Enduring Outcomes of COVID-19 Work Absences on the US Labor Market.

Importance: Although the adverse outcomes of the COVID-19 pandemic on the US labor market have been well documented, the impacts of ongoing SARS-CoV-2 circulation are less clear. Objective: To determine the extent to which COVID-19 continues to generate work absences and decrease labor force participation beyond the pandemic period in the US. Design, Setting, and Participants: This cohort study used monthly data from employed survey respondents in the nationally representative Current Population Survey spanning January 2010 to December 2024 and linked to COVID-19 wastewater surveillance data from the Centers for Disease Control and Prevention. The setting was the US before the COVID-19 pandemic (before March 2020), during the pandemic (March 2020 to April 2023), and after the end of the public health emergency declaration (May 2023 to December 2024). Exposures: COVID-19 prevalence as measured by wastewater viral activity levels and comparisons across the periods before, during, and after the pandemic. Main Outcomes and Measures: The primary outcomes were health-related absences from work and subsequent labor force exits. The association between health-related absences and all measures of wastewater viral activity was analyzed using state-level data and linear regressions with state and month fixed effects. Results: The study cohort was the employed US population and represented approximately 158.4 million workers in February 2020. At this baseline, approximately 35% of workers (55.3 million workers) were aged 15 to 34 years, 41% (65.1 million workers) were aged 35 to 54 years, and 24% (38.0 million workers) were aged 55 years and older; 48% (75.2 million workers) were female; 1% (1.7 million workers) were American Indian, 7% (10.5 million workers) were Asian, 18% (27.7 million workers) were Hispanic, 11% (18.1 million workers) were non-Hispanic Black, and 62% (97.9 million workers) were non-Hispanic White; and 33% (52.5 million workers) had educational attainment of high school or less. Adverse outcomes from the COVID-19 pandemic persisted, although at attenuated levels compared with the acute pandemic period. Health-related absences from work continued to track COVID-19 circulation and were 12.9% higher in the postpandemic period compared with before the pandemic (140 000 monthly absences). Workers in occupations at greater risk of exposure and some demographic groups continued to experience elevated levels of absences in the postpandemic period. Specifically, absences were 8.1% higher for workers in low work-from-home occupations and 12.5% higher for workers in high physical proximity occupations compared with prepandemic values. Labor force exits after a health-related absence also continued to be elevated, with 13.1% more exits in the postpandemic period compared with before the pandemic (13 500 monthly exits). Conclusions and Relevance: In this cohort study of employed workers in the US, the new year-round baseline for work absences appeared to be on par with the levels formerly confined to prepandemic influenza season conditions. Policymakers should consider the consequences for workers, including the value of policies and actions that mitigate the spread of COVID-19 in the workplace. This study additionally highlights the potential for using nationally representative labor market data to monitor the impacts of public health crises.