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About the series
The Centers for Disease Control and Prevention (CDC) reported that new cases of COVID-19 are down over the last two weeks. We are now at 80,000 new cases daily, down from 95,000 new cases a week ago. However, many states are behind on reporting due to the Thanksgiving holiday, and some experts predict a bump from holiday gatherings. New hospital admissions are up 5%, which reflects the higher rate of infection in past weeks. Average deaths per day have dipped below 1,000.
Source: CDC, December 3, 2021.
Implications for employers:
The first cases of Omicron were identified in the U.S. While some patients had recently traveled in southern Africa, many appear to have been infected in the U.S., including infections that happened before the Omicron variant was reported to the World Health Organization. Many of the cases were in people who had been vaccinated. The rate of genetic surveillance of positive PCR tests in the U.S. is low and the timing is slow. The U.S. does genetic sequencing of just under 3% of samples and reports results in an average of 28 days, compared to the U.K., which does sequencing of 11.5% of samples and reports results in an average of 10 days. Omicron is likely already spreading in many U.S. communities.
We still don’t know whether Omicron will outcompete the Delta variant and become dominant, and we don’t know how well Omicron will overcome the immunity already in the population. Some early reports from Europe suggest that Omicron might cause less serious illness, but the number of cases remains small, and we should be cautious in interpreting this since those who have recently completed international travel are more likely to be vaccinated than the general population.
Implications for employers:
Rapid antigen tests are able to detect Omicron as well as other variants and remain much less expensive than PCR tests. The rapid at-home tests are not as sensitive to low levels of virus in the nose, but they are exceptionally good at detecting people who are currently infectious. My entire extended family used at-home antigen tests before our Thanksgiving gathering. These tests can help reduce community spread.
The Biden administration announced that at-home testing would be free, either through coverage by employer-sponsored health insurance or through federally purchased tests distributed at community sites. Regulations have not yet been established, and insurers will establish processes for member reimbursement for home tests. These tests are less expensive than PCR tests done in laboratories, but are likely to be used far more often, so this is a new unexpected cost for health plans. The operational hassles for members and the administrative costs for health plans will be significant. I hope we’ll see federal purchase and distribution of antigen tests as a public health measure, as opposed to driving up the cost and future premiums of health insurance.
Implications for employers:
The Willis Towers Watson Fall Vaccination and Return to the Workplace Survey, fielded in November 2021, had 543 employer responses from companies that have a total of 5.2 million employees. The survey report gives insights on several top issues.
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.
