With transmission rates and the number of new Covid-19 infections declining in highly vaccinated countries, governmental agencies have substantially eased their guidance about masks and distancing. As normal activities resume, remote employees may now return to the workplace. Yet the pandemic is not over, and employers must continue to protect their workers and manage risk. Here are seven key considerations for company executives and leaders as they manage this transition.
1. Be mindful of community infection rates and workforce vaccination rates.
While the United States as a whole is showing dramatic decreases in infection rates, some counties remain at high risk for Covid transmission and the Delta variant will likely drive local infection “hot spots” over the summer. Vaccination rates also vary widely, and those who are fully vaccinated are eleven times less likely to be infected if they are exposed. Therefore, the optimal time to return to the workplace could differ by geography based on community transmission levels and vaccination rates in the community or among employees.
Companies with high levels of employee vaccination in geographies with few infections are unlikely to see workplace infections when their employees return to the workplace. However, companies with many unvaccinated employees in geographies with continued widespread community transmission will face more challenges. These organizations can mitigate risk of workplace exposure by delaying remote workers’ return or decreasing how many employees come to the workplace on any given day. Companies should continue to monitor local conditions in case they need to implement new capacity limits, masks or even temporary workplace closures, if necessary, in locations with severe community outbreaks.
2. Focus on evidence-based efforts to decrease viral transmission in the workplace.
Employers have made extensive efforts to protect their employees during the pandemic, and fortunately workplaces have generally not been among the leading settings of community Covid transmission. Strategies to decrease person-to-person air exchange are key, including:
• increase air exchange in indoor spaces to decrease the risk of transmission by both droplets and aerosols.
• Decrease room capacity to allow more distancing
• Decrease time together in poorly ventilated areas, such as small conference rooms.
We have learned that some of the efforts that employers made early in the pandemic do little to decrease viral transmission but are expensive and disruptive. A majority of employers we surveyed currently require temperature screening, although many with contagious Covid do not have a fever. Symptom checkers are also not sensitive in finding those who are likely to spread Covid-19, although all employers should continue to encourage workers with Covid symptoms not to come to the workplace and to be tested, no matter their vaccination status. Acrylic (plexiglass) dividers can provide some protection from large droplets and encourage physical distancing, but do not interrupt aerosol transmission. Finally, Covid is rarely, if ever, transmitted from contaminated surfaces, so increased disinfection of surfaces in the workplace is unnecessary except when there has been a workplace Covid case.
3. Use effective tools to encourage employee vaccinations.
The currently authorized Covid-19 vaccinations have proven remarkably effective at preventing the spread of coronavirus. Even those who are fully vaccinated who get Covid tend to have lower viral loads and are much less likely to transmit the infection to others. Here are some strategies that are being used widely:
• Offer paid time off for vaccination and to recover from side effects. Employees were about 50% more likely to be vaccinated if offered time off by their employer.
• Promote vaccination. Employees are about 75% more likely to be vaccinated if encouraged by their employer.
• Make vaccination convenient with onsite or near-site options if the current vaccination rate remains low
• Consider small incentives or raffles to get attention, but avoid large financial incentives. Large incentives can backfire by sending a paradoxical signal to some hesitant employees that vaccination is undesirable or difficult.
Employers are likely to mandate employee vaccination in some industries, such as health care, where unvaccinated employees could infect unvaccinated patients or those with weakened immune systems. Employers might also mandate vaccination for those who frequently travel internationally to avoid potential illness or quarantines far from home. Most employers, though, will be cautious about mandating vaccines, which could lead some hesitant employees to firm up their opposition to vaccination or to quit. Employers in the United States are legally allowed to mandate vaccination, although they must provide medical and religious exemptions to the extent this would not cause the business “undue hardship.”
4. Require unvaccinated employees to continue to wear masks and distance, and make all employees feel comfortable with mask use.
