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About the series
New cases of COVID-19 continue to decline; we’re now at a level approaching that of last summer. We’re also seeing a continuing decrease in hospitalizations, and there are only two states currently at risk for shortage of hospital beds.
One note of caution is that the U.K., which eliminated all of its COVID-19 community protection guidelines last month, has had a 50% increase in new cases and a 10% increase in hospitalizations over the last 10 days. The new Omicron strain (BA.2) is more contagious than BA.1 and now represents about one in eight new cases in the U.S.
Source: Centers for Disease Control and Prevention (CDC)
Implications for employers:
Each winter before the COVID-19 pandemic, we saw a wave of influenza infections, which often led to as many as 30,000 to 50,000 deaths a year. New data from the U.K. suggests that the combination of immunity (from both vaccines and prior infections), better treatment and the decreased severity of Omicron has meant the case fatality rate for COVID-19 is now substantially lower than for influenza for those under age 60 and about the same for those over age 60.
A few important caveats to this:
Implications for employers:
A new study from the U.K., which followed about 500 people with documented COVID-19 without hospitalization, showed that one in six continued to have symptoms six months after infection. Of these, more than half missed work for a median of 12 days. While death was the cause of most quality adjusted life years lost for those over age 45, these symptoms of long COVID were the main cause of lost quality adjusted life years in those under age 45.
A small study of patients with neurologic symptoms showed abnormalities in nerve biopsies. Another small study showed that those who eventually got long COVID were more likely to have abnormal spinal taps, suggesting that inflammation might be the cause of ongoing symptoms. Either of these findings could pave the way for new treatments and make it easier for those with long COVID to obtain disability benefits.
Implications for employers:
The Kaiser Family Foundation published data confirming that the Omicron surge led to a large number of days away from work and many of these, especially for lower-wage workers, were unpaid. One in three low-wage workers reported going to work even when they felt ill or had been exposed to COVID-19.
Total | Less than $40k | $40k to $89.9k | $90k or more | |
---|---|---|---|---|
Quarantine following exposure | 26% | 33% | 21% | 26% |
Tested positive for COVID-19 | 20% | 27% | 20% | 16% |
Work closed or hours reduced | 13% | 35% | 9% | 6% |
Kids sick or school closed | 28% | — | — | — |
Missed work for any of above reason | 42% | 60% | 33% | 43% |
Implications for employers:
Employers are seeking to protect their immunocompromised employees who return to the workplace as states and localities remove mask mandates and more employees return to the workplace. About 3% of adults are on medications that reduce immune function.
Potential employer interventions:
The New England Journal of Medicine published data from Qatar showing that for at least the first month, a booster shot decreased symptomatic infection by 47% (from 4.5% to 2.4% for the Pfizer vaccine, and from 1.9% to 1% for the Moderna vaccine).
The CDC’s Morbidity and Mortality Weekly Report showed that vaccination continues to be highly effective at preventing hospitalizations in children. While the Pfizer vaccination is less effective at preventing infection altogether in those under age 12, it is far more protective than not being vaccinated. As I mentioned last week, virtually all children severely ill with COVID-19 in large studies were unvaccinated.
Source: CDC, Morbidity and Mortality Weekly Report, March 4, 2022
Implications for employers:
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.