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Advice

Institutions Must Do More to Accommodate Those With Long Covid

Long haulers are just one more group excluded from fully participating in academe.

By Colleen Campbell, Soha Hassoun, Stefanie Israel de Souza, Sazana Jayadeva, Emmanuelle Marquis, and Kerstin Sailer October 27, 2022
illustration of a teacher at the blackboard and covid spores
Joan Wong for The Chronicle

More and more colleges and universities are moving past Covid-19 and advocating a return to pre-pandemic norms. But those decisions often ignore the fact that many students and employees have or are at risk of developing long Covid. Long Covid entails countless symptoms, including extreme fatigue, brain fog, and shortness of breath. It can be a disabling condition that parallels other chronic illnesses. In the United States, it is estimated that up to 2.4 percent of the work force is now out of work due to the condition. In Britain,

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More and more colleges and universities are moving past Covid-19 and advocating a return to pre-pandemic norms. But those decisions often ignore the fact that many students and employees have or are at risk of developing long Covid. Long Covid entails countless symptoms, including extreme fatigue, brain fog, and shortness of breath. It can be a disabling condition that parallels other chronic illnesses. In the United States, it is estimated that up to 2.4 percent of the work force is now out of work due to the condition. In Britain, 7 percent of workers have had or currently have long Covid. Those numbers are only going to rise with continued infections.

We have firsthand experience with long Covid in academe, either as long haulers ourselves or as allies. We have witnessed from our employers a wide range of responses, from very generous to repressive. Our experiences have further exposed what disability advocates in academe have long pointed out: the intersectional issues of inclusivity, invisibility, and academe’s culture of ableism. Chronic post-infectious illnesses disproportionately affect women. And women of color (Black women especially) experience more chronic illnesses because of structural racism, sexism, and classism. At the same time, these groups are disproportionately burdened by service work and work that involves advancing diversity.

We call on colleges and universities to develop the following transparent, tailored strategies to explicitly respond to the needs of people with long Covid and other disabilities:

Rethink medical evaluation. Employees with visible disabilities and well-defined and accepted illnesses may be able to communicate directly with their institution’s disability coordinator. Employees with invisible, chronic, and complex illnesses and disabilities have an added burden of proof to convince employers that they are indeed sick and need medical leave or accommodations.

This burden of proof is challenging for long haulers. The lack of testing during the initial months of the pandemic, the potential for long Covid to develop after a mild infection, and the absence of biological markers for long Covid make getting a diagnosis difficult. Moreover, the duration and severity of symptoms vary individually. Some may recover after a few months, while others may suffer for years. Some may experience different or new combinations of symptoms over time. The waxing and waning of symptoms complicate navigating our binary medical-leave system, which tends to classify a person as either too sick to work or fully recovered.

That’s why a one-size-fits-all policy is not appropriate for medical evaluations of complex illnesses, and runs the risk of violating disability law. Considerable flexibility, understanding, and compassion are required. Policies must be consistent, transparent, and fair to employees. The process must also take into account that faculty members have responsibilities that don’t stop when they go on medical leave. They still need to supervise graduate students, respond to requests for letters of recommendation from students, and meet deadlines for grant and funding agencies.

Employers also should adopt transparent and fair medical-evaluation procedures. There should be a central office responsible for processing requests for medical leave and disability accommodations. The office should trust employees and operate as their advocates, given the inherent power imbalances of and the isolating nature of the medical-leave and accommodations process. That includes not unfairly burdening employees with rigid medical-documentation requirements that have exposed disabled patients to gaslighting from skeptical providers and institutions. These have been especially harmful to patients with invisible illnesses and disabilities, forcing them to act as both patient and advocate at a time of considerable vulnerability.

Provide accommodations beyond ADA requirements. For people with disabilities who are able to work with accommodations, colleges should make the accommodations process transparent, accessible, and efficient. Long Covid can be a recognized disability under the Americans With Disabilities Act (or other governing disability law). Employers should listen to their employees who come forward with disabling symptoms, whether or not they have a diagnosis. Employers must trust that people seeking accommodations do in fact need them.

