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The 411 on Breakthrough COVID-19 Cases

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From the September Mercy Occupational Medicine eNewsletter

With the recent surge in COVID-19 cases — and specific concern over breakthrough cases involving fully vaccinated individuals, employers may have questions regarding what can be done to help keep their employees as safe as possible at work.

What exactly is a “breakthrough” COVID-19 infection?
When a fully vaccinated person tests positive for COVID-19, it is referred to as a “breakthrough infection.” To be considered a breakthrough case, the infection must occur more than 14 days after all recommended doses of a COVID-19 vaccine have been administered. While symptomatic infections are the primary concern, asymptomatic infections can occur as well.

Breakthrough cases are normal and expected
COVID-19 vaccines are very effective at preventing infection, serious illness, and death, and unvaccinated people account for the vast majority of current COVID-19 cases. However, since no vaccine is 100% effective at preventing infection, some fully vaccinated people will still get COVID-19. Some may even have severe reactions. That said, the vaccines significantly reduce the likelihood of hospitalization and death in the rare event a breakthrough case does occur. The best way to prevent infection and slow the spread of COVID-19 is to get vaccinated.

Delta and other variants
COVID-19’s delta variant is more contagious than previous mutations of the virus. However, studies indicate that the vaccines authorized in the U.S. work well against the delta variant, particularly in preventing severe disease and hospitalization. Of course, with more infections overall due to higher transmissibility, there will also be more breakthrough infections — but the risk of infection, hospitalization, and death are all much lower in vaccinated people compared to the unvaccinated.

What can employers do to prevent an outbreak of COVID-19 in their workforce?

  • Encourage employees to become vaccinated. Vaccines are safe, effective and work well at preventing severe disease.
  • Arrange work areas to allow for physical distancing, if possible.
  • If employees cannot physically distance or work in high-traffic areas, encourage the use of masks even for those who are fully vaccinated.
  • Employees who have been in contact with infected persons or who develop symptoms should be tested and limit their exposure to others.
  • Avoid crowds and poorly ventilated spaces, regardless of vaccination status.
  • Regularly clean and disinfect commonly touched work surfaces.
  • Continue to encourage thorough and frequent hand-washing.
  • Remind employees to monitor their well-being daily and watch for changes in health, such as an unusual feeling of fatigue or shortness of breath, developing a fever or cough, and loss of taste or smell.

Employers are encouraged to be vigilant in their efforts to keep COVID-19 at bay. Mercy Urgent Care and Occupational Medicine can help support workplace efforts to reduce COVID-19 exposure with vaccination programs, testing, and workplace evaluations. Please contact Jeff Howell at jhowell@mercyurgentcare.org for a consultation or to set up workplace services.

Source: Center for Disease Control and Prevention

Preventing Heat-Related Illness

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From the August Mercy Occupational Medicine eNewsletter

As temperatures soar in the summer months, heat-related illness should be a top concern for workers and employers alike. Heat-related illnesses — including heat exhaustion and heat stroke — occur when the body’s temperature rises too high, causing symptoms like headaches, dizziness, cramps, fainting, rapid heartbeat and disorientation.

Although heat-related illnesses are preventable, thousands of American workers become sick from occupational heat exposure every year — and some cases are fatal. These illnesses can affect anyone, regardless of age or physical condition. OSHA’s Heat Illness Prevention campaign seeks to educate employers and workers about the dangers of working in extreme heat or humidity.

In fact, under OSHA law, employers are responsible for providing workplaces free of known safety hazards — and this includes protecting workers from extreme heat. Any employer whose workers may be exposed to high temperatures should establish a complete heat illness prevention program. Below are some tips employers can use to prevent heat-related illnesses and identify potential overexposure in the workplace.

  • Provide workers with water, rest and shade. Allow new or returning workers to gradually increase workloads and take more frequent breaks as they acclimatize and build a tolerance for working in the heat.
  • Plan for emergencies. Train managers, supervisors and workers on the prevention and recognition of heat-related illness.
  • Monitor workers for signs of illness. Have a documented process for monitoring workers exposed to high heat conditions.

Is my workforce at risk for heat-related illness?
While extreme temperatures may be a more obvious area of concern for those who primarily work outdoors, many indoor occupations present heat-related hazards as well.

Outdoors, some of the at-risk fields include agriculture, construction (especially in roadwork and roofing), landscaping, mail and package delivery, oil and gas well operations.

