NIOSH’s Howard Offers Plausible COVID-19 Scenarios and the Implications for the Future of Work

Nancy Grover

Sarasota, FL ( – Email blasts from corporate leaders are not the best way to persuade employees to get vaccinated against the coronavirus. Instead, individual meetings will be more effective, especially coming from corporate medical providers.

“Inviting folks who are unvaccinated, sitting in a room with them, [asking] what are their reasons? Sometimes when that happens there’s a really human-to-human connection,” said John Howard, MD, director of the National Institute of Occupational Safety and Health. “Whether you are a nurse, physician … the erosion of those professions have not disappeared. I think one-on-one conversations are the most effective. Emails, talking heads on TV don’t seem to be moving folks that are against the vaccine.”

Howard’s comments came during the kickoff session of the National Safety Council’s recent Virtual SAFER COVID-19 Response and Future of Work Summit. Employee refusals to get vaccinated are among the chief challenges facing businesses trying to maintain operations. Howard cited additional hurdles and offered strategies for organizations to ‘pandemic proof’ their workplaces.

Employment Hurdles

The tremendous drop in total employment, combined with a “very high quits rate” are putting pressure on organizations seeking to return to some sense of normalcy, Howard said. More than 4 million people have left their jobs, especially in the technology and healthcare sectors. “Why aren’t people returning to work,”? Howard said. “Covid transmission, fear of contagion; baby boomers retiring; people with added care responsibilities,” such as those with children learning remotely and/or having to care for parents or others.

Another major issue impacting working-age people is mental health. A recent statistic from the Centers for Disease Control and Prevention said treatment for mental health conditions was higher in 2020 than in 2019, especially in the 18 to 44 year old group.

“Mental health is clearly in the forefront right now,” Howard said. “In 2018, 68 percent [of survey respondents] said mental health is as important as physical health. It’s now up to 82 percent.”

COVID-19 Scenario Models

In terms of how the pandemic will play out, Howard suggested several plausible scenarios being considered by experts.

Like the common cold. Under this, best-case scenario, the coronavirus pandemic is reduced to an endemic. “It would have a constant presence but not killing an alarming number of people,” Howard said. “It’s a very rosy future … but it’s certainly not happening now.”

Like the flu, but worse. “A number of modelers have looked at that,” Howard said. “It reproduces twice as fast as the flu. It’s like flu but has a higher mortality rate – maybe twice as high.” However, this model also points out that it could be on top of the actual flu, creating continued stress on hospitals.

Therapeutics to the rescue. This “promising scenario” involves antibodies made in a lab and infused into patients. Both Merck and Pfizer have new arrivals coming on the market soon,and are shown to be fairly effective. However, these must be administered in a narrow period of time – three to five days after exposure.

Worse than Delta. “Not a rosy picture,” Howard said. “What we fear is [one of the] variants [emerging] may be the ‘escape variant;’ it escapes protection from the vaccine or natural infection. It’s the worst scenario.”

With new variants, such as Omicron, researchers struggle to determine how transmissible and how severe they may be and whether they will render vaccines and/or natural infection less effective.

“When talking about ‘worse than Dela,’ realize in this scenario it will continue unless we interrupt it,” Howard said. “As long as we have millions unvaccinated the virus – for example, in an immunosuppressed person – may develop a new variant. We’re seeing variants emerge. The virus outcompetes our ability to surveil and thrives in low vaccinated uptake. This scenario is pretty depressing. It means we’ll chase variants for a while.”

The Future of Work

Along with the shift to more remote work, there have also been increases in the use of e-commerce and other digital platforms, as well as the deployment of automation and artificial intelligence. “All existed before, but they are being accelerated now,” Howard said.

While remote work offers more flexibility for employees and reduced costs for organizations due to less office space to provide, it also includes challenges. Loneliness, distractions and lack of motivation can be prevalent among some remote workers.

Trends in the increased use of automation and AI are helpful in industries that require in-person work, such a protein processing facilities. Many have been looking to machines to replace the need for shoulder-to-shoulder functions among employees. Self-checkout counters at stores have also been on the rise.

“One aspect of AI is automating supervision,” Howard said. “You sit with the boss, get an evaluation, that’s direct supervision. Now you’re at home. How are you supervised?”

Some organizations are increasingly using performance monitoring, such as Bossware, to keep tabs on employees. “Computer work can be easily surveilled,” Howard said. Screen shots and stroke recording on keyboards, for example, can be assessed. “It can be visible or invisible. Invisible is very corrosive of the employer/employee relationship. But clearly we are seeing it more.”

Advice to Employers

Whatever scenario is ahead for COVID-19 – whether it becomes akin to the common cold or is worse then Delta, the future of work is likely to be at least somewhat remote, for those employers able to accommodate that. Employers are advised to take a number of steps immediately to prepare for the “coronormal” workplace.

“The first issue is getting the vaccine to 100 percent of your workforce, minus exemptions [for disability or religious reasons,]” Howard said. “That’s really number because we know vaccines do protect us.”

Undertaking the maximum mitigation for each particular workforce is also paramount, Howard said. For example, implementing a flexible schedule so all workers don’t need to be in the office at the same time, and not every day.

Providing psychological support for workers in need is also important. “We are all worried about being in physical proximity to each other. That’s not going to go away,” Howard said. “Supporting people in their fears of exposure is a program employers need to pay attention to.”

Organizations need to consider, for example, how to address issues such as a worker who tests positive after attending a particular event, and whether, how and who else should be tested. “The rules of engagement of coronavirus,” Howard called it. “A lot of these things have to be thought out ahead of time and the employer has to have a really thought-out plan.”