One billion days lost: How COVID-19 is hurting the US workforce

COVID-19 has gradually become a part of the US landscape. Changes in official policy have indicated as much, as has the public’s clear acceptance of the risks of the disease. These shifts are consistent with the scenarios that we and others have described: COVID-19 is now endemic in the United States.

However, that does not mean that we have defeated the disease. Every day, between 250 and 400 US families lose a loved one to COVID-19.1 That’s roughly 2.5 to 4.0 times the average number of daily deaths from the flu in the decade preceding the pandemic.2  For these families (and those of the more than one million victims since 2020), COVID-19 is an unalloyed tragedy.

Another ongoing effect of COVID-19 is less critical, and less obvious, but nevertheless substantial: more than two years after the lockdown, the disease continues to exert a brake on the US economy through productive workdays lost to worker illness, caregivers’ responsibilities for children and seniors, and compliance with isolation guidelines. And some analysts are starting to notice.3

We estimate that each case of COVID-19—including both those diagnosed and those that do not make it into official statistics—leads to 1.0 to 1.5 days of productive work lost, depending on the scenario. By itself, that is not catastrophic for anyone, worker or employer. But the scale of the endemic is vast: the Institute for Health Metrics and Evaluation suggests that there were 315 million to 690 million COVID-19 cases in the United States in 2022. Only a small portion of these cases, however, are captured in public-health statistics.4

Do the math, and 315 million to 1.05 billion worker days were likely lost to COVID-19 last year, equivalent to 1.3 million to 4.3 million workers dropping out of the workforce for the full year.5 At the high end, that’s about double the average number of sick days taken by US workers in the decade before the pandemic. Stated differently, the cumulative impact of lost time due to COVID-19 is equivalent to a 0.8 to 2.6 percent reduction in the availability of the US workforce.6  In our view, this is a hidden loss that could help explain the persistent US worker shortage.

In this article we review the analysis and explain our assumptions. And while our review is confined to 2022, early epidemiological estimates suggest that US case rates will continue on a similar trajectory in early 2023, particularly if new subvariants such as XBB.1.5 drive new waves of disease. If that happens, then the US workforce will lose productive days at a similar rate.7 In the meantime, severe outbreaks of influenza and respiratory syncytial virus (RSV) in the United States are also wreaking havoc on workers’ availability.8  Many analysts have asked about the missing US workers.9 Our answer: they’re out sick, and companies will have to adapt.

How COVID-19 affects workforce productivity

COVID-19 affects productivity in four ways:

  • Missed work due to acute illness. The average symptomatic person loses some productive working time because of COVID-19, and the amount of time lost varies. Some will isolate for the full recommended period, which is currently five days. (We account for these workers separately.) Others will miss work only while they feel unwell—for example, missing work for a couple of days, working at 75 percent of their usual capacity for ten days, or similar adaptations. Finally, a smaller though still meaningful number of people experience severe acute illness and miss work for a longer period.
  • Productivity loss due to long COVID. Long COVID is a complex and poorly understood syndrome. We recently estimated one form of its economic impact: the affordability challenge that it places on the nation’s healthcare system.10The gathering storm: The affordability challenge of endemic COVID-19,” September 21, 2022.  Reduced productivity is another such challenge. A relatively large number of people experience mild to moderate medium-term symptoms, which cause a modest productivity decrease. A smaller number suffer debilitating symptoms and are unable to work for a substantial period of time.
  • Missed work due to isolation based on COVID-19 protocol. While compliance is far from universal, some people, irrespective of symptoms, do follow the US Centers for Disease Control and Prevention’s (CDC’s) recommendation to isolate for at least five days after testing positive.
  • Productivity loss while caregiving for a dependent family member. Cases in dependent family members can also lead to workdays lost, as parents may have to care for sick children (or grandparents).

Across all four categories, we estimate that each case of COVID-19 in the United States currently causes workers to lose between 1.0 and 1.5 days of work (see sidebar, “Our methodology,” for an explanation of our assumptions). Exhibit 1 reflects three scenarios, derived from the range of our assumptions.

The economic impact of lost productivity

Many economic analysts are puzzled by the conundrum in the US labor market: even as the economy cools, there are still nearly twice as many job openings as there are unemployed people. It seems that one of the factors keeping workers on the sidelines is COVID-19. And on the other side of the equation, COVID-19 also seems to be a critical factor holding down productivity and hurting companies’ ability to keep up with demand.

A billion workdays lost to COVID-19 is enough to have a substantial impact on the economy. Even the midpoint scenario of roughly 600 million workdays lost represents nearly a week missed per worker on average, more than doubling the prepandemic number of sick days taken by Americans.11 The implied reduction of 1.5 percent in the US labor force is material at a time when unemployment stands at only 3.7 percent, and many sectors are labor constrained.

The impact is asymmetric across industries; those sectors whose workers are unable to be productive remotely bear a greater burden. Exhibit 2 shows our estimates of remote-working potential by sector.

The impact of lost workdays is asymmetric across industries; the sectors whose workers can’t be productive remotely bear the greatest burden.

The impact will also likely be disproportionate across regions. Those parts of the country with higher vaccination rates among working-age populations are likely to see less work lost due to severe disease. Areas with economies that are less dependent on industries with a low potential to work remotely will also see a lighter burden.

Moreover, reduced productivity from COVID-19 is likely to continue into this year. Without a change in trajectory, the United States will experience hundreds of millions more COVID-19 cases in 2023, although the situation could improve if milder variants become dominant or if new preventive or therapeutic modalities reduce the average severity of cases or rates of long COVID.

In the meantime, workers continue to get sick and miss work. Amid the many ways that COVID-19 has slowed economies, the impact on economic productivity may be among the most enduring.

While this analysis is focused on the United States, many other countries that saw a high number COVID-19 cases during 2022 are also likely to encounter a substantial effect on their workforces. Business and government leaders in these countries may want to take stock of this little-understood economic effect of COVID-19.

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