The Delta Variant: How Companies Should Respond

News

The spread of the highly contagious Delta variant of Covid-19 is causing infections and hospitalizations to rise again in the United States, even in communities with high vaccination rates. Hopes that the pandemic would soon fade away have been dimmed by the spread of the variant, which appears to evade at least some of the immunity conferred by past infection or vaccination. And with low global vaccination rates, there are likely to be new variants that could be even more threatening. Consequently, we can expect sporadic cases and periodic outbreaks of Covid-19 in the months and years ahead. Given this prospect, how can employers fulfill their difficult obligation to protect their workers, customers, and communities while continuing to grow and prosper?

The good news is that as the virus has evolved, employers have honed their strategies to keep infections in check. By continuing to be creative, flexible, and adaptive in their approaches, they can contain the threat now and handle other outbreaks as they arise. Here are some broad measures they can apply.

Encourage Vaccination

Vaccination remains the best way to prevent serious illness, hospitalization, or death from Covid-19, and employers have overwhelmingly been encouraging their workers to get vaccinated. In a survey of U.S. employers we conducted in May, we found the overwhelming majority of employers (82%) communicated the importance of vaccination to their employees, which is especially important because employers are a trusted source of information about the pandemic.

Communication is most effective when it draws attention to short-term benefits and incorporates stories; statistics on their own are much less compelling. Communication should be culturally appropriate: Diverse influencers can help spread the word of the importance of vaccination throughout the workforce.

Sixty-two percent of employers reported offering time off for vaccination, and 58% offered time off for side effects from vaccination. A small number of employers (10%) offered financial incentives, generally under $100.

Making vaccination easy is key to increasing vaccination adoption among those who are not highly motivated and worksite vaccination is certainly convenient. Employers were rarely able to offer onsite vaccination earlier in the pandemic when supplies of the vaccines were scarce and had complicated transportation and storage requirements. But vaccines are now available to employers who wish to conduct onsite vaccine clinics, although widespread availability of vaccines at pharmacies, grocery stores, public sites, and physician offices might make this less necessary.

Weigh Whether to Mandate Vaccination

The Delta variant — and the recognition that the risk of Covid-19 infection will remain for a long time — has increased employer interest in mandates that require workers be vaccinated to perform their jobs onsite. Few of the employers (9%) who responded to a survey we conducted in May reported that they were requiring employees be vaccinated. (Mandates were the most common in health care and higher education.) But the U.S. Food and Drug Administration’s full approval of a Covid-19 vaccine will likely lead to more mandates across different industry segments.

About 6% of Americans say they will only be vaccinated if it is required. For employers considering vaccination mandates, Houston Methodist, an academic medical center comprising eight hospitals in Houston, offers guidelines that could prove helpful.

Consider Local Transmission Rates in Return-to-the-Office Decisions  

The risk of workplace Covid-19 transmission is highly correlated with the community infection rate. Businesses can feel comfortable about having their remote workers return to their facilities in many communities where the current weekly infection rate is low (less than 10 per 100,000). However, there are some communities with weekly infection rates that exceed 50 per 100,000 where the likelihood that an employee will bring Covid-19 into the workplace is very high. Companies can reduce this risk by delaying employees’ return or by keeping down the number of employees in the workplace through hybrid work and staggered schedules.

Reduce Exposure through Social Distancing

Flexible schedules and remote work have helped create adequate social distancing. Moreover, employers are transitioning remote employees back to the workplace gradually or on a staggered basis to increase safety as they adopt new ways of working. Employers can use behavioral economics techniques to “nudge” employees to maintain social distancing at the workplace. If the capacity of a conference room should be two people, be sure there are only two chairs in it!

Improve Ventilation

Ventilation in a building impacts transmission, and increasing the amount of air that’s exchanged indoors decreases the likelihood of infection in the workplace. Improving ventilation doesn’t always require expensive renovations; many workplaces can add more air exchanges and improve the filtration systems on existing air-handling systems, and some can open windows. However, employers can skip ultraviolet lights, given that there is little evidence that ultraviolet treatment of indoor air prevents Covid-19 transmission.

Decide When to Recommend or Require Masks

Masks provide protection against both being infected with Covid-19 and infecting others. The U.S. Centers for Disease Control and Prevention (CDC) recommends that all unvaccinated people wear masks when indoors with others. Those with any degree of immune compromise, including those undergoing cancer treatment, taking immunosuppressive drugs, or who have had organ transplant, should also continue to wear well-fitting masks indoors. Some employers restrict unvaccinated employees from entering certain areas like cafeterias or gyms, where mask-wearing is difficult.

More and more localities have reinstituted universal indoor masking, and some healthy vaccinated employees may choose to wear masks indoors or work remotely, if possible, during any local outbreaks. We expect indoor mask mandates to expand with increased infection rates. Employers can avoid complaints under the Americans with Disabilities Act about masking requirements by abiding by the U.S. Equal Employment Opportunity Commission’s guidelines.

Encourage Testing

While few employers (18%) were performing Covid-19 tests last spring, many will take another look at testing given the Delta variant. Antigen tests are now readily available, the cost is modest, and results are available in real time. Employers can instruct employees to test themselves at home and can arrange follow-up confirmatory tests for those who have no symptoms but are positive. The costs of these increased tests will likely be borne by employers who opt to increase testing. All employees should be instructed not to come to the workplace if they feel ill.

Be Cautious about Reinstituting Travel

Most companies eliminated international business travel earlier in the pandemic, and many curtailed domestic travel as well. The more contagious variants mean that leaders should err on the side of caution in allowing employees to travel to places where risks of Covid-19 infection are fairly high and instead should ask them to conduct business meetings by videoconference. Recognizing the cost and time savings and environmental benefits of reduced travel, leaders are likely to continue to hold down their travel and expense budgets for the foreseeable future.

Communicate Exposures

Many workplaces will experience Covid-19 cases over the coming months. Employers should communicate honestly about exposures in given facilities, while respecting the medical privacy of employees who have reported that they have Covid-19. Vaccinated employees who are exposed to Covid-19 should not be required to quarantine if asymptomatic.

Support Mental Health Care

Attending to employee mental health needs will be even more important in the coming months. Rates of depression and anxiety have surged during the pandemic, and last year saw the largest number of drug overdose deaths ever. Many are mourning the deaths of friends and loved ones. Employers can continue offering access to virtual and digital mental health care, although they should take into account the fact that scientific evidence of the effectiveness of many digital mental health apps is still limited.

Stay Current on the Effectiveness of Interventions 

Last, we recommend that businesses keep up to date on which interventions to limit the spread of Covid-19 are effective and which ones have limited value. For example, 60% of the businesses we surveyed in May reported that they were conducting temperature screenings when employees entered the workplace, and only a third of these intended to remove these screenings in the coming months even though temperature screening has been proved to be ineffective in decreasing workplace transmission.

Similarly, we now know that normal cleaning is adequate to protect against Covid-19 infections in most instances, and disinfection can be reserved for high-touch, high-traffic surfaces and workplaces with a known Covid-19 case. Employers can create more bandwidth for effective pandemic or business initiatives by eliminating those which minimally increase safety.

Covid-19 has been a humanitarian tragedy and has upended business plans across the globe. Unfortunately, the pandemic is not going to end imminently. Consequently, employers and their workers must continue to remain nimble in how they cope with it. As the local situation dictates, employers must remain vigilant and implement existing and new processes that are proven to keep employees, customers, and communities safe while meeting their organizations’ needs.

SHRM Jeff Levin-Scherz, MD