Sarasota, FL (WorkersCompensation.com) – A mandate may be a great way to ensure employees get vaccinated, but it’s not necessarily the best way to run a business. Case in point is the Houston hospital system that successfully fought off a legal challenge to its requirement that employees get vaccinated. That hospital system now finds itself with workforce capability issues because many employees were either fired or quit.
“Mandate is something that oftentimes creates pushback and that’s certainly what we are seeing, that push-and-pull from a societal standpoint,” said Mark Pew, The Rx Professor. “So requiring vaccination from an employer standpoint can be a sticky situation depending on your perspective.”
Pew was among the panelists in a recent discussion on COVID-19. Among the issues they discussed were the efficacy of vaccines, managing COVID-19-related workers’ compensation claims, long-haul symptoms, monoclonal antibodies and how employers should proceed.
Vaccines
“There are a lot of things that are up in the air, there are a lot of things that are disputed; but there are certain things that are not,” said Martin Kus, MD, chief medical officer for Occupational Medicine at Next Level Urgent Care. “Vaccines work. Of all the deaths out there and all the people who are sick, vaccinated are excluded from that almost entirely.”
However, there are an increasing number of stories about people who have been fully vaccinated and nevertheless get the virus and become symptomatic. Kus said the symptoms for these so-called breakthrough cases are generally similar to those of a normal cold, in which the body recognizes it but then shuts it down after several days.
“The vaccine does not guarantee you will never test positive for COVID-19,” Kus said. “The vaccine’s stated purpose is not saying that you will never get COVID0-19. It’s that you will not get sick, you will not die from COVID, and in that way it is 9 plus plus plus true.”
Despite what Kus and other medical experts say, there is conflicting information about the vaccines. They describe it as an important weapon.
“The vaccine does not put us in a magic bubble. That’s not what its intended to do,” said Elizabeth Barnes of Injury Management Organization and a registered nurse by trade. “It’s intended to create a military for our body to fight the war against COVID. Sometimes we lose a little of the battle – get the sniffles, or a little sick. The goal is to win the war. It creates the things we need to fight the war.”
Managing COVID-19 WC Claims
The majority of workers who get the coronavirus are able to recover at home. Stakeholders working with these injured workers advise them to maintain a healthy lifestyle and manage their symptoms.
“The key with these patients is education,” Barnes said. “Educating them about ‘hey it really is important to stay home and isolate, I know you feel fine.’ And making sure we get them back at work as soon as the isolation period is over.”
Another available option is monoclonal antibodies, which are becoming increasingly available throughout the country, usually for free. While described as a safe therapy, the treatment is not recommended for everyone with the virus.
“If you get very sick with COVID-19, don’t get monoclonal antibodies. If you need oxygen, need to be in a hospital – those people are not good candidates,” Kus said. He said studies show the therapy works best for those with milder symptoms, but offers only marginal help for those severely affected. “It’s the best thing we have out there. It is not nearly as good as having a vaccine.”
But injured workers treating symptoms at home can typically get a prescription from their physicians and get the monoclonal antibodies infusion within 24 hours, Barnes said.
Managing injured workers who are hospitalized with COVID-19 is more complicated. They may have complex discharge plans. “Often they are going into post-acute rehabilitation, and [require] setting up rehabilitation once they are in the home setting,” she said. “Generally, it is like a critical care claim.”
Among the biggest challenges for claims managers is addressing injured workers who become ‘long haulers,’ those who have symptoms long after the virus is over. While most long haulers are those more severely impacted by the virus, that is not always the case.
“35 percent are treated on an outpatient basis. They stayed home. They are having these long-term symptoms as well,” Barnes said. “The greatest one across the board I hear is this generalized fatigue; not the ‘oh my gosh, I can’t get out of bed,’ but ‘I felt great for two or three days but just can get myself going.’ … All these patients say ‘I feel like I’m OK, but then when I have a day when I’m really active it all just starts to flood back.’ We are seeing symptoms when they have physical or mental activity.”
Especially challenging are long haulers with mental health problems; memory, concentration, sleep problems, depression, anxiety and the like. “People tend to have an opinion about these. They can’t physically see them,” Barnes said. “But it’s a very big problem with COVID.” Antidepressants and/or cognitive behavioral psychotherapy are often prescribed for these injured workers.
While managing such claims may seem like something new and more challenging, it’s really a matter of sticking with the basics of workers’ comp.
“It’s best practices, in regard to communication, a team approach, education and staying in front of this instead of playing catchup,” said Michael Stack, founder and lead trainer of the Amaxx Workers’ Comp Training Center. “We’ve got a lot of knowledge, treatment – leverage those experts on your team and treat them early.”
While the speakers agreed that vaccines are key to preventing severe illness among employees, it’s important for each organization to determine the best approach to take. The president’s recent announcement that companies with more than 100 employees will be required to mandate vaccines or conduct frequent testing may be more complicated than it seems, especially since OSHA may not have the manpower to enforce the mandate.
Companies “need to figure out how to comply with federal, state and local requirements also while maintaining being a viable business that is profitable,” Pew said. “It’s very difficult circumstances for businesses to balance that.”
Working with employees to craft a policy is the best way to ensure buy-in, the speakers agreed. “We talk about collaborative return-to-work, the interactive process,” Stack said. “The more you have people participate in the decision, the more they are going to adopt it as their own. If you’re stuffing it down their throats, they are not going to like that.”