Indoors, hazardous conditions can occur in bakeries, kitchens and laundries (anywhere with indoor heat-generating appliances); electrical utilities (particularly boiler rooms); fire service; iron and steel mills and foundries; manufacturing with local heat sources like furnaces (i.e. paper products or concrete); and warehousing.

Personal Risk Factors
Some workers are more susceptible to heat-related illnesses due to personal risk factors, including medical conditions, lack of physical fitness, previous episodes of heat-related illness, alcohol consumption, drugs, and use of certain medications. Employers should factor in personal risk factors to help prevent heat-related illnesses for all employees, regardless of their heat tolerance levels.

Workers who have not recently been physically active and/or spent time in warm or hot environments will need time to build tolerance to the heat. Employers should encourage all new or returning workers to:

  • consume adequate fluids (water and sports drinks).
  • work shorter shifts.
  • take frequent breaks.
  • quickly identify and report any heat illness symptoms.

Heat-related illnesses can have a substantial cost to both workers and employers. Heat stress can cause fine motor performance to deteriorate, even in acclimatized individuals. Heat illness can contribute to decreased performance, lost productivity due to illness and hospitalization, and possibly even death. OSHA encourages water, rest, and shade as prevention and treatment for heat-related illness.

Ask how Mercy Occupational Medicine can help you evaluate your company’s heat-related protocols

Source: OSHA.gov, CDC.gov

Workplace Reopening Guidelines

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From the July Mercy Occupational Medicine eNewsletter

As more employers return to a fully staffed, pre-pandemic workforce, there are guidelines that may be helpful as companies fully open to their employees and the public. And with a new surge in COVID-19 cases throughout the U.S., it’s as important as ever that companies take precautions to keep their employees and customer base as safe as possible. Below are some guidelines designed to help companies maintain a safe environment for their workforce and customers.

1. Health Monitoring
Monitoring your employees’ health and wellness is a critical step in the return to normal business operations. Consider policies that will help employees remain home during illness, like paid time off or remote work duties, if possible. There should be systems in place to detect and monitor employee health concerns.

Temperature monitoring stations, masking protocols, proper respiratory etiquette, regular sanitation and a robust reporting system are all requisite precautions in a post-COVID workplace. Vaccinations should be offered to workers, and providing paid time off or onsite vaccinations is a great way to increase vaccine rates among your staff.

2. Safety Refreshers
OSHA recommends employers create a refresher program for returning workers on new or overhauled safety and health procedures. It should focus on protocols that may have been overlooked or deferred during a partial or full shutdown, while also incorporating more common safety policies that employees may have forgotten while away. Machine operating procedures, safety requirements, preparation guidelines, equipment use, etc., should all be covered in a refresher program. Some organizations may also need to cover workplace exposure or hazard concerns, including those that may have cropped up during the shutdown because of neglect or inactivity.

OSHA recommends employers revisit and update standard operating procedures, as exposure to hazards may increase during startup and shutdown periods. It is important for employers to review and address safety as part of their overall reopening efforts.

3. Physical Distancing and Limited Capacity
OSHA recommends limiting capacity for both workers and customers to accommodate for physical distancing, where possible. This remains one of the best ways to prevent or mitigate the spread of the virus. Signage reminding workers, customers, and visitors to maintain at least six feet between one another is a great way to keep this in mind.

4. Open Communication
Ensure workers understand their right to a safe and healthy work environment, and be sure they know who to contact with questions or concerns about workplace safety. By law, employees have the right to raise concerns about health and safety conditions without fear of retaliation. Companies should maintain proper communication channels so employees can report health-related concerns or suggestions in a timely manner.

5. Proper Planning
Proper planning will be key to a successful reopening of any business. Employees may feel added stress, fatigue or mental conditions like depression as a result of the ongoing pandemic and returning to the workplace. Employers should plan for these additional workplace concerns, allowing employees additional time or resources to fully acclimate to normal operations.

Employers should be mindful and empathetic, but most importantly, there should be clear guidelines in place to help employees as they return to work. OSHA suggests employers carefully plan for worker safety and acclimation before attempting to increase production to pre-pandemic levels.

These guidelines should be used as part of a comprehensive plan by employers to fully reopen their businesses. Employers should carefully evaluate their reopening procedures based on their specific situations and assessment of risk in their workplace. This will ensure that employees (and customers) are as safe as possible when returning to a place of business.

Ask how Mercy can support your company’s return-to-work efforts with Safe & Well onsite services

Source: OSHA.gov, CDC.gov