As the vaccination rate steadily builds toward “herd immunity” to COVID-19, employers will be faced with a “new normal” in terms of workplace safety and employee heath. Will they try to wash their hands of the whole COVID-19 mess or, hopefully, will they realize that improving employee health should be a business priority? Judging from their efforts in 2020, I am betting that some of the largest U.S. employers will opt for the latter. Here are two examples.
Walmart: Like many other large companies, Walmart responded quickly to the pandemic by updating and implementing health safety policies (e.g., daily temperature checks and health screenings), providing personal protective equipment (PPE) for its employees at more than 5,000 locations, assuring paid leave for employees (e.g., quarantine pay, pay while dealing with confirmed case of COVID-19), and offering cash bonuses to help all employees.
In terms of post-pandemic employee and consumer health improvement planning, Walmart is ahead of the game — and making a profit in the process. As COVID-19 made its presence known in the U.S. last January, the company had just expanded its employee benefits through telehealth; the $4 charge for Doctor-on-Demand visits was waived for employees during the pandemic. Over the course of 2020, the company began to pilot a freestanding clinic model aimed at lowering the cost of health services by as much as 40% (e.g., $30 medical checkups, $25 teeth cleanings, $1 per minute mental health counseling) while reducing administrative red tape. A partnership with Quest Diagnostics is helping to expand COVID testing by opening testing locations at about 500 Walmart pharmacies.
Amazon: In addition to a reported $2.5 billion in pandemic related employee bonuses and incentives, Amazon invested approximately $10 billion in COVID-related initiatives in 2020 — from enhanced cleaning, disinfectant spraying and social distancing measures to distributing PPE and checking employee temperatures across worldwide operations. Employee benefits were adjusted to provide up to 2 weeks of paid time off in addition to other options for those diagnosed with COVID-19.
It is already clear that healthcare will remain an important focus for the company post-pandemic. For instance, the company has forged partnerships with CVS and Thermo Fisher Scientific to promote employer-based COVID-19 testing; Carrier Global Corp. to boost temperature controlled delivery of medicines and vaccines; and Crossover Health (a primary care clinic chain) to provide virtual or in-person visits and develop employee health centers in five cities.
For all employers, COVID-19 and its growing cadre of variants will continue to put the health of all employees at risk in the foreseeable future. In addition to determining that the virus meets the “direct threat” standard under the Americans with Disabilities Act (a move that has enabled employers to ask employees health-related questions and keep those with symptoms from entering the workplace), the Equal Employment Opportunity Commission has made it clear that employers may opt to make vaccination mandatory. As a result, many employers are discussing plans to mandate vaccinations before permitting their employees return to the office.
I suggest that all employers give serious consideration to a mandatory vaccine policy for their workforces, keeping in mind some practical issues such as:
- Does the company need a mandatory vaccine policy? Do employees work remotely, making it feasible for them to make their own decisions? Is close contact required among employees or with the public, making vaccination a “must”?
- If a policy is implemented, how will requests for exemptions be handled — and what happens to those who refuse?
In a big shift from the previous administration’s position (i.e., leaving coronavirus precautions to the discretion of employers), President Biden has tasked the Occupational Safety and Health Administration (OSHA) with ensuring that workers are protected from catching or spreading COVID-19. National standards for employers will be established and OSHA will have the power to enforce them. Because workers are guaranteed the right to refuse employment that will jeopardize their health, workers will be allowed to receive unemployment benefits if they quit jobs that do not follow pandemic protocols.
For employers, it all boils down to this: you can run, but you cannot hide! Like mandatory drug testing for certain jobs and mandatory meningitis vaccinations on college campuses, requiring a COVID-19 vaccination for certain employee populations is totally appropriate. Think of it as a “passport” to work.
I recognize that not every firm has the resources of a Walmart or an Amazon but, in the final analysis, your own employees don’t care about that. As your employees, they look to you.
David Nash, MD, MBA, is founding dean emeritus and the Dr. Raymond C. and Doris N. Grandon Professor of Health Policy at the Jefferson College of Population Health. He serves as special assistant to Bruce Meyer, MD, MBA, president of Jefferson Health. He is also editor-in-chief of the American Journal of Medical Quality and of Population Health Management.