For about a year, coronavirus outbreaks and variants tossed and turned employers' office reopening plans. With case numbers trending downward and public attention to the omicron variant fading, however, such plans are once again resurfacing.

Microsoft, for example, implemented the final stage of its hybrid workplace model effective Feb. 28, according to its official blog, and has fully opened its facilities to employees, visitors and guests, citing high vaccination rates in the county where most corporate employees live.

Facebook parent company Meta has set a March 14 deadline for employees to request either a full-time or temporary remote work arrangement, the company confirmed in an email to HR Dive, and all others will begin working from Meta's U.S. offices on March 28.

The public sector may soon follow. Axios reported Feb. 27 that the Biden administration is looking to accelerate in-person work return planning for federal agencies. Against that backdrop, the U.S. Centers for Disease Control and Prevention adjusted masking guidelines to recommend that only counties with high COVID-19 spread require all individuals to wear masks while indoors in public.

But a lull in outbreaks does not mean the end of coronavirus-related workplace challenges. One of the biggest issues employers face on reopening their offices has to do with supporting employees experiencing post-COVID-19 conditions, also known as "long COVID," or long COVID-19, according to Dr. Akl Fahed, chief medical advisor at healthcare benefits vendor Goodpath.

"What we see is that pretty much everyone in this space is realizing that this is a significant problem," Fahed said.

Why long COVID-19 is a challenge

There are two key reasons why long COVID-19 poses such difficulty for both employers and workers, Fahed continued. The first is that the condition is "pretty tough to detect," as it is not always necessary for those who have long COVID-19 to have experienced symptomatic infection with COVID-19 in the first place.

The second has to do with the sheer number of symptoms infected persons may present. On its website, the CDC maintains an extensive list of commonly reported symptoms, ranging from respiratory issues like shortness of breath to difficulty thinking or concentrating, among several others.

"The challenge with any of those symptoms is that they are common to begin with," Fahed said. That could make it more difficult for employees to recognize that they are experiencing long COVID-19.

Estimates vary as to the prevalence of long COVID-19. A February 2021 research letter from the University of Washington, Seattle found that among a cohort of 234 individuals with COVID-19 who were followed for up to 9 months after illness, approximately 30% had persistent symptoms. Fatigue, which occurred in 14% of individuals, was the most common symptom.

Later, Stanford University researchers published a May 2021 systematic review of 45 studies including 9,751 participants with COVID-19. It found that 72.5% of COVID-19 patients reported at least one symptom at 60 days or longer after diagnosis, symptom onset or hospitalization, or at 30 days or more after recovery from acute illness or hospital discharge. Fatigue and shortness of breath were the most frequently reported symptoms, while 1 in 7 reported atypical chest pain and 1 in 4 experienced an inability to concentrate.

Such a wide spectrum complicates both detection and treatment, Fahed said, and what works for one patient may not be as effective in treating another. That differs from past organizational strategy around COVID-19; a universal approach, such as implementing hand sanitizer stations or implementing social distancing at meetings or masking, does not yet exist.

"The approach needs to be individualized," he added.

Accommodations and other tips

Long COVID-19 may constitute a disability under the Americans with Disabilities Act if it substantially limits one or more major life activities, according to the U.S. Department of Labor, and therefore an employee who has it may be entitled to workplace accommodations.

Per a publication by DOL's Job Accommodation Network, accommodations include options such as:

• Providing or modifying equipment or devices.
• Job restructuring.
• Part-time or modified work schedules.
• Reassignment to a vacant position.
• Adjusting or modifying examinations, training materials or policies.
• Providing readers and interpreters.
• Making the workplace readily accessible to and usable by people with disabilities.

The ADA requires employers to provide reasonable accommodations, but not necessarily the one an employee requests, David Barron, member at Cozen O'Connor, said in an email. Additionally, because not every case of long COVID-19 constitutes a disability, employers should assess each case on an individualized basis, he noted.

If an employer determines that an employee is impaired from participation in a major life activity, "the employer is required to engage in an interactive process to determine whether a reasonable accommodation can be made to allow the employee to perform the essential functions of the job," Barron said. "An employer is not required to make changes that would eliminate essential functions of a role, or make changes that would pose an undue hardship on the business."

At a more basic level, employers should ensure that managers are trained to understand that long COVID-19 can constitute a disability and to be responsive to an employee's request for accommodation related to such a disability, said Adam Sencenbaugh, partner at Haynes Boone.

Additionally, a lack of awareness around long COVID-19 could make it difficult for employees to recognize potential symptoms of the condition in the first place. Sencenbaugh said confusion on the part of the employee about their symptoms also may lead to mental health issues, such as depression.

"That puts a lot more onus on the employer to be vigilant about that and to be ready to respond," Sencenbaugh said. Managers, he added, can point workers in the direction of employee assistance programs and other avenues that may guide them toward needed care.

Remote work also could emerge as an option for employees with long COVID-19, Barron said, but employers may need to consider whether job performance in a specified workplace is an essential function of an employee's job, and whether continued remote work would constitute an undue hardship for the employer.

"Employers should be wary, however, that every decision in this area, especially now that the pandemic is subsiding, is potentially creating a precedent," Barron said. "Tight labor conditions have made it necessary for many employers to allow remote work for retention issues as well as health reasons. Once that door is opened, it will be difficult to deny requests for accommodation in the same or similar jobs."