The Hartford’s medical, HR and Absence Management experts discuss what employers should consider when cautiously preparing to bring employees back to their workplace after COVID-19 restrictions begin to ease around the country.
Host, Laura Marzi, Chief Marketing Officer of Group Benefits at The Hartford speaks with Kimberly Mashburn, The Hartford’s Absence Management Practice Lead, The Hartford’s Chief Medical Officer Dr. Adam Seidner and Assistant Vice President of HR Benefits Karen Howard about helping businesses prepare to safely return their employees to the workplace.
Laura: Hello everyone, I’m Laura Marzi and thank you all for listening in today on this special Line on Leave Podcast.
We’ve never been through a time quite like this. We all lost our “normal” with COVID-19 almost overnight. But now, three months later, many businesses are about to enter their “new normal” as parts of the country slowly reopen.
Today’s Line on Leave podcast is going to discuss:
- What will that reopening look like?
- What are some of the best practices for a safe reopening?
- And where exactly are we in the pandemic today?
I’m delighted that we have some experts here to help us answer some of those questions. They include: Dr. Adam Seidner, who is The Hartford’s Chief Medical Officer, Karen Howard, who is our Assistant Vice President of Benefits and also The Hartford’s Absence Management Practice Lead, Kimberly Mashburn.
So, Dr. Seidner we will start with some of your perspectives. You’ve worked on many public health issues, including pandemics and vaccine development. What is it about this virus that makes it so dangerous and are we headed in the right direction?
Dr. Seidner: Basically today, we have over 1.75 million cases in the U.S. with over 103,000 U.S. American deaths. What makes this different is that it is three times more contagious than the flu … and it is more lethal as well. So like the flu, it is an RNA virus and what we are seeing is a significant part of the population that is having sever symptoms.
Now realize, this is a respiratory condition, it’s spread between people, and 80% of people will have mild to no symptoms. Fifteen percent will have severe symptoms and 5% of the population will wind up needing hospitalization in the Intensive Care Unit (ICU). It is because of the contagious aspect and lethality that we see a significant problem when it comes to managing this, in addition to the fact we don’t have a vaccine.
So even though we don’t have a vaccine, there are other abilities we do have and some medications are being used to look at managing the virus. Remdesivir is one. It’s an anti-viral agent that has been shown to decrease those hospitalizations by four days and also decrease deaths.
There are also medications, Losartan, which works on an ACE2 receptor. Which again, is how the virus gets into us to cause all of the symptoms we see. Now remember, 50% of people may show no symptoms whatsoever. But the other 50% will see things like: shortness of breath, cough, they may have a fever, sore throat, they may have a decreased appetite, they could even have gastro-intestinal symptoms like diarrhea nausea. And another area we found, is that people have lost their sense of taste and smell. In addition to all of this, individuals can experience generalized muscle aches.
So, between the treatments and knowing what the symptoms are, we’re able to go through and address some other issues such as meaningful metrics and capabilities ... and part of that requires testing. There are different aspects of testing. First, I’ll talk about types of testing. There is diagnostic testing, and that tells you: Are you infected? Do you have this virus? There are two types of tests that are out there. One is called PCR, polymerase chain reaction, and FIA, fluorescent immunoassay. This basically tells us if the virus is present in the individual. The other test that people are familiar with is the anti-body test. That’s really a surveillance test and tells you whether or not someone has developed anti-bodies to the virus. So between the two tests, we are able to determine: Are you infected? And did you already have the virus?
As we go through, then we will have to look at the quality of these tests. We have to understand that on the diagnostic test side, that up to 30% of the tests could have false negatives. So, that’s pretty high. That means that even though you are infected with the COVID-19, the test may not identify it as such. And there is an issue on the anti-body test quality as well. That is a 50% have a false positive in some cases. So again, they may say you have anti-bodies and in fact you don’t – so that is a problem.
And then finally, the volume of testing. We should be testing approximately 1% of the population per week, or roughly 500,000 people per day. So the testing does help us start to define the metrics that we want to look at. The metrics include things like number of cases – which I mentioned earlier –hospitalizations, ICU admissions, the deaths that we are seeing. Usually that’s using being measures as case fatality rates, based on those who have testing positive against those who have tested positive and died. There are other metrics that we are looking at: cases per population – so it could be per 1,000 population or 100,000 population. This way we can normalize the data and compare cities, metro-areas, to rural areas or less populated areas.
Then there are other metrics that we look at, such as daily growth-rate, or doubling rate of cases. All of this can help us identify where then next outbreak may come. Or we may even see decreasing rates, that’s the good news. So if do we start to see decreasing rates, meaning we have reached a peak and we are in a plateau, we like to see those rate either plateau or decreasing for two weeks before we’re able to say the virus is contained, controlled and we’re able to move forward.
