“Long COVID” increases the urgency for a state paid family and medical leave program

“Long COVID”— that is, the persistence of COVID-related symptoms for months after being sick — is likely to cause many Oklahomans to experience long-term health conditions that could impact their ability to work, including brain fog, fatigue, and mobility loss. In severe cases, federal guidelines state that these symptoms can even amount to a disability. Given the reasonably anticipated increase in need for employment accommodations due to COVID-related symptoms, Oklahoma’s Legislature should act now to create and implement a state paid family and medical leave program that will support job and paycheck stability to workers caring for their own or their families’ long COVID-related conditions.

Paid family and medical leave will help workers manage their or their families’ long COVID conditions

A well-designed paid family and medical leave program gives stability and flexibility to workers caring for medical conditions. Essentially, it allows workers with serious health conditions to take time off work to address those conditions and still receive partial pay for the time they are gone. Unlike sick leave, paid family and medical leave extends this paid time off to allow workers to care for a family member’s serious illness or bond with a newborn. If a worker or their family experiences serious long COVID, paid family and medical leave could allow them to take the much-needed time off work to care for themselves or their family member.

A significant number of Oklahomans are going to experience long COVID

While it’s still too soon to determine the full impact of long COVID, recent estimates suggest that half of people who contract COVID will experience symptoms for six or more months. Of these COVID “long haulers,” approximately 1 in 5 will experience some kind of cognitive impairment, 1 in 5 will experience a loss of mobility, and nearly 2 in 5 will experience fatigue or muscle weakness. 

Assuming Oklahoma follows national trends where more than 1 in 3 Americans has caught COVID at some point, this would mean that more than 650,000 Oklahomans have experienced long COVID symptoms for six or more months*. Of these, it can be estimated that more than 200,000 have experienced some form of cognitive impairment, almost 250,000 have experienced a decrease in mobility, and nearly 460,000 Oklahomans have experienced fatigue or muscle weakness for six or more months after catching the COVID-19 virus. In addition to being extremely inconvenient and unpleasant, these conditions can make it challenging to perform basic functions such as working a job, caring for family members, cooking, exercising, and household chores.

A state PFML would fill gaps left by existing leave programs

Low-income workers have been the hardest hit by the pandemic and are therefore at a higher risk of contracting long COVID. Because of this, they likely have an even greater need for family and medical leave. In the absence of paid leave policies, low-income workers impacted by long COVID are faced with an impossible choice: either they go to work while they or their loved one is seriously ill, or they take time off and lose the paycheck they need to put a roof over their head and keep food on the table. To ensure that no family is forced to sacrifice their health or their financial security, Oklahoma’s Legislature should make sure that workers of all income levels have access to paid leave.

Most Oklahoma workers are covered by some form of family and medical leave, but many can’t realistically use it. The federal Family and Medical Leave Act guarantees most workers 12 weeks of leave to care for their or their loved ones’ serious medical condition. However, it completely fails to cover workers employed by small businesses of fewer than 50 people — about 1 in 10 workers. Furthermore, because the act only guarantees unpaid leave, it is effectively useless to low-income workers who can’t afford to forego their paycheck. 

Unfortunately, most workers don’t have access to paid family or medical leave. Data on medical leave is scarce, but the Bureau of Labor Statistics estimates that only 2 in 5 workers have access to short-term disability insurance, and fewer than 1 in 4 workers have paid family leave. Low-income communities are even less likely to have paid leave, with only about 1 in 10 workers in the lowest wage quartile having access to paid family leave. Offering paid leave allows workers of all income levels to take advantage of the leave they need knowing that their jobs and paychecks are secure.

A paid family and medical leave program would be an investment in our workforce and economy as a whole

Even setting aside Oklahomans’ pressing need for paid leave following a COVID-19 illness, creating a state paid family and medical leave program is a sensible policy that would benefit our families, our employers, and our economy as a whole. Paid family and medical leave has been shown to improve parental health as well as boost children’s health and future financial outcomes. Paid leave also increases employee productivity and job satisfaction, decreases reliance on public assistance, and increases labor force participation (which has been declining in Oklahoma for decades, leaving us with fewer workers to support our population). Likely due to these economic benefits, most employers find that paid family and medical leave is cost neutral to businesses or even revenue positive

Paid family and medical leave’s negligible cost to business is in large part because of how the program is funded. Across the U.S., paid family and medical leave programs are funded by payroll taxes, ranging from 0.13 percent to 1 percent of employee wages. In some states, this tax is paid entirely by workers and comes at no cost to businesses. Meanwhile, businesses benefit from decreased employee turnover and increased worker productivity. Research has thoroughly proven that providing paid family and medical leave is a crucial step to building a healthier, stronger, and more modern economy.

Paid family and medical leave is a necessary tool to meet an unprecedented challenge

The burden of long COVID will place new levels of strain on Oklahoma’s workforce as large numbers of Oklahomans will face long-term conditions that our medical community doesn’t even fully understand yet. Our Legislature should anticipate this unprecedented strain and create a statewide paid family and medical leave program that will give Oklahomans of all income levels the support they need to manage their or their families’ COVID-related conditions. Taking this action will be an investment in our workers, our public health, and our economy — all at a minimal cost to workers and business owners.


*This number is based off of Census population estimates for Oklahoma and a Columbia University study estimating that by the end of 2020, 1 in 3 Americans had caught COVID-19 at least once. As more Americans have continued to catch COVID-19 during 2021 and 2022, these estimates are likely underestimating the actual number of Oklahomans who have caught the virus.


Josie Phillips joined OK Policy in June 2020 as a policy intern and transitioned into a policy Fellowship with a focus on labor and the economy in August 2021. She served as a Policy Fellow until July 2022. She currently serves as State Priorities Partnership Fellow with the Maine Center on Economic Policy. Josie graduated from the University of Oklahoma in 2020 with a double major in Economics and International & Area Studies along with a minor in Spanish. While she has dabbled in working with various non profit organizations and a political campaign, her most treasured experience before entering the public policy field has been her time volunteering with the Women’s Resource Center, a rape crisis center and domestic violence shelter in Norman, Oklahoma.

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