A Message from WorkSTEPS Chief Medical Officer Dr. Ben Hoffman

Cold + Flu + COVID = Trouble: A Strategy to Reduce Illness-Absence This Winter

A Perfect Storm

This spring Australia experienced its worst flu season in five years, with cases peaking at over three times average, and spiking two months earlier than normal. This matters, because when forecasters try to predict what the coming flu season will be like in the US, they look to countries like Australia and New Zealand for clues.

Australia’s experience is a dark cloud to our west, but it is not our only threat. There’s more contributing to this perfect storm:

• Exposure: For the most part, children are no longer masking in schools, which means they will be more apt to bring viruses home. And, while cooler weather is driving gatherings indoors (particularly in norther states), most people no longer take steps to reduce their exposure to viruses like mask-wearing, and distancing.
• Vulnerability: Due to Covid-19 precautions, most of us haven’t been exposed to the flu virus in a couple of years, reducing our immunity to the flu virus. Uptake of booster vaccinations in the US have been disappointing at just 40% of those eligible, and even the new bivalent vaccine that promises to offer strong protection against Omicron-derived variants of Covid-19 has been met with a shrug.
• Confusion: There is a lot of overlap between the symptoms of the common cold, the flu, and sickness caused by Covid-19. So, when people do get sick, they will be confused about what they have and how to treat it, and uncertain about when to return to work.

While this storm is unlikely to cause a lot of serious illness among workers, the absence costs due to exposure, vulnerability and confusion are likely to be significant.

Telehealth as Part of the Strategy to Reduce Lost Time

In a recent article, I offered a 100-Day Strategy to Reduce Covid-19 Illnesses and Costs, recommending companies focus on doing five things well: 1) Promoting and supporting vaccination (Covid-19 and Flu); 2) Optimizing ventilation; 3) Tracking and managing cases; 4) Providing access to high quality masks and tests; and 5) Educating employees to help them make informed decisions to prevent and manage illness.

Because of the high cost of confusion and uncertainty, in this article I’m recommending a sixth tactic – the provision of telehealth support. To understand the value of continued telehealth support, consider two employees, Bill and Sandy, waking up with a slight headache and cough.

• Bill’s company provides telehealth support, so as soon as he recognizes he’s not feeling well, he knows to give the service a call. By walking Bill through a series of questions, the health care provider(HCP) helps Bill eliminate the common cold and fall allergies as possible causes and advises Bill to take a home test for Covid-19. The test is positive, and given Bill’s age and health history, the HCP encourages Bill to call his doctor to get a prescription for Paxlovid. Within two days, Bill is feeling better, and five days after symptom onset Bill is able to return to work wearing a mask as a precaution against transmitting the virus to his team. Throughout the episode, the HCP keeps Bill’s supervisor informed about Bill’s progress and return to work expectations.
• Sandy’s company doesn’t provide telehealth support. On recognizing her symptoms, Sandy calls her mother who reminds her that she’s always had a bad reaction to leaf mold and says it’s probably just allergies or a cold. Sandy heads into work, and by mid-day it’s clear she’s not getting better. She heads home, but not before exposing her team toCovid-19 during a safety meeting. She picks up a Covid-19 test on the way home and tests positive. While Sandy is a candidate for Paxlovid, she’s heard from friends that it doesn’t work, so she doesn’t call her doctor for a prescription. Sandy avoids hospitalization, but it’s six days before she starts feeling better, and eight days before she returns to work, still unsure if she should be there or not.  

In this perfect storm of cold + flu + Covid-19, companies will bear a high cost for employee confusion, hesitation, and poor decision-making. Telehealth services will reduce lost time by helping employees understand what they have, how to treat it, and when they can safely return to work, improving recovery time and reducing unnecessary lost time.

Questions or Comments?

I always appreciate questions and comments from our readers. You can reach me at benh@worksteps.com.

Be well,

Dr. Ben Hoffman, MD, MPH

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