COVID-19 and Workplace Fatigue: Lessons Learned and Mitigation Strategies

Posted on by Imelda Wong, PhD; and Mary B. O’Connor, MS


The declaration of coronavirus disease 2019 (COVID-19) as a US public health emergency on March 13, 2020, altered the way we work and live, intensified feelings of stress, and created uncertainty about the future for many people. The closure of many businesses led to financial instability and the highest unemployment rates since 1976 1. Exposure to an abundance of news coverage, some of which has been conflicting or has changed over time, has fueled feelings of mistrust and fear2-5. New routines and behaviors, such as wearing masks and social distancing, along with frequent messages about handwashing and cleaning, are chronic reminders of our “new normal” and have been shown to increase stress and anxiety6. Lessons learned from COVID-19 studies report that fatigue is linked to different factors, including changes in work schedules and routines and worries about economic stability and health. Effective employer-led strategies to mitigate fatigue include clear communication about safety policies and procedures and implementation of organizational safety measures (e.g., creating safe work spaces, developing sanitization routines, provision of employee assistance programs). Suggestions for workers include knowing about employer-based fatigue mitigation programs, keeping regular and healthy routines, and developing strong social networks (while protecting yourself and others). These unprecedented times require that employers collaborate with workers on a holistic approach and creative solutions to manage workplace fatigue.

Fatigue, Stress, and Sleep

Fatigue in the workplace is commonly associated with shift work, long work hours, and the resulting sleep impairment. However, many other factors—such as stress, health, and health behaviors —can cause fatigue7. Especially during these times, fatigue may also be a symptom of depression or other mental health challenges, and sleep impairment or reduced sleep quality can intensify existing mental health issues8. In times of stress, sleep problems are common, and sensitivity to sleep disruption increases the likelihood of chronic insomnia9,10. Insomnia is a risk factor for post‐traumatic stress disorder when people are exposed to major stressors. This, in turn, is associated with an increase of sleep disruption, which can create a spiral of stress, mental health issues, sleep impairment and fatigue11,12.

Fatigue can slow down reaction times, reduce attention or concentration, limit short-term memory, and impair judgment, thus increasing the risk for fatigue-related incidents, such as work injuries. However, worker fatigue can also affect others when mistakes are made, for example, when fatigued workers operate machinery at work, make family-related decisions at home, or drive while tired. Recognizing the sources of fatigue can allow for targeted, effective mitigation strategies to keep everyone healthy and safe.

COVID-19 and Changes in the Workplace

In response to the declaration of COVID-19 as a public health emergency, more than 55 million workers were in jobs considered essential to maintaining critical infrastructure12. While the pandemic has provided unprecedented challenges, some industries have established the infrastructure, plans, and training to navigate through emergencies. In other industries, employees who do not face emergency situations in their normal work (grocery clerks or delivery drivers for example) are not typically provided the training and resources to manage stress, longer work hours, increased work demands, and fatigue13.

Millions of healthcare personnel on the frontline for responding to the pandemic have been at the greatest risk for exposure to SARS-CoV-2, the virus that causes COVID-19 while working around the clock to care for the sharp increase in patients. A surge of new cases of depression, anxiety, and insomnia, plus worsening of existing mental health issues—particularly among nurses—has been attributed to limited resources, overwhelming workload, longer shifts, disruptions to sleep and work-life balance, process inefficiencies, occupational hazards, and concerns about health and financial instability14-16.

Demands for essential goods, such as cleaning supplies and toilet paper, put extreme pressures on our supply chain. To meet this sudden increased demand, the Federal Motor Carrier Safety Administration amended hours of service regulations to allow truck drivers more time to transport emergency or critical supplies and avoid situations in which drivers could be too fatigued to operate their rigs safely17. Drivers reported that transport routes were shortened to focus on regional deliveries, more time was needed to unload and load trailers due to additional COVID-19 mitigation practices, and the closure of many businesses and rest stops reduced the number of safe places to stop, eat, and rest18. Given that drivers are paid by the load and mileage, these conditions raised concerns that drivers would be pushed to operate longer, forgo rest breaks, and park in unsafe or unsecure locations if they ran out of available hours—all of which adds to worries about financial instability and fatigue among truck drivers who haul essential goods in our supply chain.

Stay-at-home orders and social distancing recommendations prompted many businesses to adopt work-from-home options for their employees where feasible. For many of these workers, lack of physical and temporal work boundaries between work and home life resulted in longer work hours and fragmented focus time, leading to stress, burnout, and fatigue19-21. Many are also juggling increased caregiving responsibilities in response to changing school arrangements and work, and research suggests mothers may be more affected than fathers based on differences in childcare duties19,22.

