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3/20/20 COVID-19 Brief from WorkSTEPS

The WorkSTEPS team continues to carefully track what is happening with the COVID-19 pandemic.

A Message on COVID-19 from WorkSTEPS Chief Medical Officer, Dr. Ben Hoffman:

The Goal (For Now) – Flatten the Infection Curve

After a rough start marked by confusion and conflicting messages, leadership in the US and around the world has come together around the need to slow the spread of Covid-19. Each test and each case brings more data and an improved ability to model population impacts and scenarios to guide policy-making by governments and businesses. For now, what we’ve learned from examples in Italy and other countries is that – unchecked by mitigation practices – infection spreads quickly, and that the elderly and those with pre-existing health conditions are likely to require care in a hospital, resulting in an influx of patients whose need for critical care and specialized equipment such as ventilators can quickly out-strip system resources.

So for now, reducing the rate at which Covid-19 spreads (flattening the infection curve) must be our shared goal in order to avoid overwhelming the capacity of health systems to provide care – not just for those afflicted by the virus, but for others who customarily fill hospital beds and ICUs, including women giving birth, people who’ve suffered a heart attack or stroke, accident victims, and of course, people with severe symptoms due to run-of-the-mill influenza.

Some good news: this animation demonstrates that mitigation strategies are working – most notably in China, Japan, South Korea and Singapore. Of course, efforts in the US, EU and other countries with less legal and cultural authority to impose safeguard measures are going to look different. One important way they will differ is in the role private companies will play/are playing to set and enforce policies and take actions that help employees and their families achieve social distancing and quarantine goals.

Critical actions continue to be:
  • Continue with actions to prevent spread among employees, contractors and customers
  • Seek creative ways to mitigate health and financial impacts of business and operational changes on employees
  • To the extent possible, mobilize within communities to support individuals/families hardest hit by economic impacts and isolation
Continue to monitor this blog and other sources for ideas and updates, because each day brings more innovation and more data, and thus more insights to inform policies and actions.

Dr. Ben Hoffman, MD, MPH
Chief Medical Officer, WorkSTEPS


Click here for more info on our Coronavirus Medical Hotline for Employers & Employees

Medical:


Area Reported Cases Deaths Recovered
Global 226,504 9,285 85,955
United States 11,699 174 108

As the US enters the Acceleration phase of the Covid-19 Pandemic, current data shows containment and mitigation strategies in Italy, South Korea, Japan, Singapore and China are “flattening the curve.”



“Science” published a retrospective study estimating 86% of all infections of COVID-19 are undocumented cases contributing to the rapid geographic spread of the disease. These undocumented infections also compound the difficulty containing the virus.

Good news on the horizon as summer approaches. Analysis of the affect temperature and humidity on the R0 (currently 2.2) of COVID-19 virus shows for each 1 degree Celsius increase in the ambient temperature and 1% increase in humidity results in a decrease of R0 transmission rate by 0.0383 and 0.0224 respectively. Source

Once R0 is <1, sustainability of the virus to continue living / transmitting essentially ends. These decreases in R0 with temp and humidity are also seen with the common flu giving it the seasonal type characteristic.

Chinese researchers have identified Chloroquine phosphate as a valuable therapeutic treating Covid-19. The study indicates patients treated with the drug had fewer hospital days, less severe illness, and improved patient outcomes.

Multiple studies are also investigating Covid-19 treatment with Remdesivir, a broad-spectrum antiviral, which are showing promise in the search for an effective treatment.

Prevention / Mitigation:

China reports its first day without a COVID-19 death as Europe passes China in total deaths and its cases pass 85,000. This is one clear example of the different phases and effects of the COVID-19 Pandemic in differing parts of the world.

The first testing in humans of an experimental vaccine for the new coronavirus began on Monday, the National Institute of Allergy and Infectious Diseases announced.

European Union has implemented its strictest ban on international travel into 26 nations stretching from Portugal to Finland.

The Trump administration released new guidelines on Monday to slow the spread of the coronavirus, including closing schools, bars, restaurants and food courts, avoiding groups of more than 10 people, and recommending discretionary travel.

Mr. Trump, flanked by task force members including Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, said the guidelines would apply for 15 days. The CDC supports the President’s proposed measures.

New York Times Article

Corporate:

Employee Exposure and return-to-work criteria are affecting all aspects of business. The CDC has released guidelines for specific occupations based on the latest data for the safest return-to-work policy. This guideline should be applied by all businesses as the safest policy:

Return-to-work for employees with confirmed COVID-19, or who have suspected COVID-19 (e.g., developed symptoms of a respiratory infection [e.g., cough, sore throat, shortness of breath, fever] but did not get tested for COVID-19).
Use one of the below strategies to determine when the employee may return to work:

1)Test-based strategy. Exclude from work until:
  • Resolution of fever without the use of fever-reducing medications and
  • Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
  • Negative results of an FDA Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens)
2)Non-test-based strategy. Exclude from work until:
  • At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
  • At least 7 days have passed since symptoms first appeared
  • If the employee tested negative for COVID-19 and has an alternate diagnosis (e.g., tested positive for influenza), criteria for return to work should be based on that diagnosis.
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