COVID-19 workforce impacts in the US

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COVID-19 has gradually become a part of the US landscape. Changes in official policy have indicated as much, as has the public’s clear acceptance of the risks of the disease. These shifts are consistent with the scenarios that we and others have described: COVID-19 is now endemic in the United States.

However, that does not mean that we have defeated the disease. Every day, between 250 and 400 US families lose a loved one to COVID-19.¹ That’s roughly 2.5 to 4.0 times the average number of daily deaths from the flu in the decade preceding the pandemic.² For these families (and those of the more than one million victims since 2020), COVID-19 is an unalloyed tragedy.

Another ongoing effect of COVID-19 is less critical, and less obvious, but nevertheless substantial: more than two years after the lockdown, the disease continues to exert a brake on the US economy through productive workdays lost to worker illness, caregivers’ responsibilities for children and seniors, and compliance with isolation guidelines. And some analysts are starting to notice.³

We estimate that each case of COVID-19—including both those diagnosed and those that do not make it into official statistics—leads to 1.0 to 1.5 days of productive work lost, depending on the scenario. By itself, that is not catastrophic for anyone, worker or employer. But the scale of the endemic is vast: the Institute for Health Metrics and Evaluation suggests that there were 315 million to 690 million COVID-19 cases in the United States in 2022. Only a small portion of these cases, however, are captured in public-health statistics.⁴

Do the math, and 315 million to 1.05 billion worker days were likely lost to COVID-19 last year, equivalent to 1.3 million to 4.3 million workers dropping out of the workforce for the full year.⁵ At the high end, that’s about double the average number of sick days taken by US workers in the decade before the pandemic. Stated differently, the cumulative impact of lost time due to COVID-19 is equivalent to a 0.8 to 2.6 percent reduction in the availability of the US workforce.⁶ In our view, this is a hidden loss that could help explain the persistent US worker shortage.

In this article we review the analysis and explain our assumptions. And while our review is confined to 2022, early epidemiological estimates suggest that US case rates will continue on a similar trajectory in early 2023, particularly if new subvariants such as XBB.1.5 drive new waves of disease. If that happens, then the US workforce will lose productive days at a similar rate.⁷ In the meantime, severe outbreaks of influenza and respiratory syncytial virus (RSV) in the United States are also wreaking havoc on workers’ availability.⁸ Many analysts have asked about the missing US workers.⁹ Our answer: they’re out sick, and companies will have to adapt.

How COVID-19 affects workforce productivity

COVID-19 affects productivity in four ways:

Missed work due to acute illness. The average symptomatic person loses some productive working time because of COVID-19, and the amount of time lost varies. Some will isolate for the full recommended period, which is currently five days. (We account for these workers separately.) Others will miss work only while they feel unwell—for example, missing work for a couple of days, working at 75 percent of their usual capacity for ten days, or similar adaptations. Finally, a smaller though still meaningful number of people experience severe acute illness and miss work for a longer period.
Productivity loss due to long COVID. Long COVID is a complex and poorly understood syndrome. We recently estimated one form of its economic impact: the affordability challenge that it places on the nation’s healthcare system.¹⁰ The gathering storm: The affordability challenge of endemic COVID-19,” September 21, 2022. Reduced productivity is another such challenge. A relatively large number of people experience mild to moderate medium-term symptoms, which cause a modest productivity decrease. A smaller number suffer debilitating symptoms and are unable to work for a substantial period of time.
Missed work due to isolation based on COVID-19 protocol. While compliance is far from universal, some people, irrespective of symptoms, do follow the US Centers for Disease Control and Prevention’s (CDC’s) recommendation to isolate for at least five days after testing positive.
Productivity loss while caregiving for a dependent family member. Cases in dependent family members can also lead to workdays lost, as parents may have to care for sick children (or grandparents).

Our methodology

To estimate work lost in each of the four categories, we made assumptions based on our work with public-health agencies and a review of the medical literature, always keeping in mind the traditional five-day work week:

