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March 31, 2020

Why “Flattening the Curve” is Crucial for Employers, Too

Artemis Health

Coronavirus continues to spread in the U.S. and around the world, and leaders all over the globe are responding with lockdowns, “shelter in place” orders, and other measures to keep people apart. Those who can are maintaining social distance from others in an effort to “flatten the curve.” Flattening the curve is crucial not just for governments and cities, but for employers too. We’ll dive into how this strategy will help businesses cope with the pandemic, protect their employees, and plan for the future.  

What is “flattening the curve?” 

Epidemiologists and data scientists study infection rates on a mathematical curve. If one person carrying the novel coronavirus comes into contact with 10 people each day, and those 10 people each come into contact with 10 more people, and so on, we can graph the rise in infections over time. The resulting graph is what’s known as an “exponential curve,” and it indicates that without a means of stopping the spread of an infection like COVID-19, it would continue to spread until no more hosts are available. Basically, exponential growth means that everyone in a community or population will eventually become infected. This video does a great job of explaining the problem in a way non-mathematicians can understand. 

Bryson Pope, Data Scientist at Artemis Health, explains: 

“At the time of this writing, in the last week in the U.S. we have gone from ~45k infected people to ~135k infected people.  This implies an average growth rate of ~1.21. Without any improvement in exposure rate or probability of infection from each exposure, true exponential growth would imply that over the course of the next two weeks, approximately 2 million people in the U.S. will be infected with COVID-19. That is incredibly daunting to think about. However, remember that many of these factors are under our control. If every person in the entire country (however unfeasibly it may be), perfectly self-quarantined, there would be no new infections. In large part, we get to decide the parameter values of the model. There is no reason that exponential growth at the current growth rate can’t be stymied. Exponential growth is not immutable.” 

With many parts of the world imposing strict social distancing guidelines, the hope is that if we can limit the number of people exposed by each infected person, we can reduce how many COVID-19 patients need testing, hospitalization, ICU beds, and other medical treatment at a time. 

As the Washington Post’s fantastic piece on flattening the curve explains, it’s all about limiting opportunities for the novel coronavirus to spread. If people stay home, interact with fewer other people, and keep their distance, the virus won’t be able to spread as quickly. 

The opportunities to spread the virus abound in bars, restaurants, concert venues, and in the workplace. The faster it spreads through a population, the harder it will be on the U.S. healthcare system. Here are some sobering facts around our ability to provide ongoing care for COVID-19 patients: 

  • There are less than a million total hospital beds in the United States, and fewer than 100,000 ICU beds (source: American Hospital Association)
  • Estimates also place the number of ventilators at roughly 100,000, though it varies greatly by state (source: USA Today)
  • A worldwide shortage of personal protective equipment (PPE) like masks, gowns, and gloves has resulted in medical TV dramas such as Grey’s Anatomy and The Good Doctor donating their supplies to local hospitals (source: CBS News)
  • Ford, GM, and Tesla are reportedly retooling and coordinating with existing manufacturers to produce more ventilators (source: ArsTechnica
  • Without immediate action and social distancing, experts predict as many as 2.2 million Americans could die from COVID-19 within a year (source: The New York Times)

Because the data on this novel coronavirus is so new and varied by region, it’s difficult to know exactly how quickly and effectively we’ll be able to “flatten the curve” with social distancing measures. 

Artemis’ Data Scientist Bryson Pope explains why the data is so challenging for tracking and predicting the impact of COVID-19. 

“One of the biggest challenges the data presents is parsing out how much of the growth rate is due to more people being infected, and how much is due to the prevalence of testing increasing. We are only now testing many people who should have been tested weeks ago. This presents a challenge when trying to compare the U.S. with other countries, such as China and Italy, which have had different levels of testing.”   

But one thing is certain: social distancing and flattening the curve is crucial not just for our healthcare system, but for employers, too. 

Why employers must flatten the curve. 

Many Artemis Health clients and partners are large, self-insured employers with 10,000+ employees. These employers effectively manage mini-cities of workers and their families when it comes to health and wellness. Workplaces are gathering points, transmission points, and vectors that can and do spread disease. While many large employers aren’t in a position to shut down completely, social distancing measures can still be implemented to protect employees and their families and still keep the business running. 

Artemis has created an analysis using “dummy data” from a sample employer population. It’s been widely reported that COVID-19 symptoms are mild for younger adults or those without chronic conditions, but symptoms are likely more severe for older people with conditions like diabetes, hypertension, and others. This information is changing, however, as experts gather more data from affected populations. Artemis examined sample data to map age demographics and chronic conditions. Watch the video to see an overview of what we found. 

While it’s still early to draw real-world conclusions based on actual COVID-19 infection rates and outcomes, a large, self-insured employer could certainly use this information to make decisions around work-from-home policies, at risk populations, and more. For example, if you have employees in critical roles who are also at higher risk of developing severe symptoms, the organization may want to prioritize transitioning these folks to remote work before focusing on other groups. 

If, as the most alarming models have shown, as many as 2.2 million Americans could die from COVID-19, think about the impact on an employee population. It’s very difficult to pin down a reliable mortality rate for this illness because it has varied so much around the globe. This article from Oxford’s Center for Evidence-Based Medicine shows anywhere from 12.8% (Bangladesh) to 0.23% (Israel) mortality rates depending on the country in question. 

Assuming a worst case scenario in the U.S., think of the devastation to an employee population if just 2% of workers died from the disease. In our sample data of roughly 40,000 members, that’s 800 people. If it rises to Italy’s currently reported mortality rate of 7%, the employer would see as many as 2800 deaths in this population. This is why organizations should be taking “flattening the curve” and social distancing as seriously as municipalities and state governments are. 

One way some businesses are doing this is to limit the number of people each employee comes into contact with through a “pod” or small team system. For example, in a warehouse shipping and receiving environment, workers may be assigned to pods and work only with the same 6 people each day. Other businesses are assigning shifts to the same employees each day instead of the usual system of varying shifts. The fewer people each worker comes into contact with, the lower chance of exposure. OSHA has some helpful guidelines for how to respond if workers become sick with COVID-19 as well. 

One really important way employers can flatten the curve is by ensuring employees and their families know how and when to get tested. Benefits teams should closely coordinate with carriers and help communicate information to everyone on their health and benefits plans. If and when someone enrolled in your plan gets sick, they should know their options for seeking care: 

  • A telemedicine visit 
  • A remote call with their PCP 
  • Drive-through testing centers available in their areas 
  • Costs of testing and copays 
  • Healthcare centers in their network 

By educating members on how to seek care, you’ll reassure them that the organization is doing its part to keep everyone healthy and safe. 

What else can health and benefits professionals do to flatten the curve at their companies and beyond? Is your company putting innovative policies in place or trying new ideas that you’d like to share? If so, please join the conversation in the Employee Benefits Pros Slack channel here. 

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