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About the series
The U.S. Omicron wave continues to trend down. Over the last two weeks, new cases have decreased 13%, but there are 5% more people in the hospital (over 153,000). Deaths are up too; we’ve had multiple days where over 3,000 deaths were recorded. Reports from Europe suggest that a subset of Omicron (the BA.2 variant) is “outcompeting” the original strain (BA.1). This might be why the “tail” of the Omicron wave is decreasing at a slower rate in the U.K. and Northern Europe than modelers originally forecast.
You might hear this new variant, which has already been reported globally, including in the U.S, called the “stealth” Omicron – because it often appears different than BA.1 on some PCR tests. PCR and rapid antigen tests, though, continue to be accurate in diagnosing this variant. BA.2 is likely to be more contagious but does not appear to cause more severe symptoms.
Source: Centers for Disease Control and Prevention (CDC)
Implications for employers:
Many people who have been hospitalized in recent weeks were incidentally found to have COVID-19, as opposed to being hospitalized because of respiratory or other symptoms from COVID-19. Here is data from Massachusetts, where almost half of all COVID-19 admissions were “incidental” rather than “primary.”
Patients hospitalized due to COVID-19 (primary) and patients reported as testing positive for COVID-19 while hospitalized for other reasons (incidental). Source: Boston Globe
This is good news because it means fewer people on ventilators and less death. But in some patients, COVID-19 may have exacerbated a chronic illness like asthma or diabetes and might still be the underlying cause of the admission. Treating people with an abdominal complaint or an orthopedic injury is more complicated if they have COVID-19; they need to be in a private room and all hospital staff must wear extra personal protective equipment when caring for them. Additionally, room turnover takes longer due to enhanced disinfection.
Hospitals are also under severe stress due to staff illness and isolation/quarantine. Some hospitals are so short-staffed they have asked infected employees to return to work before the isolation period is complete. Some are unable to discharge recovering patients to skilled nursing facilities, which have been hit hard by staff shortages. Hospital bed shortages mean that sick patients, including those with COVID-19, may be cared for in the emergency departments for days.
Implications for employers:
COVID-19 clearly causes disability in some who have survived, and mechanical ventilation in an intensive care unit (ICU) setting often leads to problems in physical and mental health for survivors. Researchers in the Netherlands did follow-up a year after 246 patients (71% male, average age 62) were discharged after being treated in an ICU for COVID-19.
They found that about three-quarters reported physical ailments and a quarter reported mental health concerns. Of those who were working before their illness, over half reported trouble with working, including disability, reduced hours or reduced capabilities.
Source: JAMA Network January 24, 2022
A study from the U.K. published in Lancet Infectious Disease earlier this month similarly showed that those who had two shots of the COVID-19 vaccination were less likely to be hospitalized, more likely to have asymptomatic infections and less likely to have symptoms 28 days later compared to those who were unvaccinated.
Implications for employers:
Vaccination primarily keeps people from getting long COVID-19 by preventing them from being infected with COVID-19 altogether. But those who were vaccinated and got COVID-19 anyway were still substantially less likely to have long COVID-19 symptoms 12 weeks after their infection. The unvaccinated were 53% more likely to have symptoms of long COVID-19 than those who were vaccinated, and 58% more likely to have symptoms that limited their day-to-day activities.
Source: U.K. Office of National Statistics, January 26, 2022. Note: Groups were propensity adjusted.
Implications for employers: Employers that achieve higher vaccination rates among their employees are likely to face less disability in their workforce.
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.
