For employers and teams

More than tiredness

Long COVID and ME/CFS are physical illnesses that can affect many body systems. Their best-known symptom is fatigue, especially in ME/CFS. But it is not the only one: many people also have trouble with concentration and memory.

Fatigue is severe exhaustion caused by the illness. Sleep and breaks often do not leave people properly rested. Energy and symptoms fluctuate, even from day to day. This is not a matter of willpower or motivation.

For some, symptoms get worse after exertion, even after mental effort or conversations. Often this does not show until hours or days later. This is called PEM (post-exertional malaise). PEM is the hallmark of ME/CFS.

With PEM, pushing through is dangerous, at work too. It can lead to a relapse or cause a lasting worsening of the condition. As a result, the illness can become chronic and more severe. That is why flexibility and a return to work without pressure are needed.

Sources: WHO: fact sheet on Long COVID, 2025, D-A-CH consensus statement on ME/CFS, 2024

What those affected experience at work

Some face distrust because they are often absent but look healthy. Some lose their jobs, for example after long absences or during a work trial. Others have to reduce their workload.

Many wish for managers who believe them, stand by them and give them time.

Sources: Long Covid Switzerland survey, 2022, Swiss study on ME/CFS, 2024, Beobachter, 2022, Südostschweiz, 2021

What lightens the load at work

Some keep their illness to themselves for fear of negative consequences. So ask in confidence what would help. The person knows their limits best.

• Flexible hours and working from home where possible
• A lighter workload that matches the energy available
• Breaks without having to justify them
• A quiet place to work and rest
• Giving tasks in writing and planning fewer meetings

Returning to work without pressure

Plan the return to work together and without a fixed timetable. Only increase the workload after a stable phase. If symptoms get worse, reduce it again.

Keep expectations realistic, including the person’s own. Some play down their symptoms and go back to work too early. With PEM, this can cause a worsening, even a lasting one.

For more tips, see the guide “Zurück zur Arbeit” (Back to work) by Long Covid Switzerland at long-covid-info.ch.

Sources: Long Covid Switzerland: guide “Zurück zur Arbeit” (Back to work), part 1, Long Covid Switzerland: guide “Zurück zur Arbeit” (Back to work), part 2

What helps in the team

• Instead of“But you look well.”BetterBelieve the person. Many people with the illness do not look ill.
• Instead of“I’m often tired too.”BetterTake it seriously. Fatigue is more than ordinary tiredness.
• Instead of“It must be burnout.”BetterDo not speculate about causes. It is a physical illness.
• Instead ofCommenting on breaks or last-minute cancellationsBetterAccept them without comment. Breaks can help to avoid setbacks.
• Instead ofTalking about the illness in the team without asking the person firstBetterAsk first. The person decides what the team is told.

Sickness benefit and disability insurance (IV)

Often the employer has daily sickness benefit insurance that pays part of the salary. If someone is ill for a longer time, the Swiss Federal Council says it is crucial to register early with the Swiss disability insurance (IV). The IV follows the principle of “integration before pension”.

Assessments often take a long time and drain a lot of energy. For many, this becomes a fight for recognition. With PEM, the effort of the process alone can cause a worsening, even a lasting one.

Knowledge of these illnesses, especially of PEM, is often lacking at insurers and in expert reports. Some people are declared fit for work despite being signed off sick.

Sources: Swiss Federal Council: press release on Long COVID and social insurance, 2025, SRF Kassensturz, 2024, D-A-CH consensus statement on ME/CFS, 2024