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How should employers prepare for the likelihood of COVID-19 outbreaks this fall?

Health and Benefits|Wellbeing
COVID 19 Coronavirus

By Jeff Levin-Scherz, MD | June 1, 2021

Despite falling COVID-19 infection rates, the U.S. is unlikely to reach zero cases this summer, which makes outbreaks this fall likely.

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About our “The COVID-19 Crisis” series

“The COVID-19 Crisis” series is a weekly update by Dr. Jeff Levin-Scherz covering the latest developments related to the COVID-19 pandemic in the U.S. Explore the entire blog series.

COVID-19 numbers in the U.S. keep on looking better. We had two days of under 20,000 new reported cases in the last week, and our seven-day average was 18,913. To put this in perspective, we had 70,000 new cases per day just six weeks ago.

The seven-day moving average for May 29, 2021, was 18,913.
Daily trends in number of COVID-19 cases in the U.S. reported to the CDC

Source: CDC

Vaccines are a big part of the reason for this success. We hit over 50% of all adults fully vaccinated this week and continue to administer over 1.5 million doses a day. By the time this article is published, we’re likely to have reached 50% vaccination of the entire population having received at least one dose. Eighty-five percent of senior citizens have had at least one jab, and 75% are fully vaccinated. This is why we are seeing such impressive declines in viral infection rates.

COVID-19 is not gone, though. There are still over 22,000 in U.S. hospitals with COVID-19 now, and some of these people will die. We’re also not likely to get to zero cases this summer, as countries such as New Zealand and Taiwan did earlier (these countries never had the severe wave of infections that we have had here). Therefore, we are likely to have some outbreaks this fall. Many of these will occur in places that have lower rates of vaccination, but we could see small outbreaks in geographies with high vaccination rates too, due to randomness.

What this means for employers

  • Many employers have started bringing remote workers back — although this still often varies depending on the rate of local community transmission:
    • Many employers are finding that some employees love working remotely and are not eager to return to the workplace.
    • The federal government announced that it will allow far more of its employees to work remotely post-pandemic.
  • We continue to get many questions about mask policies:
    • Currently, those who are unvaccinated should continue to mask and practice distancing inside at work. Many employers are not formally tracking vaccination and are relying on the honor system.
    • Those who are not vaccinated and do not wear masks face larger risks themselves but pose a relatively small risk to those who are vaccinated.
    • Those whose immune systems are weaker, such as those who have had organ transplants or are on chemotherapy or immunosuppressant drugs, might not be well protected by vaccines and should continue to wear masks.
    • Companies should create an environment where any employee who wishes can wear a mask comfortably regardless of the reason.
  • Employers that are bringing back remote workers should have plans to do exposure tracing in the event there is a workplace exposure and should develop contingency plans to reduce capacity or even briefly return to remote work if there is a local outbreak.
  • Many companies are evaluating their ventilation systems. Increasing air exchange can decrease the risk of worksite transmission.
  • Some interventions to keep employees safe don’t work especially well, including temperature scanning before entry and plexiglass shields. Nonetheless, many employers will not discontinue these approaches immediately.

Other COVID-19 news

  • Moderna announced that its two-dose mRNA vaccine provides excellent protection for those 12 to 17 years old. In a trial of 3,700 adolescents, there were no infections in the vaccinated group (and four infections in the placebo group). Side effects were similar to those in adults. Moderna will apply for emergency use authorization for its vaccine for 12 to 17 year olds globally over the coming days, which could make it easier still to ensure that all high school students are able to be vaccinated before school resumes in the fall.
  • Researchers in Germany say they found evidence that the adenovirus vector might be the cause of the very rare blood clots seen with the Johnson & Johnson and the AstraZeneca vaccines. A small change in the sequencing for these vaccines could eliminate this problem.
  • The CDC is investigating reports of heart inflammation in teens (mostly boys) who received mRNA (Pfizer and Moderna) COVID-19 vaccines. All cases have been mild, and it’s not clear that the vaccines are the cause. All those evaluated so far are expected to recover fully. If people develop chest pain or shortness of breath four to seven days after vaccination, they should seek medical care.
  • Raffles get people’s attention! We all have “optimism bias” and overestimate the (small) likelihood of winning a raffle. Raffles are fun, and the Ohio decision to do five weeks of $1 million lotteries for those who got vaccinated has gained an enormous amount of publicity. New York, Oregon and Maryland have also decided to do raffles, as is CVS. It doesn’t look like there has been an avalanche of new vaccinations in Ohio since the lottery announcement, but the state is at least keeping up its vaccine momentum.
Ohio saw a slight increase in the number of vaccinations when its $1 million lottery was announced.
State of Ohio vaccine dashboard

*Indicates that an individual has received at least one dose of COVID-19 vaccine. Source: CDC

  • SARS-CoV-2 was first found in Wuhan, China, and there is growing demand to independently investigate whether the pandemic began with a leak from the Wuhan Institute of Virology there. President Biden has requested a report from U.S. intelligence and promised to release this publicly. We know that other viruses (including HIV, SARS and MERS) have jumped from animals to humans, so regardless of the result of this investigation we’ll need to continue to be prepared for future pandemics.
Author

Population Health Leader, Health and Benefits, North America

Jeff is a practicing physician and has led Willis Towers Watson’s clinical response to COVID-19. He has served in leadership roles in provider organizations and a health plan, and is an Assistant Professor at Harvard Chan School of Public Health.


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