The doctor’s prediction was right.

If her patient, a city employee, had to return to in-person work, the doctor cautioned, the symptoms plaguing her since she first contracted COVID-19 in March 2020 would only worsen. Among them: pain, headaches, dizziness, extreme fatigue and memory issues. She would wind up stuck in bed, unable to get up at all.

The 40-year-old patient, who spoke to THE CITY on condition of anonymity, has worked a desk job at a city agency for nearly a decade. In spite of her prolonged symptoms, she managed to plow through during much of the pandemic, thanks to remote work. 

But Mayor Bill de Blasio’s order for in-office work threatened that — initially, with one day a week in person starting in May, eventually expanding to all five days in September. Meanwhile, city employee requests to work remotely are exploding.

In a note accompanying the worker’s request to telework, the doctor specified she needed to work from home through the end of the year “in order to be functional” as she battles so-called Long COVID. Her supervisor was on board.

But the agency said it could not approve a fully remote arrangement because ​​“the mayor has indicated that 100% telework is no longer an option,” according to documents reviewed by THE CITY.

The worker fought back for more than a month, and the agency arranged for her to report to a job site closer to her home to cut down on commuting time. 

But because the employee’s direct colleagues aren’t working in the same location as her, she’s conducting meetings through video.

‘I’m tired, exhausted, drained, sick. It’s extremely hard to try to continue having a life.’

And her doctor’s warning proved true: She’s alternately spent her weekdays at work and then in bed, unable to get up. 

“One of the most difficult things is that people don’t know what we go through,” said the city worker, who battled a second COVID infection last fall. 

“I’m tired, exhausted, drained, sick. It’s extremely hard to try to continue having a life, to try to continue going to everything as if nothing is happening.”

‘It’s So Unpredictable’

De Blasio’s return-to-work order has been met with protests, resignations and complaints that masking and social distancing aren’t enforced, putting even vaccinated workers at risk of break-through cases of COVID-19. 

And some employees are running up against the no-telework policy as they try to secure what they consider reasonable accommodations while they deal with the debilitating toll of Long COVID. 

De Blasio’s office did not respond to requests for comment.

A study published Tuesday found that more than one-third of COVID patients are long haulers who experience ongoing symptoms months later — with flare-ups sometimes re-emerging long after the original illness.

“The body took a beating,” said Dr. Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health on Long Island, describing the lasting effects of the virus. “Some people can recover from that, some people may not fully recover from that. It’s so unpredictable.”

Adrian Popp, chair of Infection Control at Huntington Hospital/Northwell Health Credit: Courtesy of Adrian Popp

Employees with Long COVID symptoms that “substantially limit” their activities like work are eligible for reasonable accommodations under the Americans With Disabilities Act, according to federal guidance. And New York City law entitles employees to reasonable accommodations if they are pregnant or have underlying medical conditions to “protect against increased risk of complications from COVID-19.”

The law requires the employer to engage in a good faith, “cooperative dialogue” with employees, which means an open conversation is necessary to understand their needs and flesh out the potential accommodations. 

An employer can deny a requested accommodation if it constitutes an “undue hardship,” meaning it’s expensive, disruptive or wouldn’t enable the employee to do the job. But bosses must engage in a process with the employee before exercising discretion.

“If an employee can show that their job duties can be accomplished with the accommodation, then the burden is really on the employer to explain why that’s not true,” said Dana Lossia, partner at employment law firm Levy Ratner. 

“A lot of people have demonstrated during the pandemic that they can get their jobs done very well working remotely, and so employers are going to have to come up with a reason why in-person work at particular times of day is necessary for the essential functions of the job,” Lossia added.

Her Body ‘Vibrates Inside’

The city worker said she never got an explanation of what undue hardship her agency would suffer if she worked from home. 

Working from home let her get the job done while navigating her symptoms. It was draining, but she used her lunch hour to nap, regaining energy for the rest of the day. 

She moved around her home to switch positions so she wouldn’t get as tired. And she could be alone, limiting outside stimuli that overwhelmed and exhausted her. 

“It’s different going in in-person, even though I was working all the time at home,” she said. 

She needs to prepare her food, medications and clothes, expending extra effort just to get out the door and to the office — not to mention the walking commuting requires. 

At the alternate office she reports to, her employer provided a room with a cot. But she knows she’s not the only person who uses the room, which often smells of sweat and must, and she doesn’t get the same rest on her breaks there that she did at home.

All the symptoms become worse when she’s under stress or more tired, she said.

