Don’t take a one-size-fits-all approach to Covid-19 workplace safety. To keep everybody healthier in the long term, identify vulnerable employees and accommodate their needs.
By Dr. John Showalter, MD, MSIS – Chief Product Officer of Jvion
All 50 states have reopened, but employers are still grappling with how to bring workers back safely, What measures can they implement to prevent transmission? How can they screen returning employees for infection? And what if the virus enters the workplace anyways?
The stakes are particularly high for healthcare organizations, who collectively lost $202.6B over the last four months as routine and elective procedures were put on hold. Patients also avoided care they needed: Emergency rooms nationwide saw 42% fewer visits in April compared to the previous year. Now, to make up for lost revenue and accommodate a looming surge of patients who deferred care, providers must first bring back furloughed staff.
In the absence of widely available testing, many employers have turned to high-tech solutions that scan temperatures or track symptoms. But detecting infections isn’t enough to keep workers safe. Inevitably, people will report to work before they show symptoms, or before their test results come in, and expose their coworkers.
Studies have found that between 56% and 80% of infections are asymptomatic. That means workers cleared to return by symptom tracking tools could infect their co-workers, who may have diabetes, obesity or cancer, and put them at high risk for hospitalization or death.
No matter what infection screening measure you have in place, there is always the risk of asymptomatic transmission in the workplace. So what are businesses to do? If asymptomatic transmission is inevitable, how can employers protect their workforce?
The key is to acknowledge that some employees are more vulnerable to hospitalization, organ failure and death than others. Employers can then help employees understand their own vulnerability, and accommodate the needs of their most vulnerable employees.
Businesses have a lot to gain from protecting vulnerable employees. They can build trust with returning workers, and avoid operational disruptions when workers are hospitalized for extended periods. They can also avoid the substantial costs that come with these hospitalizations.
The estimated median cost of a Covid-19 hospitalization is $14,366. That can add up for employer-sponsored health plans. Costs are even higher for those with long stays in the ICU, which can charge payers $6,000 a day or more. Severe infections may also leave lasting disabilities that incur long-term care management costs, much like any other chronic condition.
Medical conditions that increase the risk of hospitalization are not uncommon. As many as 56% of US adults have at least one comorbidity that increases their risk of life-threatening complications from Covid-19. These comorbidities include common chronic conditions such as diabetes, high blood pressure, obesity, heart disease, and chronic lung disease.
In some regions, the rates of these chronic conditions are much higher: A map recently published by The New York Times shows which counties are at greatest risk. Concerningly, the states with the greatest risk are in the South, where cases are currently surging. In some counties, rates of obesity and hypertension are over 50% higher than the national average.
But it’s not just clinical factors that put workers at greater risk. In fact, many population-level health disparities are driven by socioeconomic factors that increase risk and compound illness.
For example, consider that the South is largely rural, and access to public transportation and nutritious food may be sparse. People with limited access to transportation have a harder time accessing healthcare, exacerbating chronic conditions that contribute to Covid-19 vulnerability. Meanwhile, living in a “food swamp”, or an area with a high density of fast food relative to healthy food, increases the risk of Covid-19 risk factors like obesity, diabetes and hypertension.
The role of environmental conditions also can’t be overlooked. In the South, for example, oppressive daytime heat and humidity discourage an active lifestyle outdoors, and keep many inside where the virus spreads more easily. Pollution plays a significant role too: A recent Harvard University study found that those in areas with high levels of air pollution have a significantly greater risk of mortality from Covid-19.
Harnessing AI to detect vulnerability
Considering the wide range of clinical, socioeconomic, and environmental factors that drive vulnerability, identifying who is vulnerable will depend on analyzing and integrating large volumes of data — something machine learning and artificial intelligence (AI) are really good at.
With the right data, including both health data reported by employees themselves and population-level data on socioeconomic and environmental risk factors, AI can identify which employees are most vulnerable, and provide them with a much more comprehensive understanding of their risk than symptom tracking tools.
This understanding can help furloughed workers with a low vulnerability return to work, and identify others that should continue working remotely for their own safety. High-vulnerability employees can be assigned to work in low-exposure environments, and employers can increase environmental safety controls and sanitation services in areas with vulnerable workers.
In addition to supporting a return to the workplace, AI can help keep workers healthier in the long term. Ultimately, nobody knows how long this pandemic will last, and cases are likely to surge again during flu season. Through partnership with employer health plans, AI can monitor claims data for changes in vulnerability, alert employees that their risk may be elevated, and recommend actions to reduce their risk.
It’s important to note that when using AI to assess vulnerability, workers’ private health information should remain private. AI-driven back-to-work solutions should have data privacy protections built in to ensure that only employees can see the details of their vulnerability, which they can then share with their employer to make mutually informed decisions.
As long as privacy guardrails are in place, AI can be a powerful tool for protecting vulnerable workers, particularly when combined with other measures such as infection screening, environmental controls, and PPE. Cases are on the rise again, and no matter where employers are on the path to resuming operations, they need to remain vigilant to protect their workforce.