CHB 2.3: Some (bad) things take time..
Remote work and its delayed onset of consequences
The current body of literature has reported immediate consequences of COVID-19 confinements on behavior and lifestyle, i.e. changes in PA levels, sedentariness, dietary behavior. While some short-term effects such as acute changes to the body and its composition (e.g. weight gain, muscle loss, poor mental health, increased levels of pain) have started to occur, long-term effects, i.e. development and progression of conditions such as MSKd, may have a delayed onset of effects. Indeed, it has previously been discussed that social and economic burdens of these conditions may increase post COVID-19 as remote-work continues (Kakar & Lomond, 2020). MSKd has been classified as one of the leading causes for illness in the working population (Beroepsziekten, 2020; Volksgezondheidenzorg, 2020). One form of MSKd is repetitive strain injury (RSI), mostly apparent in regions of the upper extremities, and, as the name suggests, develops through repetition of tasks over time, e.g. repetitive work on the desk and computer (Beroepsziekten, 2020). Thereafter, this type of MSK disease is more prevalent in older populations (Beroepsziekten, 2020; Volksgezondheidenzorg, 2020), further exaggerated through effects of ageing and poor ergonomics of work set-ups. Conditions of COVID-19 confinements such as remote work lead to physical deconditioning directly and work-set ups were shown to be less than adequate which both inherently increase the risks for developing/worsening conditions of MSKd. However, following previous research discussing the begin of a back-pain pandemic following the COVID-19 pandemic (Kakar & Lomond, 2020), it can be suggested that observed consequences, i.e. a higher prevalence of neck and back pain (Fallon et al., 2020; Moretti et al., 2020; Nieto et al., 2020; Smith et al., 2020), are only the first signs and symptoms are likely to gain momentum in occurrence and severity and over time will affect more people in an accelerated manner. Indeed, authors characterize these conditions as a catabolic crisis that promotes physical deconditioning (Kirwan et al., 2020) and hence may worsen the burden of MSKd in the working world. Thereafter, with persistence of conditions such as remote working, symptoms as neck and low-back pain may start so show quicker than under ‘normal’ conditions prior to COVID-19. As such, younger populations may develop symptoms earlier and symptoms may intensify faster in older populations if no action is taken, eventually progressing into severe conditions that lead to an inability to work, accompanying serious consequences for both employee and employer. Ultimately, this scenario can be viewed as a chain reaction, a cascade of inconvenient events, decreasing health for employees and increasing costs for companies.
It is worth noting that technology and digitalization is able to evolve and adapt quicker and easier than humans. As such, adaptation to new environments may take years or decades for humans, whereas technology could be instantly adapted to remote work. However, if humans physiologically adapt to remote-working, or at least continue to adapt to prolonged sedentariness in non-ergonomic environments and physical inactivity, without “counteracting” the acute effects on the human body, detrimental developments in human morbidity and mortality rates are likely to occur which will result in wide-reaching consequences for the economy, i.e. loss in revenue and increased costs for health care. Current data shows that the majority of people with MSK conditions is above 40 (Beroepsziekten, 2020; Volksgezondheidenzorg, 2020), however, projecting this to 1-10 years in the future, these phenomena are likely to manifest in significantly younger populations, further increasing their burdens.
