Post COVID-19 Guideline: 7 Considerations for a Gradual Return to Work
Before we address the recovery steps, let´s briefly touch on dealing with the infection. Most health information on COVID-19 covers the mandatory steps anyone infected must take: Seeing a doctor, following the national guideline on quarantining, and taking all the necessary tests is of course essential to recover and to avoid infecting others. In addition to severe risks of lung and heart complications, diarrhea, nausea, and shortness of breath are the major effects that affect most patients. Therefore, isolation is not enough for recovering from the viral infection. Patients should consume a balanced diet and always stay hydrated. Moreover, healthy nutrition and adequate food supply can help manage the symptoms effectively.
1. Resting period: According to various regulatory bodies, the minimum time span for taking rest after the first appearance of COVID-19 symptoms should be ten days. For patients suffering a more severe progression of the disease, this period would of course be adapted by the attending physician.
2. 7 days symptom free: In addition to the recommended resting period, the patient should remain symptom-free for at least seven days after full recovery from the infection before taking the next steps.
3. Routine tasks: Stage one of the GRTP states that an athlete should be able to accomplish activities such as a 500-meter walk without feeling any tiredness. In the case of employees with a non-physical job, completing routine tasks without exhaustion would be the minimum requirement for a return to work.
4. Medical diagnostic tests: In addition, employees and athletes must undergo some diagnostic tests to ensure their safety and the safety of their coworkers. These will help the administrative bodies determine whether they should allow someone to return to activity or stay in quarantine for a few more days. One of the most crucial tests is a 24-hour Holter monitoring test to rule out arrhythmias and any subclinical myocardial disease. Other recommended tests include transthoracic echocardiograms, cardiac evaluation, and maximal exercise testing.
5. Gradually increasing activities: As part of the stages 2-4 of the GRTP athletes increase training from 15 minutes per day and an increase of the heart rate up to 70%, to longer a more frequent training periods of more than an hour per day in stage 4. If athletes remain asymptomatic during these stages spanning over a period of sixteen days, they can go back into active competition on day seventeen and stage 5.
For employees with physically demanding jobs this can be used as a guideline of gradually returning to their tasks and to working part-time to full-time. For employees with non-physical job roles, it is also a good guideline on gradually resuming physical activities – from climbing stairs to going to work by bike, walking a dog or slowly taking up sports again.
6. Back to sports: Sports that do not demand heavy physical activity and high heart rates (from yoga to golf) can be resumed shortly after the patient has remained symptom-free for the described period and shows no sign of tiredness after every-day physical activities. More demanding cardio-focused sports should be slowly taken-up step by step.
7. Workplace screening tests: Considering the possibility of transmission of the virus from a single carrier, screening tests are also imperative. Some countries and regional authorities have already made employee testing mandatory, most other agree on a strong recommendation of regularly testing all employees with client contact or close contact to co-workers.
“In addition to the gradual approach and all mandatory medical precautions, we highly recommend seeking the advice of a cardiac or infection control expert to control risks of long-term effects´, said Arto Pietilä, Senior Vice President of Bittium Medical Technologies. “In addition to mitigating physiological risk factors, medical support and remote monitoring of risk factors can also lower the psychological strain and effects as the patient knows that risk factors are monitored.´
Due to the potential adverse effects linked with cardiac disorders, cardiac evaluation holds prime importance in determining the wellness of a recovering COVID-19 patient. The Faros ECG monitoring device from Bittium has proven to be a valuable part of the diagnostic process. In roughly 10% of our cases we spotted temporary arrhythmias and / or a large number of extrasystoles. Cardiac monitoring involves calculating the resting heart rate, breath holding duration, and rated perceived exertion. The more reliable or usable data and preliminary findings of the cardiovascular system exist, the easier it is to assess and support training after the illness.
