Preparing for Return-to-Work: Employers, Are You Ready?

As states begin to relax stay at home mandates, US employers are planning for the return of their workforces. We can learn a lot from the strategies that essential employers have implemented to keep their workforces healthy and safe. It’s also important to consider the longer-term implications on our workplaces since we know COVID-19 won’t be going away anytime soon.

WHAT WE KNOW WORKS

Physical distancing is the only truly effective method of slowing the spread of COVID-19. Since the virus spreads largely from person to person, it’s important to maintain a distance of six feet or more. Use six-foot space markers to help employees and customers maintain distance. And consider other creative ways to improve physical distancing like creating unique work shifts or split-team arrangements. Of the nearly 400 employers responding to Mercer’s COVID-19 pulse survey, 54% say they will use some method to reduce the number of workers onsite on any given day, such as dividing them into two groups alphabetically and working on alternate days. About two-fifths (43%) said they will continue virtual work where possible.

In locations where physical distancing can’t be achieved, we’ve seen employers install plastic curtains or Plexiglas between employees. It remains unknown whether these measures will slow the spread of the virus.

Masks may help prevent spread of the virus when physical distancing is a challenge – but everyone at the worksite needs to wear one. We know asymptomatic and pre-symptomatic spread is occurring. To protect against transmission, it’s most important that the person who has the virus is wearing a mask. If the person who doesn’t have the virus is the only one wearing a mask, it’s less likely to reduce transmission. Masks can be made of cotton or similar material. N-95s and surgical masks should be reserved for caregivers in the healthcare setting until widely available. Masks should not be a substitute for physical distancing efforts.

Cleaning and disinfectingfrequently, consistently and diligently may help slow the spread of COVID-19. Current evidence suggests that the virus may remain viable for hours to days on surfaces made from a variety of materials. While it is certainly feasible that surface-to-person transmission is occurring, it is not the main way the virus spreads -- but cleaning is an important safety measure nonetheless.

Virtually all employers are taking action to protect their workforce: 92% of respondents from Mercer’s COVID-19 survey say they will enhance cleaning and disinfecting and 56% of respondents will provide masks.

WORKSITE TESTING AND HEALTH ASSESSMENTS

Employers are considering return-to-work strategies that would have been off the table just a few months ago, but these days all measures for creating a safe work environment should be considered -- and reconsidered -- as we learn more about what works and what doesn’t. Mercer’s COVID-19 survey suggests that most employers will screen employees with temperature checks and an on-site questionnaire and/or self-assessment. While we’ve received some guidance on screening employees , it is important for employers to stay informed about what may be required in their geographic locations.

Screening questionnaires are a practical return-to-work step but the relative value in preventing spread is unknown. Such screenings are considered medical information, therefore maintaining privacy is necessary. Common questions include asking whether the employee has symptoms and whether they’ve been exposed to someone with symptoms. You’ll need to carefully draft the questions to avoid legal liability.

Temperature screening is used to assess for a common sign of COVID-19 – fever. It’s unknown if temperature checks will help reduce the spread of the virus in the workplace. Reports indicate that people can transmit the virus when they are pre-symptomatic and some individuals may be asymptomatic throughout their infection. Thermometers may be inaccurate (especially infrared/no-touch thermometers if not regularly calibrated) and potentially provide a false sense of security. Some employers are distributing personal thermometers for employees to monitor their temperature at home before coming to work. Other employers are having employees self-administer temperature taking with a personal thermometer at designated locations on-site and show the reading to a test facilitator, as a way to support continued monitoring at the worksite. 

Antibody and viral testing is garnering a lot of interest in the employer community. Antibody testing, performed on blood samples, can tell us who had the virus and may be immune. However, we still don’t know what immunity to this virus looks like – how effective protection will be and how long it will last. Antibody tests are not an effective way to diagnose current infection. Viral detection testing (using swabs) identify if the virus is present and can diagnose current infection. This diagnostic testing can be an important part of a containment strategy to quickly identify those infected and then proceed with contact tracing – especially important given the likely significant prevalence of asymptomatic and pre-symptomatic spread. According to the EEOC, Employers considering diagnostic testing should take steps to ensure the tests are accurate and reliable.  While testing capacity is still limited in most areas, there are many tests in the pipeline awaiting FDA emergency use authorization.

An employer’s effort to mitigate the spread of COVID-19 is best achieved through a multi-faceted approach. In addition to the items listed above, implement a strict policy to stay at home if sick with symptoms suggestive of COVID-19 and follow guidance from the CDC. Remember that your paid leave practices will impact adherence with this policy. If an employee is exposed, they should follow the CDC guidance, which differs for essential workers. Clearly communicate return to work processes, procedures and screenings. Set clear parameters for how you’ll administer and enforce screening procedures. Use the utmost discretion to maintain privacy. And remember, physical distancing is the only effort proven to limit the spread of the virus.

Dave Zieg, MD
by Dave Zieg, MD

Clinical Services Leader, Total Health Management, Mercer

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