The ADA requires that employers respond to requests for accommodations in a timely manner. Although the ADA does not define what constitutes a timely manner, a formal decision should be made within a week in most cases or two weeks if a meeting first has to take place with the employee. Those with chronic illnesses and disability have suffered enough; the accommodations process should not constitute another drawn-out battle they must fight.

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Make flexible accommodations the norm. Employees with disabilities are the most qualified to determine which accommodations work for them. Exactly what those look like for employees with long Covid is as varied as the condition itself. Instructors may require classroom technology that enables instruction while sitting, access to a safe place to lie down, proximity to bathrooms, or guaranteed nearby parking spots. Employees may need to limit activities like screen time or social interactions, work only certain times of the day when least symptomatic, take regular rest breaks, or work in a fragrance-free environment to prevent severe allergies and chemical sensitivities.

Long Covid can be like a Whac-a-Mole game with unpredictable symptoms, requiring accommodations to be modified as symptoms evolve. For many, remote work is an essential part of long-Covid recovery and symptom mitigation. Luckily, the pandemic has taught us that all aspects of faculty business can safely and efficiently be conducted remotely.

As most institutions return to pre-pandemic norms, measures to prevent the spread of airborne viruses, such as mandatory masking and adequate ventilation, remain essential. A person wearing a mask, surrounded by unmasked individuals, is not sufficiently protected. Employers should offer appropriate accommodations to at-risk groups, including long haulers. Reinfection may undermine their recovery and worsen symptoms in the long term, with the possibility that reinfection could render them unable to work at all. It’s also important to recognize that while many long haulers can work with accommodations, far too many have been unable to return to work.

Enable peer-to-peer support. Long Covid is a lonely and isolating experience for most sufferers, cutting them off from their existing collegial networks. While data and privacy protection remain essential, people need to be able to choose what personal and professional information they disclose, and to whom. Institutions should create safe networks so those with disabilities — and their allies — can support one another. We also acknowledge the difficult balance of, on the one hand, advocating for what we need and speaking out against discrimination while, on the other hand, protecting our privacy and — for some of us — our career prospects.

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Combat academe’s culture of ableism. Institutions must reflect on the ableist nature of many pre-pandemic norms and create a culture of inclusivity and accessibility for students, staff, and faculty. They must also acknowledge how ableism intersects with issues of sexism and racism.

Institutions should take other necessary first steps. They should require disability awareness and education, including implicit-bias training for all members of the campus community; provide inclusive online options for all meetings and events; remove scented products from campus spaces; adjust timelines for tenure to reflect the limitations of disabling conditions; offer flexible work spaces, times, and timelines; offer accommodations to job-market candidates at all stages of the application process; consider the impact of chronic and disabling illness on job-market candidates’ research and teaching portfolios, especially for people of color who were hardest hit by the pandemic; provide paid sick leave to non-tenured and contingent faculty members to reduce the disparate toll of disabling illnesses; and ensure that networking opportunities are not limited to in-person meals, receptions, or events.

Those changes are merely the beginning. Academe must address the ingrained systemic practices that have long excluded some individuals from full participation. This includes rejecting the framing of different bodies as the problem. Bodies are not the problem. Institutional policies structurally produce disability by devaluing some bodies while prioritizing the needs of others. The mass disability presented by long Covid provides an opportunity for institutions to reckon with this culture of ableism.

We welcome your thoughts and questions about this article. Please email the editors or submit a letter for publication.
Tags
Health & Wellness Disability & Accessibility Diversity, Equity, & Inclusion Opinion
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About the Author
Colleen Campbell
Colleen Campbell is an acting assistant professor of lawyering in the School of Law at New York University.
About the Author
Soha Hassoun
Soha Hassoun is a professor of computer science at Tufts University.
About the Author
Stefanie Israel de Souza
Stefanie Israel de Souza is an assistant professor of sociology and criminology at California State Polytechnic University at Humboldt.
About the Author
Sazana Jayadeva
Sazana Jayadeva is a lecturer in sociology at the University of Cambridge.
About the Author
Emmanuelle Marquis
Emmanuelle Marquis is a professor of materials science and engineering at the University of Michigan at Ann Arbor.
About the Author
Kerstin Sailer
Kerstin Sailer is a professor in the sociology of architecture at University College London.
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