Onsite physician looking at results of an injured employee

COVID-19 Pandemic Guidance: Onsite Medical Experts Are Poised to Help Manufacturers

By Michelle Hopkins | 11/09/2020

The COVID-19 pandemic is a significant challenge manufacturers face in terms of providing a safe and healthful workplace free of serious recognized safety and health hazards, as is their responsibility under Occupational Safety and Health law.1 Economic fallout from the pandemic has forced many businesses into bankruptcy – manufacturers of power equipment, apparel, medical devices, restaurant tableware, pharmaceuticals, and even the world’s largest manufacturer of Halloween costumes.2  Challenges will persist for manufacturing companies even when the number of cases declines to the point where the pandemic can be declared over. The National Association of Manufacturers (NAM) reports that “the flood of COVID-19 litigation isn’t expected to begin until the spring of 2022,” and “as much as $21 billion in litigation could represent take-home infections” where an employee contracted the virus at work and then infected family members at home.3, 4

The challenge for employers becomes a bigger one when a major illness like the COVID-19 pandemic is coupled with a low threshold of previous experience in dealing with illnesses. Manufacturing and other industries are more accustomed to dealing with occupational injuries than occupational illnesses. The U.S. Bureau of Labor Statistics reports that in 2018, the most recent data available, that manufacturing had 395,300 cases of nonfatal occupational injuries, behind health care and social assistance (544,800) and retail (401,100).5 However, across all industries, occupational illnesses accounted for a small fraction of total nonfatal cases.

In need of an effective response

Business owners need an immediate solution to help provide a healthy work environment. One answer is an onsite medical expert. Concentra®, with more than 40 years of experience in occupational health, provides a continuum of solutions. This means manufacturers of all sizes and pandemic-related circumstances are able to choose from a variety of models and enjoy a limited but targeted solution now, with the flexibility of adding other options later when business conditions improve.

Why manufacturers need an onsite medical expert

There are six reasons why an onsite occupational medicine expert is a compelling solution to help manufacturers manage workforce health amid the COVID-19 pandemic.

Specifically, an onsite occupational medicine expert and/or an onsite clinic or program can do the following:

  1. Navigate the myriad state and local COVID-19 requirements and assist in developing workplace infection response and prevention protocols;
  2. Serve as an informed access point when a referral to a specialist is needed;
  3. Guide manufacturers in understanding new medical research and potential long-term health effects of COVID-19. Occupational medicine experts have specialized knowledge of medicine, workplace/industry operations, and exposure risk;
  4. Provide care and testing at the onsite and also through telemedicine to support the health of employees working remotely or at other locations;
  5. Use knowledge of workers’ compensation to manage return to work for employees following infection or after working remotely due to the pandemic;
  6. Provide solutions that can be scaled, as needed, and seamlessly adjusted over time as conditions change. The focus here is on diverse onsite models – ranging from a single onsite nurse to a fully staffed clinic, all customized to the needs of the employer.

The single advantage that unites all six reasons for an onsite medical expert is the vital importance of establishing and maintaining a relationship with an occupational medicine expert you trust.

What an established occupational medicine relationship offers

This may feel like ancient history now, but think back for a moment to March 2020 when the COVID-19 pandemic began to spread across the U.S. Many businesses, perhaps your own, scrambled to shift business priorities, assess and mitigate health impacts, and motivate employees – many suddenly working from home – to keep the wheels of productivity turning. At its onset, the challenge was so big and complex, you may recall, people had to learn dozens of new words and their meanings to even begin to comprehend what was happening. And that was only the tip of the iceberg.

Beyond knowing how to talk about the virus, what did it mean for employee health: how did infection occur, what were the early signs of illness, and how did it spread? Was the virus in common areas like the break room? On cardboard boxes and other deliveries? How long did the virus pose a threat on surfaces? Or were virus-laden droplets from coughs, sneezes, and speech the bigger worry? Employers were on alert to watch for signs if COVID-19 hit so fiercely it required emergency attention, signs like trouble breathing, persistent chest pain, confusion, inability to stay awake, and bluish lips or face.6 A small sigh of relief was possible when news of testing arrived, but bringing with it more complexity. What was an RNA test? What was an antibody test? If an employee was infected and recovered, was re-infection possible?

These are just some of the early challenges but they support a conclusion: Businesses that had an established relationship with the medical community – such as provided by an onsite nurse, program, or clinic – were better able to respond effectively, rapidly, and accurately to the challenges of the COVID-19 pandemic.

Health-related emergencies, like a pandemic, are exceedingly complex and require medical knowledge and expertise to assimilate technical guidance from national and international health agencies into practical action steps for diverse workplaces and industry environments. In addition, the emergency response must also meet the standard regulatory compliance requirements of agencies, such as the Occupational Health and Safety Administration (OSHA), the Department of Transportation (DOT), and the Equal Employment Opportunity Commission (EEOC). Without an onsite medical expert, these responsibilities fall to the human resources department, safety staff, or legal counsel – teams already heavy-laden with their own emergency-related demands.

