Die long-covid-Patienten Jörg Schneider (l) und Ulrich Lowers (r) machen ein Atemtraining mit Physiotherapeut Mirko Weernink (M) in einem Gymnastikraum der Klinik Teutoburger Wald, eine Reha-Klinik für Post-Covid Erkrankte. Niedersachsens Gesundheitsministerin Behrens (SPD) besucht die Einrichtung.

Around 29 million corona cases have left deep scars in this country – more than 140,000 deaths are to be lamented, many of those who have recovered are still suffering from long-term consequences such as exhaustion, shortness of breath and poor concentration weeks and months after the infection. A report by Techniker Krankenkasse (TK) now shows how often long-Covid sufferers were on sick leave in the following year after an infection in 2020.

The analysis relates to around 4.3 million employees between the ages of 15 and 64 who are insured with TK. The health report shows that almost one percent of all recorded employees who were proven to be infected in 2020 were on sick leave in 2021 with a long Covid diagnosis – on average 105 days.

While every employed person recorded was ill for an average of 14.6 days, those affected with a previously mild course of Covid-19 were on sick leave for an average of 90 days due to Long Covid. Those who had previously been in hospital for more than seven days with a Covid-19 diagnosis were missing an average of 168 days in 2021 because of the long-term consequences. The previously ventilated Covid 19 convalescents were on sick leave for over half a year in 2021.

Jens Baas, CEO of TK, said at the presentation of the report on Wednesday in Berlin: “The analysis shows that anyone affected by Long Covid has had to deal with this disease, which still puzzles us, for a long time.” Long-Covid affected seems relatively low at just under one percent. “But these are only the patients who have also been on sick leave with this specific diagnosis – we also assume that there are a large number of unreported cases.”

According to the report, the proportion of all missed days caused by Long Covid in 2021 could be 1.6 percent instead of just 0.35 percent – this would make the number of unreported cases four times higher. Baas points out that the analysis only relates to the affected Covid sufferers from the first year of the pandemic. “Back then, the situation was completely different. We didn’t have that many virus variants and there was no vaccination yet. It is therefore not yet possible to foresee what is still to come.”

Sonia Lippke, health psychologist and behavioral doctor at Jacobs University Bremen, is not surprised at the comparatively small number of long-Covid sufferers on sick leave. She is researching a more targeted diagnosis of the clinical picture. “Many long-Covid sufferers do not take sick leave with the appropriate diagnosis because they and their general practitioners cannot classify the symptoms,” Lippke told the Tagesspiegel.

“In addition, many people with Long Covid are trying determined not to take sick leave and to reach their old level of stress.” Then they are often overwhelmed or exhausted and do not recover sufficiently.

“It is therefore a major task for those affected to have to adjust their lives accordingly.” If you ask those affected who have been able to work so far, many would state that they are significantly less productive than before the corona infection.

According to the behavioral doctor, there must be flexible solutions for dealing with the disease in consultation with employers. “Those affected who are still able to work should have the opportunity to go home in the event of acute exhaustion or pain and to be able to start work again later.” That is often more sensible than sick leave, which also causes a lot of costs for companies.

However, the diagnosis remains challenging because Long Covid can express itself in many different ways: from loss of smell to chronic exhaustion to pain, shortness of breath or psychological consequences after treatment in an intensive care unit.

Christian Gogoll, lung specialist at the Evangelische Lung Clinic Berlin, wrote the medical guidelines for Long Covid and, as a person affected, also reported on his own medical history at the press conference on Wednesday: “After my infection, I went to the intensive care unit myself and was ventilated. During the subsequent rehab I still had shortness of breath for a long time – it was terrible.”

In the meantime, many complaints have decreased, but he cannot yet work as an intensive care doctor in the hospital again as before.

In addition to current figures on Long Covid, the report also highlighted other developments during the pandemic. The analysis for 2021 shows an almost complete absence of the flu and cold wave in the first quarter, which would have been “hardly imaginable” without contact restrictions and other infection control measures.

The sick leave for 2021 at 3.98 percent was also slightly below the sick leave for 2020 at 4.14 percent. Preliminary TK data for the first quarter of 2022 shows the historically highest sickness rate of 5.27 percent over the past 20 years. In the case of TC, the cause is assumed to be the spread of the highly contagious omicron variant during this period.