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Returning to work safely: measures to decrease spread of COVID-19

The fight against COVID-19 is making progress in the United States, but the crisis is not over yet. We still have high levels of community transmission and likely will see future surges. While cases have been slowly declining, transmission in much of the Baltimore region was classified as “substantial” as of late October, according to the Centers for Disease Control and Prevention.

Many businesses have sounded the call to return to “normal,” including more in-person work, as vaccination levels rise and cases come down. Vaccines have proved successful in curbing COVID-19 cases and very successful in preventing severe disease and death, but employers should not pack away their COVID-19 health and safety protocols while transmission remains high.

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The most effective way to reduce the risk of COVID-19 transmission is to take a multilayered approach to mitigation — often referred to as the “Swiss Cheese Model.” The idea is that no one measure is perfect at preventing the spread of COVID-19, but by layering mitigation measures together, including vaccination plus masks plus improved ventilation, you can “fill in the holes” and prevent large clusters of cases. The World Health Organization has termed this a “vaccine AND” approach rather than a “vaccine only” approach. This is necessary until we see improved vaccination coverage and better control of transmission.

Lucia Mullen is a senior analyst at the Johns Hopkins Center for Health Security.
Lucia Mullen is a senior analyst at the Johns Hopkins Center for Health Security. (Larry Canner)

Employers should continue to work toward raising the proportion of employees who are vaccinated in an effort to achieve as close to 100% vaccination in their businesses as possible. Vaccination greatly reduces the chances that employees will become infected and pass the virus along to co-workers. It’s also the best way to protect people from severe illness and death, and it gives the virus fewer opportunities to mutate into variants. Many companies have increased their vaccine rates by providing incentives and, most recently, requiring their employees to be fully vaccinated.

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In addition to vaccination, while levels of COVID-19 transmission in communities are “substantial” or “high” in an area, there are four measures we recommend employers and employees implement to protect health and preserve business operations.

1. Surveillance testing for unvaccinated employees: COVID-19 testing on a regular basis ensures that cases can be identified and isolated quickly and large outbreaks prevented.

2. Require masks indoors: Universal masking indoors should be promoted still, especially in crowded areas such as public transportation and densely populated meeting rooms.

3. Improve ventilation: Good practices that significantly reduce risk include high-quality filtration in HVAC systems, opening windows and doors to allow outdoor air, and using portable HEPA filters in small, enclosed spaces without good ventilation.

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Crystal Watson is a senior scholar at the Johns Hopkins Center for Health Security.
Crystal Watson is a senior scholar at the Johns Hopkins Center for Health Security. (Larry Canner)

4. Provide paid sick leave: Employers should enable employees to stay home, and support them in doing so, if they have COVID-19 symptoms, are caring for a family member who has COVID-19, or need to quarantine because of exposure to someone with the disease.

In Baltimore City, 56% of the total population is vaccinated (or 65% of the population 12 years or older). Once transmission decreases significantly and vaccination levels are higher — upwards of 85% — masking and testing may become less frequent.

But, better, paid leave policies and ventilation should never go back to pre-pandemic normal. Having improved, paid-leave policies and ventilation is beneficial in combating not only the current COVID-19 pandemic, but also bad flu seasons and other, future disease outbreaks. Employers should use this opportunity to promote the prioritization of their worker’s health and well-being.

COVID-19 has wrought fundamental change in how organizations consider the health of their employees and customers. For many businesses, this crisis has highlighted occupational health and safety as a necessity for continued operations, rather than an afterthought. This change should continue through the remainder of the pandemic and beyond.

Lucia Mullen is a senior analyst and Crystal Watson is a senior scholar at the Johns Hopkins Center for Health Security.

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