Emilie Counil, Myriam Khlat, and the EpiCoV Study group

Abstract

Introduction: Women, immigrants, and ethno-racial minorities have been disproportionately infected by COVID-19, with essential workers among the most impacted occupational groups. This study examines disparities in SARS-CoV-2 seropositivity by gender and migration background in France at the end of 2020, exploring the role of essential worker status. Methods: We analyzed data from the EpiCoV cohort, including workers aged 18–64 in metropolitan France who completed home-based SARS-CoV-2 serology testing (ELISA) in late 2020. Participants were grouped by gender and migration background into mainstream men, mainstream women, non-mainstream men, and non-mainstream women. Worker status included seven categories: non-essential workers; high- and low-class healthcare workers (HCWs), high- and low-class social and educational workers (SEWs), and high- and low-class other essential workers (OEWs). We assessed seroprevalence across gender and migration background groups. Non-linear decomposition analysis was used to explain seropositivity differences between mainstream men and each of the other subgroups, distinguishing between compositional differences (unequal representation in essential occupations) and association differences (varying infection risk within similar essential occupations). Results: SARS-CoV-2 seropositivity was lowest among mainstream men, higher among mainstream women, and highest among non-mainstream groups. The elevated seropositivity in mainstream women, compared to mainstream men, was partly explained by their overrepresentation among HCWs and the stronger association between low-class HCW status and COVID-19 risk. For non-mainstream women, higher seropositivity was partly attributable to their concentration in HCW and low-class SEW jobs, and the stronger association of low-class essential work statuses with seropositivity. Differences between mainstream and non-mainstream men and residual gender gaps were likely driven by factors beyond essential worker status. Discussion: Essential worker status, particularly in lower occupational classes, explained some COVID-19 disparities, highlighting how gender and migration background intersect with job roles to shape infection risk. These findings call for protecting workers who combine social disadvantages with high-risk job roles.

Sander K.R. van Zon, Judith G.M. Rosmalen, Tanja Fens, Lifelines Corona Research Initiative, Antoinette D.I. van Asselt, Raun van Ooijen, Sandra Brouwer

Abstract

Objective: COVID-19 has negatively impacted workers’ productivity, making them unable to work and causing difficulties to perform work and home tasks. Those with post-COVID-19 condition (PCC) potentially experienced productivity loss for longer periods of time. However, the extent and severity of productivity loss due to these conditions is still largely unmeasured, especially across multiple dimensions of productivity, as most studies have focused on absence. This study thus aimed to more accurately quantify productivity loss due to acute COVID-19 and PCC across the pandemic, in terms of absenteeism, presenteeism and unpaid work. Material and Methods: Data from workers in the Lifelines COVID-19 cohort with information on productivity loss (N=10,750) from 2020-2022 was used. Participants were grouped as having acute COVID-19, PCC, or sickness absence due to another reason. Productivity loss was quantified in euros using the friction cost method. We performed a two-step quantile regression to investigate the association of acute COVID-19 and PCC to productivity losses. Results: Those with PCC had higher average total productivity losses (5,823€) when compared to those with acute COVID-19 (2,734€) and without COVID-19 (3,766€). While both acute COVID-19 and PCC were associated with higher costs (>200%) at lower quantiles, only PCC remained significantly and positively associated with higher losses at higher quantiles (28%) when compared to those without COVID-19. The majority of the association is due to effects of PCC on unpaid work (85% increased losses at the 90th quantile). Conclusion: PCC is associated with large productivity losses when compared to acute COVID-19 and other illnesses, especially in unpaid work. Acute COVID-19, despite being associated with high losses at low quantiles, does not represent a lasting effect for workers’ productivity. This study stresses the high cost of acute COVID-19 and PCC and the importance of unpaid work in productivity studies.