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Long Covid: Returning to work with brain fog and fatigue poses a challenge for employers

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Long Covid: Returning to work with brain fog and fatigue poses a challenge for employers

  • July 09
  • Tags Our news, sustainability

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Struggling to find familiar words, their memories and thinking fuzzy, losing their train of thought mid-conversation, gasping for breath and battling constant, intense tiredness – for Covid-19 “long haulers” this is reality for weeks, even months, after contracting and seemingly recovering from the disease.

 

“Long Covid”, with symptoms of brain fog, fatigue and shortness of breath lasting for six months or more, is set to become the biggest health challenge facing business and the health care system beyond the immediate crisis of the Covid-19 pandemic.

With the focus on workplace mental health in Corporate Wellness Week from 5 – 9 July, Prof Renata Schoeman, head of the Health Care Leadership MBA programme at the University of Stellenbosch Business School (USB) said the likely long-term impact of Long Covid on productivity and employee retention would call on employers to be flexible and adaptable to accommodate employees on the long road to recovery.

Since the global spread of Covid-19 from early 2020, there is an emerging body of evidence from many countries of a growing number of people who experience prolonged symptoms beyond the initial, acute stage of the disease.

“Individual studies indicate that between 10% and 30% of patients who recover from acute Covid-19 become ‘long haulers’, still experiencing symptoms six months later.”

“Individual studies indicate that between 10% and 30% of patients who recover from acute Covid-19 become ‘long haulers’, still experiencing symptoms six months later. In one study, of 3 762 patients who had confirmed or suspected Covid-19, most of whom had symptoms lasting longer than 90 days, 45% needed a reduced work schedule compared to before they became ill and 22% were not working due to their health conditions. [i]

“This illustrates the scale of the likely impact on employers, employees, and the health care system that will need to accommodate these patients,” Prof Schoeman said.

While organisations have so far focused on primary prevention of Covid-19 infection – measures such as masks, sanitising, physical distancing and working from home – Prof Schoeman said employers also need to turn their attention to employees returning to work after recovering from Covid-19 and to what is needed to accommodate those suffering with Long Covid.

Although definitions and diagnostic criteria have not yet been settled, Long Covid is generally seen as symptoms that last for more than 28 days after an initial infection or diagnosis of Covid-19. [ii]

Long Covid affects multiple bodily systems, with cognitive dysfunction (“brain fog”), fatigue and post-exertional malaise (a relapse or flare-up of symptoms after physical or mental effort) the most common symptoms and the most long-lasting, still experienced six months after infection. [iii]

Brain fog is an umbrella term referring to symptoms such as memory loss, confusion, muddled thinking, poor concentration, and generally feeling mentally sluggish,[iv] and up to 25% of people infected with Covid-19 experience this and other neurological symptoms.

“Organisations are facing a potential increase in employees needing workplace accommodations for ill health or disability, on long-term sick leave or even medically incapacitated and no longer able to perform their current job.

“Employers need to be reviewing their occupational health services, employee assistance and wellness programmes, policies on sick leave and reasonable accommodation, post-illness return-to-work plans, and ensure they are not discriminating on grounds of mental health or disability,” Prof Schoeman said.

“The implications are far-reaching, and the likes of health care funders and income-protection insurers need to be reviewing their policies and guidelines on treatment and disability.”

She said understanding of Long Covid was still evolving and a timeline for when maximum improvement of the condition can be expected still remained to be determined.

“The implications are far-reaching, and the likes of health care funders and income-protection insurers need to be reviewing their policies and guidelines on treatment and disability. The medical profession and policy-makers need to arrive at objective diagnostic and assessment criteria, and guidelines for best practice in evidence-based treatment and management of Long Covid.”

Prof Schoeman said developing objective criteria for a diagnosis of Long Covid is important since many of its key aspects such as brain fog and fatigue are largely “invisible”, and employers would need to guard against abuse of sick leave, flexible work arrangements and workplace accommodations.

Similarly to acute Covid-19 disease, the symptoms of Long Covid are diverse and vary between individuals, and also change and fluctuate over time – making it important for employers to discuss their condition with individual employees and understand what support they need, and to allow for flexibility in workplace accommodations.

She said that where Long Covid persisted for more than a month, during which the person may need to take sick leave, by the second month the employer would need to be looking at reasonable accommodation and/or reduced responsibilities.

Beyond two months, she said it was likely that assessment and treatment by a multi-disciplinary team would be the correct approach, involving the general practitioner along with professionals in areas such as psychiatry, neuropsychology and occupational therapy.