Returning to “Business as Usual”

Following the lowest level of employment during the pandemic, employment has been rising.* However, much of the increase in new jobs has been among part-time workers who would have preferred full-time employment, but either their hours were reduced or they were unable to find full-time jobs23,23a.  Because of this, there may now be more workers employed in multiple jobs to make ends meet. While their overall hours of work per day may not change substantially, it may mean more scheduling demands from multiple part-time jobs and coordinating childcare (including dealing with school closures or remote learning). All this results in more time awake and added stress, leading to fatigue.

The addition of overnight shifts in workplaces to accommodate the physical distancing requirements, while keeping up productivity, may increase the risk for fatigue-related incidents, particularly among those who are unaccustomed to working non-standard schedules24. Organizations may be operating with reduced staff, which may lead to greater work intensity for individual workers.

A Holistic Approach for Employers and Workers to Manage Fatigue

The causes of worker fatigue can stem from a number of sources such as changes in work routines and schedules, varying degrees of stress due to adversities related to COVID-19 and concerns about exposure to SARS-CoV-2 at work. A holistic approach to worker safety, health, and wellbeing is critical for an effective and efficient return to our routines. For employers, it is important to use several strategies, learned from the impacts of public health emergencies, to manage stress and fatigue. Some strategies include structured training on large-scale disasters, increased staffing, collaborative efforts and modified human resources, such as alternate paid time off options where possible (e.g., to care for a family member with COVID-19)22. Messaging should be tailored to the workforce with considerations for literacy levels, translations, and delivery methods (e.g., infographics, online training). In times of crises, a clear plan and communications (based on risk-communications principles) from leaders, to set expectations, adjust resources, and help workers feel connected and involved can alleviate stress and fatigue. In addition, organizational measures such as social distancing, good ventilation, and psychological support systems (e.g., Employee Assistance Programs) are also effective measures 25,26. Considerations should be extended to all workers, including those working part-time or on contract. Creative solutions such as redesigning or shifting workloads may need to be considered.

Workers can consider workplace strategies like developing a buddy system or knowing employer safety protocols to help reduce the risk for fatigue-related incidents. Outside of the workplace, strategies to improve sleep include maintaining a regular routine and healthy habits. In times of common stress, it is normal for people to feel a greater need to communicate with each other. Studies from Wuhan, China, found good social support (while maintaining social distancing), creating strong social networks, and a sense of belonging reduced anxiety and fostered better sleep and self-efficacy during COVID-19 and return to work27. Health behaviors such as enhanced personal hygiene (such as wearing masks and handwashing) and using psychological support systems among coworkers, family, and friends have also been shown to decrease workers’ anxiety, depression, stress, and insomnia27,28.

More information and strategies to manage fatigue during COVID-19 is available on the CDC website and additional information about protecting and advancing worker safety, health, and well-being has been published in prior NIOSH Science Blogs and on the CDC website addressing strategies to build mental resilience, the importance of healthy work design and well-being solutions in mitigating stress among workers, sleep tips during difficult times, and the role of organizational support and healthy work design to support worker well-being.   This blog is based on a larger article published in the November 2020 issue of The Synergist, the magazine of American Industrial Hygiene Association.

Imelda Wong, PhD, is the Coordinator for the Center for Work and Fatigue Research and an Industrial Hygienist/Epidemiologist in the NIOSH Division of Science Integration.

Mary B. O’Connor, MS, is an Occupational Safety and Health Specialist in the NIOSH Western States Division.


* Section edited to reflect trends in the data vs. monthly numbers that are quickly outdated. 

For more Information

Managing fatigue during times of crisis: Guidance for Nurses, Managers, and Other Healthcare Workers

