Thoughts Around COVID-19: Linking Business & Healthcare

As business opens up and the U.S. economy restarts, we are seeing spikes in cases reported in many states(1).  Certainly, more testing is part of the reported trend but a real issue to track is rate of positive tests then understanding all the underlying factors(2)

What seems to be emerging is higher percentages positive over last few weeks and in younger population that tend to have mild disease(3). That translates to a need for better protection of vulnerable populations at risk for serious disease impacts from Covid19. This becomes a key issue in the workplace as we have young to older workers mixing daily. We now know with more certainty (data) that use of physical distancing, masks, and hand hygiene measures will go a long way in minimizing most risk, including older workers(4).  However, it does require behavior to change and sustain over a long period of time due to the viral circulation that persists in the community.

Testing remains a conundrum in the workplace for employers. Early approved virus tests have high false positive/negative rates; antibody tests indicate antibodies but no clarity on titers being protective or at what level; and many tested are asymptomatic.  

Complicating that, track & trace can’t keep up with demand or compliance that runs into personal privacy concerns, etc. in the USA.(5, 6) Further complicating all the above is the fact that Hong Kong Flu and seasonal Flu rates of positivity and deaths are reported to be much higher than Covid-19. (7, 8)
So, what is the “right” thing to do or correct guidance from CDC to follow that will be beneficial to employers trying to return to work…and avoid litigation? (9)

An irony exists for HR professionals as many personnel functions today involve health of employees or customers yet healthcare for employees as part of a value based benefit package is on autopilot. Will companies address health benefits holistically and take action to make needed changes in vendors, benefit design or employee communications so a more cost-efficient integrated coverage for care can occur? An example is payment for hospital or community based care, including mental health, continue to have wide gaps (both quality and access) or inconsistent coverage for needed services out of the hospital or clinic. HR has a prominent role during this crisis to navigate issues of the day as well as issues that have been kicked down the road. (10) What can HR be doing now and harness the crisis for long term good in the workplace?

As details mostly remain elusive about COVID-19, decision-making on detection, prevention, and treatment how can we have a best practice? For now, and in all stages of matters about COVID-19, our current best practice is based on the best information we have access to or know about. The good news is that we are closing the knowledge gaps while simultaneously working towards effective solutions for prevention and treatment.

Future best practices necessarily presume knowledge is established as to what is true, false or inconclusive. Therefore, we must assume that we will have established an actionable, reliable, and consistent knowledge base allowing for better assessment (testing) and prevention solutions that can be incorporated into policies and procedures (P&Ps). These efforts are important not only for the safety, productivity, and success of the business but for risk management across the enterprise. The unfortunate devil in the details relate to lawsuits avoided throughout workplace benefits (e.g. health & welfare, workers comp) and operations (workplace safety) in general.(11,12)

For now, HR leaders need to coordinate on their P&Ps, best practices while collaborating with other executives around other business enterprise matters for managing all risks. Vendors and healthcare supply chains serving the workplace need more collaboration as part of managing all risks related to this pandemic event. Iterations or changes along with collaborative thinking across P&Ps in the workplace are part of the evolution for optimal best practices.

 

AUTHOR:      F. Randy Vogenberg, PhD

                        Principal, Institute for Integrated Healthcare, and

                        Board Chair, Employer-Provider Interface Council

 

REFERENCES:

  1. CDC Case Updates. https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/cases-in-us.html.  Accessed July 6, 2020.
  2. CDC Kinds of Tests. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html . Accessed July 6, 2020.
  3. The US’s second peak may be less deadly than the first. https://news.yahoo.com/uss-second-peak-may-less-112000040.html Accessed July 6, 2020.
  4. CDC How to protect yourself. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html Accessed July 6, 2020.
  5. Returning to the Workplace: Testing employees for COVID-19. Cadagin E & Perlowski H. https://www.jdsupra.com/legalnews/returning-to-the-workplace-testing-51041/ Accessed July 6, 2020.
  6. Antibody Testing for COVID-19 in the Workplace. Musselman K. https://www.shrm.org/resourcesandtools/hr-topics/risk-management/pages/antibody-testing-for-covid-19-in-the-workplace-.aspx Accessed July 6, 2020
  7. Coronavirus Disease 2019 vs. the Flu. John Hopkins. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/coronavirus-disease-2019-vs-the-flu Accessed July 6, 2020.
  8. By The Numbers. WFLA. https://www.wfla.com/news/by-the-numbers/coronavirus-vs-flu-how-deaths-number-of-cases-compare/ Accessed July 6, 2020.
  9. Coronavirus Concerns in the Workplace. Smith A. https://www.shrm.org/resourcesandtools/legal-and-compliance/employment-law/pages/address-workplace-coronavirus-concerns.aspx Accessed July 6, 2020.
  10. How to Manage an Employee With a Serious Health Problem. Brault M. https://www.hni.com/blog/hr/managing-employees-with-serious-health-problems Accessed July 6, 2020.
  11. COVID-19: The Pulse of HR – What is HR Doing Now? Bersin J. https://www.hni.com/blog/hr/managing-employees-with-serious-health-problems  Accessed July 20, 2020.
  12. HR’s role in the organizations’ return-to-workplace debate is to advocate for health and safety while deciding when and who to return, and what the experience will be like. Wiles J. https://www.gartner.com/smarterwithgartner/return-to-workplace-guide-for-hr-leaders/ Accessed July 6, 2020.