Two years later, aspects of the pandemic have changed dramatically. On one hand, our risks of hospitalization and death are dramatically lower, due to immunity from highly effective vaccines and previous infections. We are on the threshold of widespread availability of effective oral drugs which will decrease the risk of severe cases of Covid-19 after infection. Vaccination of children, boosters for adults and continued infections will eventually decrease the rate of community transmission. On the other hand, we see waning of immunity from past vaccination or infection, and there will be ongoing risks as new variants arise. Therefore, decisions around resuming business travel may be difficult for many organizations. To help employers strategically determine the right guidelines for their organizations, we present seven key considerations to address the risks of business travel in a world where Covid-19 continues to pose a threat.
The pandemic has shown us that most business activities can be accomplished without travel. Although many employees are eager to return to business travel, leadership needs to clearly define those instances when travel is allowed — when the benefit of business travel exceeds the risk of potential employee COVID-19 exposure and illness while away from home. By avoiding travel when it is not business critical, employers can continue to realize financial savings while employees can both avoid risks and increase productivity.
Employers can assess travel risk by being in-the-know about the rate of community transmission at the traveler’s origin and destination. With a wide range of community transmission rates in the US and globally, business travel to or from communities with higher rates of transmission represents the highest risk. Companies can assess travel risk using up-to-date data on US counties and travel restrictions by country from the Centers for Disease Control and Prevention (CDC.)
Employers may also want to consider the prevalence of other communicable diseases, such as seasonal influenza. If the CDC or the World Health Organization is reporting high levels of influenza at the destination, this could limit available hospital resources, increasing the potential risk of travel.
Vaccinated and boosted individuals are much less likely to be infected with Covid-19 compared to the unvaccinated. Vaccinated individuals are thirteen times less likely to be infected with Covid-19, sixteen times less likely to be hospitalized, and sixty eight times less likely to die.
An unvaccinated person would also have to quarantine for at least 5 days if exposed to Covid-19. In contrast, vaccinated employees with a Covid-19 exposure only need to monitor for symptoms, wear a mask indoors for 10 days, and be tested 5 days after the exposure. Many companies may decide that the best way to reduce the risk of medical costs or business disruption is to restrict business travel to those individuals who are comfortable with the added risks of travel and up to date on Covid-19 vaccination.
Employees with compromised immune systems remain at high risk from Covid-19 even if they are vaccinated and received boosters. Employers cannot ask employees if they are immunocompromised, so employers should allow employees to participate virtually instead of traveling ‘if they feel their health may be threatened.
Evidence is growing that the immunity from vaccinations wanes six months after the first injection, and immunity from COVID infections subsides more quickly. Employers can strongly recommend their employees get a booster if they are eligible prior to business travel. Booster shots can lead to substantial increases in antibody levels in just 7 days.
The days are over for employees to pack tissues and board airplanes to “power through” an upper respiratory tract infection. Employees should initiate a business trip only if they are feeling well. Neither a negative self-administered antigen test the day of travel, nor a negative laboratory PCR test a day or more earlier provides assurance that a symptomatic employee is not infected. Companies can encourage employees to stay home if they feel ill by facilitating last-minute remote or hybrid meetings when necessary. Effective contingency plans and travel policies reassure employees that they can avoid travel when ill without repercussions.
Employers must be prepared to address cases of Covid-19 exposure or illness during business travel despite vaccination and appropriate caution. The rise of more contagious variants demonstrates that the potential threat of illness can change quickly. Businesses should be prepared to help employees who are sick or have an exposure away from home. This includes access to virtual care through telemedicine and navigation assistance to arrange for isolation stays or medical evacuation if necessary.
An employee developing illness when out-of-town should be tested for COVID-19, follow the updated mask guidance, and avoid taking any public transportation unless they are certain that they are Covid-19 negative. Unvaccinated employees who travel could be subject to quarantine if they are exposed.
Firms should have backup plans to meet their business needs if an employee is unable to travel or attend a meeting, potentially with colleagues that can join remotely to perform the task that an employee cannot attend because they are sick or quarantined.
Well-fitting, high filtration masks can meaningfully decrease transmission risk while on business travel. Airplanes have excellent ventilation systems, and risk of infection is diminished by universal masking requirements. Employees come into contact with dozens, or even hundreds of others, while in transit; masks and distancing, when possible, reduce the risk of Covid-19 transmission.
Once employees are at their destination, masking continues to be important. Business travel mixes people from different communities with different levels of risk of infection. While vaccination provides substantial protection, the Centers for Disease Control and Prevention currently recommends indoor masks even for those who are vaccinated if community transmission is high or substantial. In crowded indoor spaces, N95 or KN95 respirators are the most effective at preventing Covid-19 transmission. Moreover, masks are not useful unless they fully cover the nose and mouth.
Employees can also turn on the ‘exposure notification’ on their iPhone or Android mobile phones. This program allows users to self-report positive tests, which triggers a warning to those who they might have exposed. An individual exposed to Covid-19 should follow CDC recommendations on exposure, which may include testing, masking or quarantining.
Rapid antigen tests, which can be self-administered and provide results in 15 minutes, have been used widely in many countries to decrease community transmission. These tests are less sensitive than laboratory PCR tests but are excellent at determining who is contagious right now. Antigen tests can be used the day of travel for employees feeling well, but the company should be prepared with a protocol if the employee tests positive that morning. An employee who feels ill should delay travel even if they have a negative antigen test.
Similarly, some employees might wish to self-test 5-7 days after their travel to minimize the risk of household transmission. If a traveler is concerned about their exposure while traveling, they should quarantine within their home to the extent possible. If a traveler has respiratory symptoms, they should behave as if they are infected unless they have a negative PCR test.
The virus which causes Covid-19 is likely to continue to cause periodic outbreaks and surges even as we reach higher levels of vaccination. Prudent companies can follow these considerations to assess when, where, and how to return to necessary and valuable business travel while mitigating business risk and protecting employees, families, and the community.
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