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
Over the course of my career, I’ve had the opportunity to deliver care and promote health in places ranging from a leper colony in Africa, to a Native American Reservation in Arizona, to villages in Central America. I’ve also studied the impact of cultural differences on disease in Asia. And for the past three decades, I’ve worked with businesses, promoting health and safety in factories, offices and boardrooms around the world.
A lesson I learned early and which has been reinforced by each consecutive experience is: 1) to improve health, you need to impact behavior; and 2) to impact behavior, interventions need to reflect an understanding of culture and ways in which individual identity is rooted in culture.
Whether cultural differences are due to nationality, job role, region of the country or other factors, those differences need to be understood and accounted for in efforts to influence health or safety behaviors.
COVID-19 – A Uniquely Big and Complicated Culture Challenge
The challenge of ramping up operations and returning people safely to work amidst this pandemic feels bigger and more complicated than anything we’ve dealt with before because it is. Consider:
Whew! Yes, the dimensions and complexity of this challenge are truly unprecedented.
Addressing Culture in Your COVID-19 Strategy
I don’t have “an answer” because there is none. Instead, there is a way of thinking about your COVID-19 strategy and some elements that I recommend companies consider as part of their approach.
Finally, do all the above with a bigger picture in mind. By building or strengthening your safety culture, you will help employees understand what it means to be “in this together,” a commitment and sense of identity that doesn’t have to end when COVID-19 fades into memory.
What are you doing to meet the culture challenges at your company? Contact us with an overview of what you’re doing, and perhaps we’ll interview you for an upcoming issue of The Brief.
Be well and stay safe.
Even in some of the hardest-hit cities in the world, the studies suggest, the vast majority of people still remain vulnerable to the virus.
Some countries — notably Sweden, and briefly Britain — have experimented with limited lockdowns in an effort to build up immunity in their populations. But even in these places, recent studies indicate that no more than 7 to 17 percent of people have been infected so far. In New York City, which has had the largest coronavirus outbreak in the United States, around 20 percent of the city’s residents have been infected by the virus as of early May, according to a survey of people in grocery stores and community centers released by the governor’s office.
A report from Imperial College estimates for the U.S show that the percentage of individuals that have been infected is 4.1%, with wide variation between states. In New York, for example, they estimate that 16.6% of individuals have been infected to date. Predictions coming from the college show concern that increased mobility following relaxation of restrictions will lead to resurgence of transmission. Predictions are that deaths over the next two-month period could exceed current cumulative deaths by greater than two-fold, if the relationship between mobility and transmission remains unchanged. They recommend a continual increase in testing, contact tracing and behavioral precautions (hand washing, masks, disinfection) to offset potential effects associated with loosening of social distancing. They found no evidence that any state is approaching herd immunity or that its epidemic is close to over.
Airborne spread from undiagnosed infections will continuously undermine the effectiveness of even the most vigorous testing, tracing, and social distancing programs. After evidence revealed that airborne transmission by asymptomatic individuals might be a key driver in the global spread of COVID-19, the WHO recommended universal use of face masks. Masks provide a critical barrier, reducing the number of infectious viruses in exhaled breath, especially of asymptomatic people and those with mild symptoms.
What only a month ago had been merely an intriguing laboratory finding about analyzing wastewater to detect the virus that causes COVID-19 has quickly leapt to the threshold of real-world use.
With swab tests still plagued by capacity issues, inaccuracy, and slow turnaround, testing wastewater for the novel coronavirus’ genetic signature could give communities a faster way to spot a rebound in cases — as soon as this fall
Serological Saliva Test Researchers from Emory University and Johns Hopkins University conducted a study (preprint) to determine the feasibility of using saliva specimens for serological tests. The researchers developed a multiplex SARS-CoV-2 antibody immunoassay and tested 167 saliva and 324 blood serum specimens, including from patients that tested positive and negative for SARS-CoV-2 infection utilizing molecular diagnostic assays. They found that the antibody assay exhibited similar sensitivity and specificity for both the saliva specimens and serum specimens and performance consistent with other existing serological tests. They also demonstrated that the “temporal kinetics of IgG, IgA, and IgM in saliva were consistent with those observed in serum.” Further research is required to fully characterize the performance, accuracy, and reliability of saliva-based serological tests, but if available, they could potentially provide benefits to conducting large-scale serological testing. Participating individuals can easily collect their own specimens, as opposed to blood samples required for existing SARS-CoV-2 serological tests, and the saliva specimens can be transported and stored at ambient temperature. The US FDA has already issued an Emergency Use Authorization (EUA) for a saliva-based molecular/diagnostic test that utilizes specimens that individuals can collect on their own at home.