For anyone experiencing symptoms of brain fog, Prof Schoeman recommends tried-and-tested self-care and good mental hygiene – getting enough sleep, regular exercise (gradually phased-in if experiencing fatigue and post-exertion relapse), eating healthily and taking time out from digital devices.

 

References

[i] Hannah E Davis, et al. Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. MedRxiv. December 2020, updated April 2021:  https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v3

 

[ii] Mendelson M, et al. Long-Covid: An evolving problem with an extensive impact. SA Medical Journal. January 2021. http://www.samj.org.za/index.php/samj/article/view/13141/9649

 

[iii] See reference 1.

 

[iv] What to know about Covid-19 and brain fog. Healthline. https://www.healthline.com/health/covid-brain-fog

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South Africans use double Earth’s resources

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South Africans use double Earth’s resources

  • July 04
  • Tags Our news, sustainability

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Dr Jako Volschenk, Head of the MBA and Senior Lecturer in Strategy and Sustainability at the University of Stellenbosch Business School (USB)

South Africans are consuming beyond the capacity of Earth’s ability to sustain us, using up resources at double the rate at which the Earth’s ecosystem can recover. And the shocking part is that we have been failing for 51 years.

Running at a deficit of -2.1[1], the country, along with the world population, is depleting the Earth’s resources faster than the planet’s ability to recover and sustain, and if we do not turn our deficit around, we need to accept that we will be the instigators of the first ever man-made mass extinction.

South Africa’s Earth Overshoot Day (EOD) falls on 4 July 2021 this year – the date which marks the point in a given year when our demand for ecological resources and services has exceeded what the planet can regenerate in that year.

It’s an urgent wake-up call for South Africans.

Dr Jako Volschenk, Head of the MBA and Senior Lecturer in Strategy and Sustainability at the University of Stellenbosch Business School (USB), says nature replenishes what we consume every year – fish, forests, orchards etc – however South Africans have not allowed Earth to recover for more than 50 years.

“Imagine the earth is a company – let’s call it Earth Ltd – and we, as citizens, are the board of directors. Our natural resources represent our only income generating asset, a savings account that earns interest every year. In nature, that interest comes in the form of resources that grow from nature, such as some fish populations known to grow by twenty percent every year. If we consume more than the twenty percent, we are reducing the population to a lower level than what it was a year earlier, which in turn reduces the yield in the following year.”

He says the world population, as the board of directors, have been given the role of custodians of nature, but we are failing miserably in our duty to act in the interests of Earth Ltd.

“We have been running the company at a deficit for more than 50 years. Put differently, we have not had a positive cash-flow since 1969.  And year after year, we are consuming a bigger share of our declining pool of nature savings.”

Dr Volschenk says although the concept of using a company as an analogy to illustrate the point is useful, there are limitations when it comes to how Earth manages its bottom-line.

“With less resources, our future capacity for production is compromised.”

“Viewing natural assets as a savings account fails to capture the importance that nature holds for humanity. Everything we have ever made, and everything we will still make in the future, draws from the natural resources around us. With less resources, our future capacity for production is compromised.”

“In addition, when a company runs into financial trouble, usually it can be bought over by another company or the owners can take a loan from a bank. Earth does not offer a bail-out for us. We either have to turn our deficit around or accept that we will be the instigators of the first ever man-made mass extinction. We can’t be fired from our role – we are the only hope to turn the deficit into environmental restoration.”

EOD is calculated for all countries, and each country has its own tipping point at which the population is starting to consume its own ecological reserves. The point of overconsumption is determined by the ecological “interest” that is generated every year, and the rate of consumption.

“The pressure on Earth’s reproduction rate is closing in from all sides.”

“While overconsumption is the biggest driver, the world is also losing natural resources due to habitat encroachment, climate change, and ecologically damaging practices such as the use of pesticides. The pressure on Earth’s reproduction rate is closing in from all sides,” says Dr Volschenk.

The World Wildlife Fund reports that populations of wild animals have declined by an average of almost seventy per cent in the last 50 years[2], while other studies report that insect populations have declined by 70% in the last 30 years[3].

In some parts of China, fruit trees have to be pollinated by hand due to the absence of bees in the areas, which in turn is a consequence of pesticide usage in these regions[4].

So how do we turn this ship from its collision course?

Dr Volschenk says that understanding that Earth Overshoot Day is a result of undersupply and over-demand, provides two ways to move the date to later in the year.

“Managing demand provides the easiest opportunity to balance supply with consumption. Much debate exists between two camps – those that argue for reduction of population growth, and those arguing for a reduction in per capita consumption.”

