(NewsNation) — Employers are struggling to fill 10.6 million job openings and may be missing a key demographic for their efforts: those with long COVID. New research shows as many as 4 million “long haulers” have left the workforce, and many others have reduced hours or changed fields entirely due to a lingering group of symptoms including fatigue, brain fog, pain, shortness of breath, nausea, and heart and lung damage.

That’s according to Katie Bach, a nonresident senior fellow at the Brookings Institution. Her upcoming report examines the policy implications of long COVID on the workforce. “It’s like front page news when we see like a 0.5 percentage point drop in labor force participation, and I’m talking about something that’s a lot higher than that,” Bach said, estimating the lost wages approach $200 billion a year. “Every company needs to be cognizant of this.”

If managers want to get these workers back, they need to be more flexible about where, how, and when employees work, said Linda Batiste of the Job Accommodation Network (JAN), a free resource on disability-related employment issues. “Employers are sometimes concerned that making accommodations is going to be costly … (or) that providing accommodations will negatively affect coworker morale,” Batiste wrote to NewsNation in an email.

Yet an annual JAN survey of thousands of employers has shown the benefit of making accommodations outweighs the cost—usually under $500. Two months after making a workplace accommodation, 90% of employers reported retaining the employee, 68% reported workers were more productive and 57% of reported staff took fewer days off, according to the 2021 survey.

‘The walking wounded

Kayla Hake ran out of breath while she walked up the steps talking on the phone. A few minutes prior she’d caught her 2-year-old daughter tripping down the last few steps—but her pulse wasn’t slowing. 

“My heart rate is still at 137 right now. I mean, just doing that,” the former hospice worker said. “I’ve gotten to the point where I’ve kind of had to accept it—that I’m not going to be able to go back to work and do what I was doing previously.”

Hake faced two bouts of COVID that worsened her heart condition. She says she’s now driving for DoorDash because she can make more money and needs flexible hours. 

“The walking wounded are coming into work, and they’re doing the best they can,” said Dr. Ezra Teitelbaum, who specializes in treating chronic fatigue syndrome and fibromyalgia. He added that long COVID affects more women than men.

Employers need to be malleable where they can, Teitelbaum said. Post-COVID fatigue is due to an “energy crisis” he explained, made worse by overexertion and stress. But often there aren’t physical signs of illness, which may make it harder for managers to understand.

Finding the right accommodations

Allowing people to work remotely, asynchronous work hours, and offering more breaks within the day have been shown to help fatigue sufferers stay in their jobs. Other accommodations can include more ergonomic chairs or desks, handicap access, making a workplace quieter or less bright, and time off for medical appointments.

Long Covid Podcast” host Jackie Baxter said the best accommodation she heard of was an office that created a nap space in an unused office. “We’ll talk about pacing—you can only do so many things in a day, and if you go over that, then it’s not going to be good,” Baxter said. “If you have to do three tasks, for example, rather than doing boom, boom, boom, you do one task, rest, one task, rest.”

Ultimately, it’s about working with the employee—and helping them understand they have rights under the American Disability Act, Batiste said. Employers should keep in mind that these accommodations may not be permanent, Baxter added. Some research indicates extra rest in the first few months of long COVID may reduce the likelihood of it becoming a long-term disability.

“How can the HR people help? They can offer that, ‘I know that you’re really sick and I will help you as best I can,’” Teitelbaum said. “If you’re looking for employee loyalty in a day where it’s hard to find … if you are there for them, they’re going to be inclined, more likely, to stick around for you.”

Bach said that as long as employers view accommodations as a preference—and not an accommodation—companies will continue to struggle to hire enough people. And because the implications for the larger economy are stark, she says the government needs to expedite disability benefit applications as well.

“If there’s any hope that it will help them recover and get them back to work, that’s an obvious investment for the government to make,” Bach said. “Frankly, if we’re talking about a $200 billion cost in lost wages alone, there aren’t many interventions that wouldn’t be worth it.”