Impact of the COVID-19 pandemic on sick leave among healthcare workers: a register-based observational study

OBJECTIVES: To assess the impact of the COVID-19 pandemic on sick leave among healthcare workers (HCWs) in primary and specialist care and examine its causes. METHODS: Using individual-level register data, we studied monthly proportions of sick leave (all-cause and not related to SARS-CoV-2 infection) from 2017 to February 2022 for all HCWs in primary (N=60 973) and specialist care (N=34 978) in Norway. First, we estimated the impact of the pandemic on sick leave, by comparing the sick leave rates during the pandemic to sick leave rates in 2017–2019. We then examined the impact of COVID-19-related workload on sick leave, by comparing HCWs working in healthcare facilities with different levels of COVID-19 patient loads. RESULTS: HCWs had elevated monthly rates of all-cause sick leave during the COVID-19 pandemic of 2.8 (95% CI 2.67 to 2.9) and 2.2 (95% CI 2.07 to 2.35) percentage points in primary and specialist care. The corresponding increases for sick leave not related to SARS-CoV-2 infection were 1.2 (95% CI 1.29 to 1.05) and 0.7 (95% CI 0.52 to 0.78) percentage points. All-cause sick leave was higher in areas with high versus low COVID-19 workloads. However, after removing sick leave episodes due to SARS-CoV-2 infections, there was no difference. CONCLUSIONS: There was a substantial increase in sick leave among HCWs during the pandemic. Our results suggest that the increase was due to HCWs becoming infected with SARS-CoV-2 and/or sector-wide effects, such as strict infection control measures. More differentiated countermeasures should, therefore, be evaluated to limit capacity constraints in healthcare provision.