Updated: Mar 30, 2020
This updated addendum to our COVID-19 overview provides risk assessment and recommended actions for organizations to consider in response to the current outbreak. Please use this in conjunction with the overview for individuals.
The virus is circulating in the community in several regions of the United States. Given the mobility of Americans, it will likely become endemic across the country. Understanding the actual (versus hyped) risks and mitigations is critical for both individuals and organizations.
Could this become a major international crisis?
Yes. It is reasonable to say that it already has.
Will this have crisis-level consequences?
Not medically, but social-disruption consequences will depend on education and management campaigns by both governments and private organizations.
What does the future hold?
If not already, this will be considered a global pandemic. So far, it does not appear to be a disease with consequences like Ebola or the 1918 Flu epidemic.
Still, there will be excess deaths, primarily, but not exclusively in the elderly and/or those with other medical conditions. The general public will not initially be able to differentiate between the medical impact of diseases like Ebola or the 1918 flu versus this outbreak for the next few weeks to months. Governments will be forced to react heavily with quarantines and movement/social distancing restrictions. The spread in the U.S. will be somewhat mitigated by the better weather of spring which inherently increases social distancing (people spend less time cooped up in the same space), but the lack of immunity in the population will allow spread to continue until there is a baseline community immunity developed (naturally or via an immunization program that is still 9 to 12 months away). Expect further unfortunate situations such as the nursing facility in Washington State where many, if not most residents are infected and may likely experience a high mortality rate. Ensure your staff understands that this nursing home population is not representative of the mortality or even severity in the general community.
Organizations should have already reviewed and updated their programs and policies developed in response to both the SARS epidemic in 2004 and the (never realized) influenza pandemic fears in 2007 – 2008.
At this point, it is reasonable for organizations to begin enacting basic components of these plans. These plans do not all need to be enacted immediately, but workforces who know the plans exist and whose management is monitoring the issues closely will be more flexible and calm in adapting to the situation.
Specifically, ensure that policies, procedures, and contacts are available for:
Workforce education and information:
- Fact-based updates on the nature of the disease and real risks.
- Assume popular press will magnify threats and risks, so passing reliable fact-based information to the workforce is critical. Do not downplay real risks but keep employees from succumbing to hyperbole.
- WorldClinic will continue to provide updates as the issues develop.
Workplace infection control mechanisms including:
- Good handwashing and use of hand sanitizer. Especially after being in public places, touching common surfaces, coughing or sneezing, before preparing or consuming food, etc.
- Maintaining personal space (e.g., no hugs or handshaking). Exact distance has not been established but maintaining a 6-foot separation is generally effective for respiratory infections Ongoing disinfection of common surfaces (both by individuals using these surfaces and cleaning crews).
- Considerations for masks: Masks are more helpful in preventing infected people from transmitting disease than keeping healthy people from being infected. The most common route of viral infection is not breathing in viral particles, but inoculating yourself (touching eyes, nose, mouth) after touching a contaminated surface. Organizations should have a small supply of standard masks (N95 not needed) available to give to workers who become ill with coughing or sneezing at work before they can depart the premises.
- Mechanisms to help ensure potentially infected workers stay home (flexible sick-leave policies). This is generally more complex for hourly workers who are often not paid when they do not come to work. Construct balanced policies that encourage ill workers to remain out of the workplace until clear of illness.
- Broad-based telework policies in place for knowledge and non-direct-contact service workers, including the consideration of technologies and policies to support this. This can greatly decrease “personnel density” in the workplace which is a determinant of infection rates.
- Contingency plans to support ongoing operations if public health measures were to be instituted limiting the movement of goods and people. For critical sectors, this includes mechanisms for working with public health authorities to support continued operations.
- Social distancing (6’ separations, no shared workstations) becomes essential in critical sector operations
- Cross-training to account for predictable personnel absences is important
- Limit commercial carrier travel, especially international. Even if the absolute risk of infection is small, responses of local and international authorities can be unpredictable and organizations will want to avoid having key people forcibly held in place. At this point, while the characterization of the virus and applied control measures are still in flux, organizations may wish to delay non-essential travel. Currently, the absolute risk is low to any one individual, the chance of getting caught up in a quarantine or isolation situation is real.
One last note is that the timing of this disease and the presentation happens to coincide with one of the most widespread flu seasons in recent memory. If fear develops that this novel virus may have gotten a foothold in the U.S., there will be significant confusion between flu and this coronavirus. While the two diseases are completely independent, confusion is not helpful in dealing with an epidemic.
We will pass along additional updates as they become available.