Acute illness. In about two-thirds of COVID-19 cases, symptoms are present. Yet almost all symptomatic cases (98 percent) are considered mild or moderate.¹ Recent estimates suggest that 25 to 30 percent of people infected with COVID-19 isolate for the full recommended period (currently five days) regardless of symptoms.² Similarly, about 35 percent of people are considered able to take the time off needed to isolate for any illness, COVID-19 or otherwise.³ For about 40 percent of the isolators, working from home is not an option, and about five days of work are lost.⁴ Americans are embracing flexible work—and want more of it,” McKinsey, June 23, 2022. Assumes the days of illness are the same as the isolation guidelines. For those able to work from home, we assume that about 50 percent of their productive capacity is lost, representing some combination of working at half capacity for five days or taking around 2.5 sick days.⁵Assumes that cases of acute COVID-19 result in similar days lost as known for cases of influenza, estimated at less than one to six days per infection. See Martin Keech and Paul Beardsworth, “The impact of influenza on working days lost: A review of the literature,” PharmacoEconomics, November 2008, Volume 26, Number 11. We assume near the midpoint of this range at 2.5 days lost per case, or half capacity experienced over five days, recognizing generally milder symptoms experienced with acute COVID-19 infection. Taken collectively, this group loses about 0.7 days to 1.0 day of work per case.
Long COVID. We conservatively estimate that approximately 5 percent of cases will result in long COVID symptoms that last for 50 days on average.⁶The medical literature is still grappling to understand the frequency, longevity, and severity of long COVID symptoms. Frequency estimations vary: the UK Office of National Statistics estimates about 4 percent as of July 2022 (“Self-reported long COVID after infection with the Omicron variant in the UK,” Office of National Statistics, July 18, 2022). The CDC estimates 20 percent (Lara Bull-Otterson et al., “Post–COVID conditions among adult COVID-19 survivors aged 18–64 and ≥65 Years—United States, March 2020–November 2021,” CDC, May 27, 2022). Some publications put it at 14 percent (Roy H. Perlis et al., “Prevalence and correlates of long COVID symptoms among US adults,” JAMA Network, October 27, 2022). Others say 6 percent (Claire E. Hastie et al., “Outcomes among confirmed cases and a matched comparison group in the long-COVID in Scotland study,” Nature Communications, October 12, 2022). We conservatively estimated that 5 percent of cases result in long COVID symptoms. The duration of long COVID is also not yet agreed on and ranges from four to 12 weeks according to several sources including the BMJ, NHS, and WHO. To strike a balance, we used the halfway point between the four- and 12-week estimates, or 50 days, for average duration. Severity, or the incidence and magnitude of debilitating and mild symptoms, is also not yet agreed on. Publications note debilitating symptoms occurring, such as 15 percent incidence of neurocognitive impairment (“What have we learned about long COVID?,” Columbia University Irving Medical Center, September 13, 2022), and 8 percent of persons experiencing challenges performing even personal care (“Outcomes among confirmed cases,” Nature Communications, October 12, 2022). We assume that 12 percent of persons experiencing long COVID may experience fully debilitating symptoms for the 50-day duration, whereas our analysis assumes around 88 percent experience only mild debilitation, or around 10 percent productivity loss for the same duration, roughly akin to the on-the-job losses experienced from the common cold (Thomas J. Bramley, Debra Lerner, and Matthew Sames, “Productivity losses related to the common cold,” Journal of Occupational and Environmental Medicine, 2002, Volume 44, Number 9). Of those experiencing symptoms, we assume that 88 percent will see a loss of 10 percent of their productivity; the remaining 12 percent will experience wholly debilitating symptoms that preclude work entirely. While there is still much to learn about long COVID, we estimate the contribution of this category at 0.1 to 0.2 days of work per case.
Isolation according to protocol. About one-third of COVID-19 cases are asymptomatic. However, serial and company-mandated testing may capture up to an additional 10 percent of these cases. Assuming that about 30 percent of the population will isolate for the full five days regardless of symptoms,⁷ and that about 58 percent of people can work from home,⁸ Americans are embracing flexible work—and want more of it,” June 23, 2022. we estimate that isolation protocols cause workers to lose about 0.2 to 0.3 days of work per case.
Caregiving. For simplicity, we consider the care of only sick children under 12 (about 10 percent of all cases).⁹ Recognizing the ability of many parents to work from home or find alternative caregivers, the generally milder course of COVID-19 in children, and the fact that older children will need minimal parental support, we assume that the burden of caregiving leads to 0.1 to 0.2 days of work lost by the caregiving parent, or less than 0.1 days of work lost overall.

Across all four categories, we estimate that each case of COVID-19 in the United States currently causes workers to lose between 1.0 and 1.5 days of work (see sidebar, “Our methodology,” for an explanation of our assumptions). Exhibit 1 reflects three scenarios, derived from the range of our assumptions.

The economic impact of lost productivity

Many economic analysts are puzzled by the conundrum in the US labor market: even as the economy cools, there are still nearly twice as many job openings as there are unemployed people. It seems that one of the factors keeping workers on the sidelines is COVID-19. And on the other side of the equation, COVID-19 also seems to be a critical factor holding down productivity and hurting companies’ ability to keep up with demand.

A billion workdays lost to COVID-19 is enough to have a substantial impact on the economy. Even the midpoint scenario of roughly 600 million workdays lost represents nearly a week missed per worker on average, more than doubling the prepandemic number of sick days taken by Americans.¹¹ The implied reduction of 1.5 percent in the US labor force is material at a time when unemployment stands at only 3.7 percent, and many sectors are labor constrained.

The impact is asymmetric across industries; those sectors whose workers are unable to be productive remotely bear a greater burden. Exhibit 2 shows our estimates of remote-working potential by sector.

The impact will also likely be disproportionate across regions. Those parts of the country with higher vaccination rates among working-age populations are likely to see less work lost due to severe disease. Areas with economies that are less dependent on industries with a low potential to work remotely will also see a lighter burden.

Moreover, reduced productivity from COVID-19 is likely to continue into this year. Without a change in trajectory, the United States will experience hundreds of millions more COVID-19 cases in 2023, although the situation could improve if milder variants become dominant or if new preventive or therapeutic modalities reduce the average severity of cases or rates of long COVID.

In the meantime, workers continue to get sick and miss work. Amid the many ways that COVID-19 has slowed economies, the impact on economic productivity may be among the most enduring.

While this analysis is focused on the United States, many other countries that saw a high number COVID-19 cases during 2022 are also likely to encounter a substantial effect on their workforces. Business and government leaders in these countries may want to take stock of this little-understood economic effect of COVID-19.

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One billion days lost: How COVID-19 is hurting the US workforce

About the authors

How COVID-19 affects workforce productivity

Our methodology

The economic impact of lost productivity

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