vaccines under their current employment contracts, unless the general employment law is changed. In the absence of a such a change, demanding that current staff be vaccinated would be unlawful in most circumstances, as businesses are not allowed to discriminate against people for reasons including disability, pregnancy, and religious belief. Also, given that there are alternatives to vaccination, like mass testing which are less intrusive, it would be difficult for employers to justify enforced vaccinations.
The potential effect of Long COVID on the Employee Benefits Safety Net
Standard policy terms and benefits of health Insurance policies allow for conditions/complications from COVID-19 to be assessed for available treatment. It is not yet clear if and to what extent such policies will cover Long COVID, because, as the name suggests, such a definition would indicate a chronic medical condition.
Standard insurers’ terms do not include cover for chronic conditions unless specifically included as part of the plan design, thus cover may only be available where the chronic issue has an acute flare up. The longer-term implications are still being analysed and assessed by the insurers in both the potential impact on the terms and benefits (additional exclusions, introduction of co-funded benefits) they wish to make available as well as the cost of providing the cover.
Delays in seeking treatment due to a fear of contracting the virus, are concerning for both the individual and for the healthcare providers, both the National Health Service and the private health sector. Should diagnosis occur at a later stage, treatment tends to be longer, potentially more intrusive, and more expensive to administer. Long term recovery could also be affected by such delays. So, we must wait to see how private medical insurers manage Long Covid Support going forward.
Some life insurers have seen an impact from COVID-19, particularly in the blue-collar environment, as many employees were not able to self-isolate in the working environment. Cases often occur in combination with underlying conditions. As a result, underwriters may decide to be more selective with this group and develop a higher sensitivity to individuals who have a heightened risk of developing severe symptoms. Further, because some individuals may be avoiding treatment for other conditions (e.g., cancer or cardiovascular) due to fear of contracting the virus, may see their symptoms worsen, which could potentially lead to an early (avoidable) death. As a result, this would increase the claims exposure for insurance providers and, depending on the scale of the issues, impact the cost of life insurance policies in future.
The role and importance of having life policies in place for staff has been reinforced by the figures recently released by the Association of British Insurers (ABI). Over the last twelve months the ABI announced that there were sadly 11,198 claims received under individual and group life insurance policies. Of these, 10,205 were individual policies (whole life, term insurance and critical illness claims) with 993 on group life insurance schemes. A total of £202m was paid out throughout the year on 96% of individual and 99% of group claims. The average payout on individual policies was £13,100; for group polices it was £74,600. This important employee benefit has helped to support affected families and their dependents (4).
Group income protection (GIP)
The potential cost for long term absence in the workplace brought on by Long COVID will be a source of concern for many employers. The group income protection (GIP) providers are, similarly to other insurance companies, still assessing the potential impact. However, GIP providers are currently stating that exclusions are not yet being considered. They are also promoting the existing services available through GIP policies to assist employers both in helping an individual employee back into the workplace (as soon as medically feasible) as well as through financial support.
Some providers have already signaled that they will offer direct help in form of tailored intervention to employers and employees based on their condition and circumstances with any post COVID-19 return to work planning. This can include, among others:
As the numbers affected by Long COVID are unknown, but potentially significant given the number of people that have been infected during the year and the on-going emergence of new variants, there may well be a possible future impact on the costs of such policies. Increase in claims and associated costs plus the issue of individuals not seeking treatment for conditions or later than they would have done pre COVID may result in GIP claims lasting longer and thus having a larger impact. This in turn would push up the cost of providing that cover.
£2.4 million has so far been paid from 968 claims made under individual and group income protection insurance, so helping those who suffer a loss of income due to COVID illness (4).
Another valuable tool that employers should look at having in place as part of their benefits programme is an EAP. EAPs are an important resource and source of reassurance for employees, as through the service they have access to professional support whenever they need it. Train counsellors can help them deal with the inevitable negative effects of long-Covid on emotional and psychological wellbeing and see them through whatever setbacks the condition brings and allow them to make working part of their balance and recovery. Because the service offers 24/7 on-line and telephony access employees can access it at any time.
Prioritising your next steps
If 2020 was the year the world turned upside down, 2021 is all about looking for new ways to organise and take the opportunities that present themselves. Business leaders need to ensure that they first prioritise looking after their core asset, the people in the business by supporting them with a good range of employee health benefits.
Managing Director, Busy Bees Benefits
Provider of the SmartHive Platform
Smart Hive is an integrated, cost effective employee benefits platform that provides your employees with access to all their health and wellbeing benefits in one place. Talk to a member of our team today or book your very own demonstration.