Having an established relationship with the medical community, possibly through an onsite presence, was not just an asset in responding to the COVID-19 pandemic initially. There continue to be valuable reasons for businesses that don’t have a medical community relationship to establish it now because the COVID-19 pandemic’s impact on employees’ lives will continue for a while. Scientific research is uncovering vexing findings about the long-term health effects of COVID-19. These findings suggest that your pandemic-related workforce health concerns may not be over, even after infected employees “recover,” turn in negative test results, and/or meet criteria to discontinue isolation.

Post-COVID-19 infection “return to usual health” may be delayed

Since COVID-19 emerged less than a year ago, researchers must base their long-term findings about COVID-19’s health effects on studies of a similar pathogen that has been around longer.7

So what do studies show?

  • Reduced levels of physical function and fitness for one to two years post-infection. Among 10 research studies investigated by researchers in the United Kingdom, nine concluded that recovery of from the coronavirus studied (SARS) was incomplete and some people experienced residual impairments for one to two years.8
  • Reductions in lung function, exercise capacity, and health status. Another study examined survivors of SARS at three-, six-, 12-, 18-, and 24-month intervals. They found persistent impairments in lung function, exercise capacity, and health status.9

That’s just a glimpse into the long-term health effects of another coronavirus. Now let’s turn to some of the early anecdotal findings concerning COVID-19.

  • Symptoms of fatigue, shortness of breath, achy joints, foggy thinking, and loss of smell. These symptoms wax and wane for thousands of people for extended periods post-COVID-19 infection, with some instances of damage to heart, lungs, kidneys, and brain, according to an article published by the American Association for the Advancement of Science.10 These findings have also been supported by the COVID-19 Symptom Study, which uses an app to track the health and well-being of millions of people infected by COVID-19 in the U.S., the United Kingdom, and Sweden.
  • Twenty percent of otherwise healthy young adults (ages 18 to 34) with no chronic conditions had not returned to usual health two to three weeks after a positive COVID-19 test. Also, 35 percent of symptomatic adults of all ages with milder outpatient COVID-19 similarly were not back to usual health status in two to three weeks. The conclusion was that COVID-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions. These findings were from random telephone interviews conducted April 15 to June 25, 2020 and reported in the July 31, 2020 Morbidity and Mortality Weekly Report (MMWR) of the Centers for Disease Control and Prevention (CDC).11

How will you know the usual, or baseline, health of your employees? How will you know if employees returning to work after a COVID-19 infection have lingering reduction in physical capacity or experience fatigue, brain fog, achy joints, or loss of smell? An onsite medical expert offers support to help restore workforce health to optimal levels.

Onsite clinicians can monitor the physical capacity and performance of employees following COVID-19. Additionally, onsite technology platforms are integrated with those of Concentra community-based medical clinics. An employee who needs additional testing only available at a Concentra medical clinic can go seamlessly from the onsite clinic to a nearby Concentra medical clinic to get the needed services.

Don’t be surprised. Be prepared.

In health emergencies like the COVID-19 pandemic, onsite programs and onsite clinics are a strong underpinning of business continuity planning. No one knows when the COVID-19 pandemic will be over or what the future will bring but one lesson we have learned is the value of an onsite occupational medicine expert to support workforce health in these challenging times.

Contact Concentra today to learn more about Concentra onsite clinics, telemedicine, and other options to support workforce health.


NOTES

1 Employer Responsibilities, Occupational Safety and Health Administration. https://www.osha.gov/as/opa/worker/employer-responsibility.html 
2 “Coronavirus Bankruptcy Tracker: These Major Companies Are Failing Amid the Shutdown,” Forbes, May 3, 2020. Read
3 “Take-Home” COVID-19 Lawsuits Could Be Costly.” National Association of Manufacturers blog. September 29, 2020. https://www.nam.org/take-home-covid-19-lawsuits-could-be-costly-10676/ 
4 ‘Take home’ lawsuits over COVID infections could be costly for U.S. employers,” Reuters, September 28, 2020. Read
5 2018 Survey of Occupational Injuries and Illnesses. Charts Package. November 7, 2019. Bureau of Labor Statistics. https://www.bls.gov/iif/soii-charts-2018.pdf 
6 Symptoms of Coronavirus. Coronavirus Disease 2019 (COVID-19). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html 
7 Human Coronavirus Types. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/types.html 
8 Rooney S, Webster A, Paul L. Systematic Review of Changes and Recovery in Physical Function and Fitness After Severe Acute Respiratory Syndrome-Related Coronavirus Infection: Implications for COVID-19 Rehabilitation. Physical Therapy. July 31, 2020. https://pubmed.ncbi.nlm.nih.gov/32737507/
9 Ngai J, Ko FW, Ng SS, To KW, Tong M, Hui DS. The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology. 2010; 15(3): 543-50. https://pubmed.ncbi.nlm.nih.gov/20337995/ 
10 “From ‘brain fog’ to heart damage, COVID-19’s lingering problems alarm scientists. American Association for the Advancement of Science. July 31, 2020. https://www.sciencemag.org/news/2020/07/brain-fog-heart-damage-covid-19-s-lingering-problems-alarm-scientists# 
11 Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network – United States, March-June 2020. Centers for Disease Control and Prevention – Morbidity and Mortality Weekly Report. July 31, 2020. https://www.cdc.gov/mmwr/volumes/69/wr/mm6930e1.htm.