Sleep Research Society


  1. Bureau of Labor Statistics. Current Unemployment Rates for States and Historical Highs/Lows, Seasonally Adjusted., November 2020.
  2. Jurkowitz M. Most Americans say COVID-19 has changed news reporting, but many are unsure how it’s affected industry. 2020;
  3. Garfin D, Silver R, Holman E. The novel coronavirus (COVID-2019) outbreak: Amplification of public health consequences by media exposure. Health Psychology. 2020;39(5):355-357.
  4. Jamieson K, Albarracin D. The Relation between Media Consumption and Misinformation at the Outset of the SARS-CoV-2 Pandemic in the US The Harvard Kennedy School (HKS) Misinformation Review. 2020;1.
  5. Simonov A, Sacher S, Dubé J, Biswas S. The pursasive effect of Fox News: Non-compliance with social distancing during COVID-19 pandemic (No. w27237). National Bureau of Economic Research;2020.
  6. Wang C, Pan R, Wan X, et al. A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, behavior, and immunity. 2020;87:40-48.
  7. Di Milia L, MH S, Costa G, Howarth H, Ohayon M, Philip P. Demographic factors, fatigue, and driving accidents: An examination of the published literature. Accident Analysis & Prevention. 2011;43(2):516-532.
  8. Lavidor M, Weller A, H B. How sleep is related to fatigue. British journal of health psychology. 2003;8(1):95-105.
  9. Altena E, Baglioni C, Espie CA, et al. Dealing with sleep problems during home confinement due to the COVID-19 outbreak: Practical recommendations from a task force of the European CBT-I Academy. J Sleep Res. 2020:e13052.
  10. Akerstedt T, Kecklund G, Axelsson J. Impaired sleep after bedtime stress and worries. Biological Psychology. 2007;76:170-173.
  11. Sinha S. Trauma-induced insomnia: A novel model for trauma and sleep research. Sleep medicine reviews. 2016;25:74-83.
  12. McNicholas C, Poydock M. Who are essential workers? A comprehensive look at their wages, demographics, and unionization rates. Working Economics Blog 2020; Accessed June 2020.
  13. Axonify. State of Frontline Employee Training 2020. Waterloo, CA2020.
  14. Sasangohar F, Jones SL, Masud FN, Vahidy FS, Kash BA. Provider Burnout and Fatigue During the COVID-19 Pandemic: Lessons Learned From a High-Volume Intensive Care Unit. Anesth Analg. 2020;131(1):106-111.
  15. Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA. 2020;323(15):1439-1440.
  16. Lai J, Ma S, Wang Y, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA network open. 2020;3(3):e203976-.
  17. Federal Motor Carrier Safety Administration. Expanded Emergency Declaration Under 49 CFR § 390.23 No. 2020-002 (Relating to COVID-19). 2020;
  18. The American Transportation Research Institute, The OOIDA Foundation. COVID-19 Impacts on the Trucking Industry. April 2020.
  19. Greer TW, Payne SC. Overcoming telework challenges: Outcomes of successful telework strategies. The Psychologist-Manager Journal. 2014;17(2):87-111.
  20. Reisenwitz C. How COVID-19 is impacting workers’ calendars. 2020; Accessed June 2020.
  21. Ashforth B, Kreiner G, Fugate M. All in a day’s work: Boundaries and micro role transitions. Academy of Management review. 2000;25(3):472-491.
  22. Alon T, Doepke M, Olmstead-Rumsey J, M T. The impact of COVID-19 on gender equality. (No. w26947). National Bureau of Economic Research;2020.
  23. Bureau of Labor Statistics. Employment Situation Summary USDL-20-1140. June 2020; Accessed June 2020.

23a. Bureau of Labor Statistics. Employment Situation New Release USDL-21-0582. April 2021;

24. Neis B, Neil K, K L. Mobility in a Pandemic: COVID-19 and the Mobile Labour Force. 2020.

25. Harter J. What Employees need from Leadership Right now. 2020; Accessed May 2020.

26. Tan W, Hao F, McIntyre R, et al. Is returning to work during the COVID-19 pandemic stressful? A study on immediate mental health status and psychoneuroimmunity prevention measures of Chinese workforce. Brain, behavior, and immunity. 2020;87:84-92.

27. Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Medical science monitor: international medical journal of experimental and clinical research. 2020;26:e923549-923541–e923549-923548.

28.Kim SW, Su KP. Using psychoneuroimmunity against COVID-19. Brain Behav Immun. 2020.

Posted on by Imelda Wong, PhD; and Mary B. O’Connor, MS

5 comments on “COVID-19 and Workplace Fatigue: Lessons Learned and Mitigation Strategies”

Comments listed below are posted by individuals not associated with CDC, unless otherwise stated. These comments do not represent the official views of CDC, and CDC does not guarantee that any information posted by individuals on this site is correct, and disclaims any liability for any loss or damage resulting from reliance on any such information. Read more about our comment policy ».

    talk about work stress during Corvid. My employer increased the work load . Decreased the amount of staff and expects us to do the work of 2-3 people. Then we cant even have places in our assignments to wash our hands or have running water. If we don’t get the work done then we are threatened with a write up . [organization name removed].

    what i would like is stop this changing the time. go bak.saver for the kids going to school and workers to. but also at home im so depressed because of this.

    With a year behind us now with the COVID-19 Event, do we have any case study work completed to determine what the labor impact was on a daily basis. Was the impact at 10%; 20%; 30% per a 8 hour workday?

Post a Comment

Your email address will not be published. Required fields are marked *

All comments posted become a part of the public domain, and users are responsible for their comments. This is a moderated site and your comments will be reviewed before they are posted. Read more about our comment policy »

Page last reviewed: April 26, 2021
Page last updated: April 26, 2021