“Global population numbers have doubled in the last 50 years[5]. Globally, we are still adding in excess of 80 million people per year, more than the total population of South Africa. Part of the long-term solution should focus on stabilising or even reducing the global population.”

For South Africa EOD was almost a month later in 2020 than the year before, providing strong evidence that reducing per capita consumption of products and services can be very effective to avoid the collapse of our ecological resources in the short term.

“Due to Covid-19, driving less, flying less and buying less accounted for much of the reduced consumption we observed in 2020 in comparison to 2019.”

  1. Circular economy: The circular economy can help reduce the need for virgin material. In circular design, products and services are not created with a linear lifecycle of a clear beginning, middle and end. The target is a closed-loop system that aims to minimise the use of resources and subsequently the creation of waste. It enables a system where products are reused, shared, repaired, refurbished, remanufactured and recycled within that circularity.
  2. Sharing economy: Better public transport and car-sharing services have much potential to bring down both the cost of transport, as well as the environmental impact. But the sharing economy can be extended to many other industries, such as buildings, tools, and products that we normally do not require all the time.
  3. Servitisation: Switching from an economy based on selling products to providing services, holds much potential. Imagine how producers of hot water geysers would change their production if they sold a hot water supply, rather than geysers.
  4. Flexitarian diets: The World Economic Forum reports that, at any point in time, there are three times more farm animals in the world than there are people, with many of these animals destined to end up as food. Contrary to popular belief, we have tripled the amount of meat we eat per capita in the last 50 years[6]. Switching to flexitarian diets can make a huge difference in our food-footprint. The flexitarian diet implies a vegetarian diet that allows a little bit of meat consumption. In the United Kingdom and Germany, one of every three people consider themselves to be flexitarians.  The reasons for doing so range from health to a strong movement towards considering animal welfare.
  5. Renewables and storage: The reduction in the price of renewable energy, combined with the improvement in battery storage technologies, have changed the electricity and mobility landscapes forever. While the world is unlikely to be rid of fossil fuel soon, some countries have already committed to have net zero carbon footprints by 2050. While this may sound far away, it is likely that this target will move closer as technology improves and awareness rises.
  6. Voluntary simplicity: The voluntary simplicity movement is rooted not in environmental ethics, but rather in positive psychology. The pursuit of material belongings drives many people into corporate jobs they dislike so that they can afford a new car and a big house that ultimately robs them from relationships and fulfilment of their passions. Voluntary simplicity does not call for voluntary poverty, but rather encourages consumption that is aimed at quality of life rather than quantity of material belongings.

References

[1] Ecological Footprint – Global Footprint Network

2 https://livingplanet.panda.org/en-us/

3 New study suggests insect populations have declined by 75% over 3 decades – CNN

4 Tang, Y., Xie, J.S., Chen, K.M., 2003. Hand Pollination of Pears and its Implications forBiodiversity Conservation and Environmental Protection: a Case Study fromHanyuan County, Sichuan Province, China. Unpublished report submitted to theInternational Centre for Integrated Mountain Development (ICIMOD).http://www.internationalpollinatorsinitiative.org/jsp/studies/studies.jsp. (Accessed 1 February 2014)

5 (4) World Population Doubled in 50 years. And Will Raise Up +50% By the End of the 21st Century. | LinkedIn

6 https://www.weforum.org/agenda/2019/02/chart-of-the-day-this-is-how-many-animals-we-eat-each-year/

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Person Holding Green Grains

We Can Restore Ecosystems, Together as #GenerationRestoration

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We Can Restore Ecosystems, Together as #GenerationRestoration

Person Holding Green Grains
[Source: Min An; Pexel]

  • Jun 04
  • Tags Our news, sustainability

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By Dr Lize Barclay, Senior Lecturer in Futures Studies and Systems Thinking at the University of Stellenbosch Business School

The theme of World Environment Day, on Saturday 5 June 2021, is Ecosystem Restoration. It will also launch the United Nations Decade on Ecosystem Restoration. From 2021 to 2030 the United Nation, along with all of us living and depending on the ecosystems of planet Earth, will aim to prevent more ecosystem degradation, halt the destruction taking place and attempt to reverse the damage that has been done.

We all depend on our ecosystems to stay healthy to provide us with clear water, viable land and fresh air. Each part of the ecosystem is important to ensure a thriving planet, on land or sea. Each insect, grain of soil and plant plays a role in their ecosystem; in deserts, forests, savannahs, coral reefs and even cities.