Then finally, the other capability to consider is contact tracing. Being able to go and talk to individuals who tested positive, find out where they have been, who they’ve talked to, and who they’ve experienced and spent time with. All of that can come together and help us utilize tests appropriately and do isolation as well.
In that, we’ve actually had some help from our librarians since they’ve been volunteering to help with the contact tracing. They’re making the phone calls and doing the follow up calls for a lot of the cases we are identifying. That’s excellent and we thank them for all of their help.
Then we can look at some issues around reopening guidelines. So, how and when can we start reopening – seeing that many states have? And, when and how can we get back into the office?
Once we are in a plateau, or a decreasing in the rates, then we know that we have the virus under control and we can take a look at a number of other areas. We have reopening guidelines from the Center for Disease Control (CDC), Occupational Safety and Health Administration (OSHA), World Health Organization (WHO), Department of Labor, and may others. So, taking all of those into considerations, we’ve got some good ideas as when it’s safe to reopen. You see many governors have started reopening in a phased approach in many parts of the states.
Now what about going back to an office environment? Again, people work in many different types of environments. I think you have to know the number of local cases. We can look at this – it’s all being mapped – and we can look at different jurisdictions and we can look beyond just a state level and get down to the county level. We can look at the number of hospitalizations and ICU admissions that I mentioned earlier. All of that needs to be looked at to determine, “Is it safe to again open certain businesses?”
All of this is done on the backdrop of having universal source control. We’re still going to be wearing face masks or face coverings. We’re going to have social distance. We’re going to maintain our hand washing with soap and water and sanitizations – especially as we get back into the workplace. And there will be other things that you see: questionnaires – screening questioners – that may ask if you have been in contact with someone known to have COVID in the last week or so. You may be asked if you have any of the symptoms that I outlined earlier. And, you may be asked about your temperature. You don’t want to have a fever; which is defined at 38 degree centigrade or 100.4 degrees Fahrenheit.
All of this will then allow the individual to know that they are safe and won’t be transmitting COVID-19 to coworkers. But, as I mentioned earlier 50% of people may have no symptoms. They may be asymptomatic, so what else will we need to do? Other things we will do are have a whole hierarchy of controls. Those controls are in a different category, such as eliminations. So if we do find a COVID-19 infected worker, we want them to stay at home. We may be able to use telework for certain occupations and/or we want to make sure solo work stations are maintained. We really don’t want people sharing phones and work stations, so there’s no contamination that can occur.
The other thing is that we can look at engineering and environmental controls. So you’ll see barriers, plexiglass, sneeze and cough guards that are out there to try to maintain six-foot distances. Again, the mask and hand hygiene with sanitizers throughout from the alcohol or soap and water are very important to continue.
And then there are administrative controls. There will be a staggered presence. There will be a phased approach as to what employees come in and when. There will be new signage – people need to look for that. There will be training and education. So, we want to make sure that all of this come together. In addition to limiting meeting size, are conference rooms going to be used or not used? And even limiting, from an administrative control perspective, travel. So there may be new restrictions on who travels and where. All of that is really what we need to keep in mind as we move forward.
One of the things as people come back in, is that we have to recognize is that it is a difficult time for many employees. They may express anxiety and we need to be able to show sympathy and empathy. Sympathy if they have the infection. Empathy, just realizing how difficult this time has been for everybody. And so, you want to communicate the company’s support. All of that together with a review of the company’s policy and procedures for COVID-19 and understanding what the quarantine or self-isolation periods will be if people have symptoms, when they can return to work, what PTO (personal time off) and Sick Leave options are, Paid Leave, FMLA. We need to keep adherent to all of the ADA and EEOC privacy rules. There is a lot to go on and the employers will need to clean areas, provide the sanitizers, and really be able to refer to HR (Human Resources) or the Employee Assistance Programs (EAP) for employees who are anxious.
We should periodically check in on employees. Whether it be the supervisors, or Human Resources, or in small companies, the CEO may want to check in on employees as well. So, with all of that, there are resources for taking care of the anxieties and helping the employees. Whether it be their own doctors if they have primary care doctors or all of the EAP resources. And, if it is a small company that does not have robust EAP resources, there are other organizations that are readily available to help those employee that are having a difficult time. SAMHSA, which is the Substance Abuse and Mental Health Services national disaster group has a distress hotline. So you can go to SAMHSA, call up and get plugged in with some help. The other areas … the CDC has mental health and coping guidelines during COVID-19, the World Health Organization has advice for the public, in addition to all the national call lines that are available, and being able to call 211. So, there are plenty of opportunities to make sure that we have safe return-to-work. And that for the anxious employees, that they have resources to help them through this difficult time and doing everything, knowing that the public health interventions are while we are waiting for the vaccine to be developed. Again, we don’t have a vaccine today … we’ll have one probably near then end of 2021 that will give us an opportunity to get our economy going again and address all the safety issues for good medical health.