South Korean Study Shows No Evidence Recovered COVID-19 Patients Can Infect Others (NPR): South Korea's Center for Disease Control has reassuring news about people with COVID-19 who test positive for the coronavirus weeks after their symptoms have resolved. Health officials there studied 285 patients who tested negative for the virus after recovering, but weeks later tested positive again. the scientists followed up with nearly 800 of those people's personal contacts, such as family members. They found no evidence that they had contracted the virus from the people who had a fresh positive result. The scientists also tried to grow the virus in secretions from these patients. They could not.
States are trying to contain continual spread of COVID-19. New York City contact tracing program began on Monday with a newly hired force of 1700 contact tracers with a plan to increase to 5,000-10,000 tracers. Utah has retrained 150 state employees to work as contract tracers. Contact tracing involves seeking information from COVID-19 patients about their contacts with other people. The goal is to obtain information on close contacts defined as people the infected person spent significant time with within six feet. Experts estimate that at 100,000 - 300,000 contact tracers are needed in the U.S. Utah’s Gov. Herbert announced public beta testing phase for Healthy Together, a symptom checking mobile application that helps augment current contact tracing efforts. The app is designed to help the Utah residents work together with public health officials to slow the spread of COVID-19.
To suppress their epidemics to manageable levels, countries around the world have turned to contact tracing — tracking down people who might have been exposed to the coronavirus to ensure they don’t pass it to others, a way of stalking routes of viral spread and severing them before they reach more people. And, to varying degrees, it has worked. But, for it to succeed in the United States, experts are cautioning that it’s going to take more people, more money, and more cooperation than the country has in place.
Shortage of Testing Machines: Following a series of challenges and delays in distributing a variety of supplies needed to scale up SARS-CoV-2 testing in the United States—including test kits, reagents, and nasal swabs—the next barrier may be a shortage of the machines needed to perform the tests. Multiple manufacturers of these machines—including Hologic, Inc; Roche; and Abbott Laboratories—have reportedly confirmed that they have not been able to manufacture enough of the testing machines to meet the existing demand. The machines are capable of processing hundreds of specimens at a time, and increased availability is critical to expanding testing capacity to the volume that health experts argue is necessary to conduct large-scale testing and surveillance and support efforts to relax social distancing. Both private labs and government laboratories, including those operated by the US Army, have reported challenges obtaining additional testing machines, and even some orders placed prior to the pandemic have not yet been filled. While the manufacturers have stated that they are doing everything they can to increase production, there are concerns that unpredictable future demand could hinder incentives to scale up production capacity. Increasing production requires substantial investment and funding, and the units themselves are expressive. The economic impact of the COVID-19 pandemic means that available funding for many governments, health systems, and other laboratories may be limited, which could make it challenging to justify a substantial investment in new equipment, especially if the future demand could be low.
The CDC released recommendations for employers on May 27. Workers in office buildings may be at risk for exposure to the virus that causes COVID-19. Office building employers, building owners and managers, and building operations specialists can take steps to create a safe and healthy workplace and protect workers and clients.
At this point in the pandemic, Harvard Business Review answers some of the lingering questions:
8 Questions Employers Should Ask About Reopening
The Work From Home WorkSTEPS Medical Team:
Tony Nigliazzo, MD
Loraine Kanyare, MSN, MPH, RN
Director of Case Management
Robert L. Levitin, MD
Lynda Phillips, LVN
Nurse Case Manager
Codey Church, LVN
Nurse Case Manager
Kerry Womack, LVN
Nurse Case Manager
Strategic Communications Consultant
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