As the website for World Environment Day puts it, it is time to Reimagine, Recreate and Restore. It is a call to action for each individual, workplace, school, university and organisation on earth to do something restorative, even if it is small. Some of the actions we can do:

  • Know what we are trying to restore and why, because through knowledge comes action. Use libraries and the internet to explore ecosystems, understand their worth, enjoy their beauty and if possible visit local, provincial and national parks.
  • Think circular, understand everything we use has been taken out of a thriving ecosystem and turned into a product, which we must be careful when discarding, as there is no ‘away’.
  • Green our towns and cities by planting indigenous trees and shrubs and rewilding our gardens.
  • Clean up our areas, rivers and beaches, and recycle and compost what we find.
  • Focus on supporting locally made environmentally friendly products and green procurement.
  • If we are really up for the challenge: #gozerowaste and #govegan.

For more information and ideas, please visit the United Nations website

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Unemployed man sitting near wall

The backbone of our country’s frail economy is weakening – rebuilding SMMEs needed

USB News

The backbone of our country’s frail economy is weakening – rebuilding SMMEs needed

Unemployed man sitting near wall
[Source: Skitterphoto; Pexel]

  • Jun 03
  • Tags Entrepreneurship, economy, SMME

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By Seraj Toefy, Custodian of Entrepreneurship at the business school

With lockdown destroying 42.7% of small businesses in South Africa, together with a record-high unemployment rate of 43.2% recorded in the first quarter of 2021, is a clear signal that the backbone of our country’s frail economy is weakening.

Now is the time for small business owners to look at how they can recover and rebuild in new ways for a post-pandemic business environment to retain employment and set a course for growth.

Small business globally is seen as the engine of job creation, but South Africa lags, with a high failure rate of SMMEs meaning we are still far short of the National Development Plan (NDP) target of small businesses creating up to 10-million new jobs by 2030.

The short-term outlook for small businesses most definitely varies depending on the industry, with some industries closed for the foreseeable future, however, many can still recover and consider action plans to rebuild their businesses. Amidst the uncertainty of not knowing how long the recovery will take, SMMEs must reconsider and reimagine their business models.

Embrace the changes
If your business is still yet to boom again, then there is no doubt you needed to make some serious changes to survive. What you don’t want to do is bounce back to pre-Covid routines.  Rather embrace the changes and create a new norm.

“Go back to basics and relook your business model…”

Go back to basics and relook your business model – interrogate why you did things in a certain way, and whether you could do things differently.  Most businesses grow organically with very little time spent on critical assessment. Investigate the changing consumer behaviour landscape and ask yourself how relevant your business still is, how can you adapt your service or product, attract a completely new consumer group, or use your skillset to start an entirely new business.

Side-hustles are very often overlooked as potentially fledging full-time businesses. If you started a side-hustle to keep things afloat, consider whether this could not steer your business into a new direction either as an addition to or a completely separate business.

Reassessing your staff complement is essential in reimagining a business. Consider how you can adapt job descriptions to keep overheads lower, upskill your star employees in taking on new responsibilities or diversify their tasks. By investing in your staff and making them part of your growth, they will be in many cases, the reason for long-term, sustainable, success.

Collaborate
Isolation is the death of many small businesses. By collaborating you can potentially grow faster. Share expenses, resources, leads and staff, even if only as a temporary measure.

“By collaborating you can potentially grow faster.”

For too long, we have viewed competition in a binary way.  I win, you lose.  We need to move past that and realise that the real competition at the moment is lockdown and a struggling economy.  If forming collaborative partnerships with your immediate competition is too much of a stretch, then look to see how you can collaborate with suppliers and complementary products or services.

Rising tides raise all boats, and working together makes that easier.

Milestones
Set yourself reasonable milestones for your growth.  It will be tempting to think that you will be able to bounce back to pre-pandemic growth figures, but expecting that could be frustrating.  Reset your targets, set mini-milestones that will keep you moving forward and motivated.  Build a runway of at least six to 12 months until you can safely be looking at pre-Covid levels.

“Reset your targets, set mini-milestones that will keep you moving forward and motivated.”

Stay connected
Brand awareness is your way of letting your consumers, customers and suppliers know that you are either back in business, have expanded your business or at the very least, that you are still around.

“…never underestimate the power of a phone call.”

Strengthen or re-establish the bond by communicating regularly and excite them with your offering. Clean up your database and use email and social media to advertise your offering or share new developments in your business. Re-skin your website and ensure it visually portrays a sense of dynamism. And never underestimate the power of a phone call. A short call to your suppliers could result in new, better ways of working together.

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