As a result of neurological damage from COVID-19, her body “vibrates inside,” making her feel like bugs are crawling on her skin, she said. 

And it’s not just physical: She has trouble connecting her thoughts to words, remembering and communicating. 

Dr. Lawrence Purpura is studying the long-term effects of COVID-19. Credit: Courtesy of NewYork-Presbyterian/Columbia

Dr. Lawrence Purpura, a physician at NewYork-Presbyterian/Columbia who is studying the long-term effects of COVID-19 in more than 300 people, said long haulers need to know their limits — and proper accommodations are important for health.

“The risk is a relapse in someone who’s doing well, or preventing someone who’s on their way to recovery from recovery, or someone who’s actually still having severe symptoms — it’ll definitely exacerbate them without accommodation,” he said. “We’re going to see a lot of people suffering, unfortunately, as they try to re-engage with work.”

‘It Seems Punitive’

It’s difficult to know how many of the city’s 300,000 municipal employees are in such a position. 

Data about reasonable accommodation requests submitted by city employees and compiled by the Department of Citywide Administrative Services do not distinguish whether or not the request relates to COVID-19. But the pandemic appears to have resulted in skyrocketing requests for telework accommodations. 

Telework requests constituted about 2% of all reasonable accommodation requests city employees filed in Fiscal Year 2019, but made up over 40% of requests in the following two fiscal years encompassing the pandemic.

Another city employee who works in a different city agency also deals with Long COVID symptoms: She has chronic fatigue, dizziness, cognitive and neurological challenges that make it difficult to focus and can’t be on her feet for extended periods or else her heart rate goes up and she faints. 

She was approved to work for three days a week instead of five — and all remote — until cleared by her doctor. 

“My situation is definitely not the most common. It’s an anomaly,” the second worker said, adding that the accommodations allowed her to make progress healing. “I wish that everyone had this.”

The biggest risk for employees when they’re not granted reasonable accommodations is losing their jobs — at a time when they most need health insurance. 

“There are people that want to work and need to do what they do to make ends meet, but they can’t because they’re suffering with COVID symptoms so far out,” said Nina Ovrutsky, an employment lawyer at Manhattan-based firm White, Hilferty and Albanese. 

“If their employer can’t accommodate that and they physically or mentally can’t do the work that they do, they don’t really have anywhere else to turn and they either have to resign from their employers or or be terminated,” Ovrutsky added.

Pregnant Employee in Limbo

Another city employee at a third agency requested an accommodation to continue remote work while she waits to give birth at the end of the year because being pregnant puts her at a higher risk for COVID, even though she’s vaccinated. 

But her agency “closed” her request — without approving or denying it — citing “no further accommodations for COVID risk,” according to documents reviewed by THE CITY. She’s gotten no additional information as to what that means or why her request was closed.

“I didn’t think it’d be so hard to get the accommodation you need for health reasons, and it seems punitive right now. Why aren’t they giving people what they need?” she said. “This is my right as a person. This is a city human rights law and the city is completely flouting it.”

Employees — public or private — may contact the city Commission on Human Rights if they suspect their employer is breaking the law. Even before filing a formal complaint, the agency can engage in interventions with both parties to resolve an issue, an agency spokesperson said.

‘Not Sure What’s Next’

As for the first city employee, she’s blasted through her sick leave — used between May and September to avoid heading to work on the days she was scheduled for an in-person shift — and doesn’t know what she’ll do when her annual leave runs out.

“I always made sure things got done and took time from outside of work to make sure things got done and the work was not being affected. It’s very sad to know it’s not reciprocal,” the city worker said. “The energy I have, I spend working because I need my salary. There is no other way I can survive.”

She misses cooking. She can’t even summon the energy to do the dishes, let alone see friends or go hiking, like she used to. 

She’s lonely, but she limits the non-work calls she makes to save her energy, which compounds her isolation. She’ll soon start cognitive rehabilitation treatment and was warned it’ll be tough on her.

A city worker suffering long-term COVID symptoms said she struggles to leave her home. Credit: Ben Fractenberg/THE CITY

She wishes she could just go back to working from home — it’d allow her to do her job better than what she’s capable of now, she said.

“I’m not really sure what’s next. I consider myself a good employee, a valuable person for my team, but of course I have limitations and it’s not easy,” she said. “I’ve had to fight this accommodation and that has taken energy from me… Not allowing the body the recovery that I need is not good. 

“It’s going to be slower and I’m going to be in bad shape for longer.”