Figures released by the Office for National Statistics (ONS) on 16 December 2020 suggest that individuals suffering from ongoing symptoms related to COVID-19, so called long COVID symptoms, could be more common than previously thought. The ONS survey of almost 8200 participants from random household coronavirus samples showed that around one in five people who tested positive still had symptoms five weeks later, and around one in 10 still reported symptoms 12 weeks after infection.

On 18 December 2020 Scotland's national clinical director, Jason Leitch, announced that agreement had been reached on a clinical definition of long COVID. On the same date, the National Institute for Health and Care Excellence (NICE) publish guidelines entitled "Covid-19 rapid guidelines: Managing the Long-term Effects of COVID-19".

These guidelines, aimed at health and care practitioners and those involved in planning and delivering services, provide a clinical definition of long COVID together with guidance for identifying, assessing and managing the condition.

In light of the growing awareness of the potential long term effect of COVID-19 we have considered the impact of long COVID for client facing industries, the risk of an increase in claims and what steps can be taken to manage those risks.

Defining Long COVID

The NICE guidelines set out the following clinical definitions for both the initial illness and long COVID at different times:

  • Acute COVID-19: signs and symptoms of COVID-19 for up to four weeks.
  • Ongoing symptomatic COVID-19: signs and symptoms of COVID-19 from four to 12 weeks.
  • Post-COVID-19 syndrome: signs and symptoms that develop during or after an infection consistent with COVID-19, continue for more than 12 weeks and are not explained by an alternative diagnosis.

The guidelines list more than two dozen commonly reported symptoms of long COVID including breathlessness, cough, joint pain, muscle aches, hearing problems, headaches, loss of smell and dizziness. The guidance also indicates that symptoms are often unpredictable and the likelihood of developing symptoms is not thought to be linked to either the severity of the original infection or whether the patient has been admitted to hospital. More information on the range of symptoms and ramifications of long COVID will become available over time as scientists learn more about the disease and its effects.

Potential Claims?

Given the growing concern and increased prevalence of long COVID, what could this mean for those working in client facing industries such as the beauty industry or sport and physical fitness?

Recently the National Hair and Beauty Federation (NHBF) warned hairdressers to stay vigilant of a potential "heightened reaction" to chemicals in hair colour by those who have suffered from COVID. Whilst there is not yet conclusive scientific evidence, given the impact of COVID on the immune system there is a concern that COVID sufferers may experience an increase in allergies post-virus.

Similarly, the impact of COVID-19 on sport has been well documented in the press with a number of high profile athletes testing positive for the virus. While the vast majority have experienced mild or no symptoms, some have experienced the prolonged after-effects of long COVID. Data released by the English Institute of Sport (EIS) shows that of the 85 Olympic and Paralympic athletes in England who have tested positive for coronavirus, 10% of them had symptoms lasting more than 30 days, and some have not yet returned to training. Although this research may be focused on elite athletes, those working in the fitness industry at a grass roots and amateur level, such as personal trainers or sports coaches, should also keep abreast of developments to consider and guard against potential claims.

Those working in industries which are client facing may consider it appropriate to revise working practices to take account of the potential impact of long COVID.

Service providers may want to consider implementing post-lockdown consultations with all new and returning clients to discuss current health conditions including any long COVID symptoms. If new clients are required to complete a health questionnaire then consideration should be given to including questions relating to any COVID diagnosis or symptoms, with updated questionnaires obtained from returning clients. This would allow suitable alterations to be made to treatments or training regimes if necessary. A suitable risk assessment with control measures identified to mitigate the risks might be appropriate.

Hair and beauty salon operators may also want to consider what treatments may pose an increased risk to long COVID sufferers, for example beauty treatments such as eye brow or eyelash tinting, waxing treatment or make up application, where chemical based products are being applied directly to a client's skin. If patch testing has not been carried out previously for any such treatments, then an assessment of the risk should be carried out, with consideration given to whether patch testing should now be implemented.

Final Thoughts

Those working with members of the public should consider how COVID-19, and in particular the potential effects of long COVID, impacts the service they offer. Are their clients at an increased risk and if so, what measures have been put in place to control those? Carrying out risk assessments and implementing new ways to identify and control the risks will be key in order to limit exposure to potential future claims.


Lynn Livesey

Legal Director

Katy Angus