Thank you and stay well.
Laura: Thank you very much for that comprehensive update. And I am going to switch gears now and direct the discussion to Kimberly.
Kimberly, employers obviously are faced with unprecedented absences during this work from home. What does the landscape look like moving forward?
Kimberly: Laura, as we look ahead at this transition back to worksite, we know that even before the pandemic returning employees safely to work was a concern for many of our employers.
The Hartford earlier this year surveyed employers and employees, and that survey showed that 59% of employers said they really needed to develop a more comprehensive return-to-work program.
Forty-one percent of the employees that we surveyed said they didn’t have enough support to transition safely and effetely back to work after they were gone from the office for an extended period of time.
In addition, we know that COVID-19 is not only changing the way some workplaces look and operate but also how they are regulated.
The federal government and several states have created new Leave laws or significantly changed, updated, and modified existing laws. Here at The Hartford we are continuing to monitor those updates and you can find the information on those on our COVID-19 Leave Laws página.
Laura: Thanks, Kimberly. Yeah, definitely huge changes afoot and would love to move the conversation over to Karen on how those plans to return-to-office/return-to-work are shaping up.
Karen, so many employers and HR departments have that huge task ahead of them. Could you actually detail for us what goes into putting together a comprehensive return-to-work plan?
Karen: Sure Laura, there’s a lot to consider for sure. And the three areas I will focus on are around: planning, communication, and flexibility. In terms of building out a return-to-work team – who’s on that team? As we all know, we’ve probably got different size employers listening in and some may need to right size based on their organization … and that may change by in even by industry as well too.
At The Hartford, our Crisis Management team is levering expertise from many areas of the company to develop our approach. That includes individuals from our Health and Safety group, Business Operations, Real Estate, and Technology, just to name a few. As companies build out their teams, there are common elements and safeguards organization should consider when building out their own plans.
First and foremost, following local, state, and federal guidelines to make sure we are compliant with those is important. And multi-state employers must be also mindful of each jurisdiction. So your plan or timing may need to be adjusted for local needs as well.
Other considerations may also include, do we have the adequate office space for social distancing? And considering your medical screening approach – whether that’s testing or a medical attestation. Reinforcing the use of healthy hygiene practices for employees is important and making we’ve got the right cleaning procedures within the office.
We also need to think about common spaces. Many of us may have cafeterias, or conference rooms, or auditoriums … how are we going to use those common spaces during this time? And coming back to work, we may want to think about a phased approach. Maybe not everyone comes back to work. And so there will be some that will continue to work remotely.
And the lastly, we’ve got to make sure we are communicating constantly with employees. Making sure those communication channels are open and making sure we’re training the staff in all the safety actions we are taking. They want to make sure they feel comfortable coming back to our workplaces. Communications is an area that I think we cannot underemphasize. It’s also so important for employees to understand that the organizations in which we work are making the health and safety of employees a priority. So we all feel safe when we do return to the office or the worksite. And so this approach includes proactive messaging, making sure we’re providing regular updates as to how the situation is evolving over time, communicating any return-to-work plan as early and often, and being transparent about what we know and what we don’t. Also informing manager and supervisors first – they are the frontline for our employees. And so, those folk will be getting a lot of the questions from employees directly. Let’s make sure there are no surprises – let employees know what to expect when they return and how the workplace may be operating differently. And always make sure we have open and honest dialogue with our employees, we really want our colleagues to feel safe as they return.
The last area that I’ll mention is around needed for continued flexibility. The COVID-19 pandemic is effecting all our lives, both professionally and personally. Employees returning to the office will have different needs and some may still continue to work from home and we need to take that into consideration. Things like ergonomic adjustments to our home offices, or work offices, we want to make sure we are keeping those in mind no matter where you work.
For those returning, there may be need for following ADA requirements and accommodations as those are requested. And some of those modifications can be simple to make – we may think about a flexible work schedule, job sharing, or maybe continued working from home or a reduction in hours.
At the end of the day, we know employers are continuing to look for flexibility during this uncertain time. And with the rules of the game changing constantly, it makes sense to be more agile in this situation.
Laura: Awesome, thank you Karen. Thank you Dr. Seidner, Karen Howard and Kimberly Mashburn for sharing your insights. As always, I’d like to say thank you to all of our listeners. Please visit our website – https://www.thehartford.com – for all of our COVID-19 resources, including a recording of this and all of our Line on Leave podcasts.
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