Those who are not vaccinated are substantially more likely to bring Covid into the workplace. The Occupational Safety and Health Administration recently published guidelines which explicitly recommend differential treatment for those who are fully vaccinated. Employers can and should require unvaccinated workers to wear masks (two layers or more) and distance indoors, while those who are fully vaccinated can skip the mask and no longer must maintain physical distance. Employers should provide masks to unvaccinated workers, and request mask use and distancing of guests or customers who are not vaccinated.
Some employers will collect vaccination data, although many will rely on an honor system. Employers are not violating employee privacy by collecting data on vaccination status as long as they do not query employees about reasons for not being vaccinated. Vaccination records are personal health information and must be stored securely. Unvaccinated employees can be restricted from use of areas where masking and distancing is not possible, such as company cafeterias or exercise facilities.
Employers should create an inclusive environment where any employee feels comfortable wearing a mask for any reason. Employees with weakened immune systems should wear masks and distance in the workplace if recommended by their health care practitioner. Other employees may choose to wear a mask because they have a family member with a weakened immune system. Employers that require masks and distancing for unvaccinated employees protect themselves from claims of discrimination or an unsafe worksite by those with compromised immune systems.
5. Strengthen your organization’s mental health benefit program.
The pandemic has caused a huge upsurge in mental health issues in all age groups. The CDC reports that major symptoms of anxiety and depression now affect 30% of the population, almost three times higher than in 2019. As many as a third of those who have recovered from Covid suffer from neurologic symptoms, mostly depression, anxiety, and “brain fog.” Moreover, employees and their families may be grieving the deaths of colleagues and loved ones due to Covid, adding a new layer of mental health needs.
Employers can continue offering increased access to digital and virtual mental health care as the pandemic recedes. Supervisors can be trained to refer employees to employee assistance programs if they need mental health care. There might be a long “tail” to the mental health needs from the pandemic; suicide rates in the Fukushima region of Japan initially fell but increased three to four years after the earthquake, tsunami and nuclear meltdown.
6. Proactively address employee concerns about safety upon return to the workplace.
Frequent, accurate and culturally appropriate communication can help employees feel confident that their employer genuinely cares about their health and can prevent undue fear of returning to the workplace. Employers should clearly lay out the efforts they are making to keep the workplace safe, including how they decided it was the right time to reopen the workplace. They should also clearly communicate why they are altering or sunsetting any previous approach, such as discontinuing temperature scanning or deep disinfection.
7. Encourage return to preventive and chronic care.
Rates of preventive care, including screening for colon and breast cancer, dropped precipitously during the pandemic. Many also stopped getting regular follow-up for chronic diseases like hypertension and diabetes. Employers can encourage return to regular medical care, to prevent future disease. We shouldn’t forget about vaccination to prevent diseases other than Covid-19, too. Employers can also decrease future absences and decrease future medical costs by encouraging their employees to bring their children for routine pediatric vaccinations, which dropped dramatically in Spring, 2020 and have not fully recovered. Lastly, employers should encourage influenza vaccination to help prevent resurgence of influenza this fall and winter.
The Covid pandemic has taken many turns. Few employees leaving their workplaces last Spring imagined that they would work remotely for over 16 months. Our understanding of Covid has progressed rapidly, but there is still much we don’t know. Vaccinations currently provide a high level of protection against variants, but that may change. Future variants could overcome the immunity we’ve worked so hard to attain or the initial protection from vaccination might diminish over time. Treatments or post-exposure prophylaxis may improve. We hope that long Covid symptoms will fade over time, but it’s possible that many will continue to suffer from long-term disabilities.
Each day of declining new cases and the steadily increasing vaccination rate enables our return to the activities we’ve missed during the pandemic. For many remote workers, this means a return to the workplace. But employers can’t sit still. By taking steps to improve employee safety during this transition, company leaders can lay the foundation of trust and collaboration that will be a competitive advantage even after the pandemic is over.