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About the series
New cases of COVID-19 are on the rise nationally as we head into the Thanksgiving and Christmas holiday seasons, raising concerns that we might have another wave of infections this winter. We are at 85,000 new cases per day, almost a third higher than a month ago. Infection rates are up across geographic regions, and the infection rate in Michigan (83 per 100,000 residents) is especially high.
New hospitalizations are up 5% over last week, stressing hospital workers who have seen an unimaginable amount of suffering and death during the pandemic. Some hospitals are reporting severe staff shortages, and decreased morale is leading to an exodus of senior experienced nurses, physicians and other staff.
Implications for employers:
The BMJ (formerly the British Medical Journal) just published a meta-analysis of studies examining various public health measures at preventing COVID-19 infections. The results:
The authors also looked at studies of handwashing, which did not show a statistically significant decrease in COVID-19 infections. That’s no surprise, as there is not significant evidence of COVID-19 spreading via surfaces. Good handwashing, of course, is still a good idea.
The BMJ study did not analyze data on workplace testing. More employers are instituting testing as an alternative to vaccine mandates or an accommodation for those with exemptions. Rapid antigen tests, which are now becoming more available, are exceptionally sensitive at detecting people who are likely to be contagious and can provide an additional layer of protection.
Implications for employers:
On November 19, 2021, the Food and Drug Administration and the CDC approved boosters for all adults who are six months past their last mRNA vaccine or two months past the Johnson & Johnson vaccine. Most adults are already eligible for boosters based on illness or body mass index, and most pharmacies or other providers are simply administering booster vaccines on demand.
The evidence for boosters is clearly growing. Israel’s Delta wave subsided when the country offered boosters to all those over age 12, and the country has seen a number of days without a single COVID-19 death. Booster shots confer antibody levels that are higher than after the primary vaccination. Booster shots protect the person being boosted and also protect the community around them, including kids under five years old and immunocompromised adults who get imperfect protection from their own vaccination.
But getting the unvaccinated their primary vaccinations remains the most important way to prevent hospitalizations and deaths and to tamp down the pandemic. Sixty health care groups issued a joint statement encouraging employers to implement vaccine mandates regardless of the court outcome of the Occupational Safety and Health Administration’s (OSHA) Emergency Temporary Standard. Signatories include the American Medical Association, the American Academy of Pediatrics, the American College of Physicians, the American Public Health Association and multiple nursing organizations.
Implications for employers:
The CDC is investigating the first big influenza outbreaks of the fall, including a cluster of over 500 cases at the University of Michigan. Data from the U.K. suggests that those who get influenza and COVID-19 at the same time are twice as likely to die.
So get your flu shot this fall if you haven’t already.
Lancet Respiratory Medicine published a report this week which showed excellent immune response when influenza and COVID-19 vaccines are given at the same time. This year, people who are eligible for COVID-19 vaccine boosters should get a flu shot at the same time if they haven’t already gotten one.
Implications for employers:
This is our second pandemic Thanksgiving, and I’m grateful that the situation is dramatically better than last year. We have safe, effective vaccines that are widely available, and we’re on the cusp of having effective and scalable oral medications to treat early COVID-19. Furthermore, our economy is proving more resilient than many would have predicted.
Sadly, many people have lost friends and loved ones this year, and many are still suffering from long COVID-19 or organ damage from severe cases of COVID-19.
Many families will gather together this year, a sign we are getting closer to a post-pandemic normal. However, most Americans live in areas that have high rates of community COVID-19 transmission, and actions that keep workplaces safer can also protect us during family gatherings. Family members who are fully vaccinated are least likely to bring COVID-19 into a family gathering, and no one should attend if they don’t feel well. Here are a few additional tips on how you can make this Thanksgiving a little safer:
Jeff is an internal medicine physician and has led WTW’s clinical response to COVID-19 and other health-related topics. He has served in leadership roles in provider organizations and a health plan and is an Assistant Professor at Harvard Chan School of Public Health.
