The Workers' Compensation Hot Seat on February 11, 2021, features the challenges with vaccinations.
The subject of SARS-CoV-2 virus and the resulting manifestation/disease COVID-19 is not news. And, the topic has been addressed in this blog many times in the last year. It seems inconceivable ("You keep using that word. I do not think it means what you think it means" - The Princess Bride, 1987) that we rapidly approach the one-year anniversary of the World Health Organization declaring the disease a "pandemic" (March 11, 2020). It seems like yesterday in many ways, and yet in others, we seem to have been under this thing's heel for a decade.
The news is filled with coverage of the manifestation. Why just yesterday, the Center for Disease Control made the news for the revelation that "Two Masks are Better than One vs. COVID-19." At some point, we may learn that three masks are better than two, or even that four masks are better than three. The analysis may be that as masks (m) approaches infinity (∞), the probability of contracting the disease approaches 0%? But, eventually, my face may begin to look like the Michelin man, and neck strain from the weight could become a factor.
Most will remember when we lived through the early days of COVID-19 and there was advice about precautions. We were told not to wear masks at all. The experts evolved from that posture through ambivalence toward mask mandates. The science was uncertain, and we experienced some uncertainty in the science itself. A year into the adventure of COVID-19, we remain unsure of its origin. There has been rumor, conjecture, and innuendo over the last fourteen months.
However, this week the World Health Organization concluded the virus (SARS-CoV-2) "most likely originated" in animals and then somehow facilitated a jump to humans. Of course, some believed this early. An article in February 2020 labeled what we have come to know as COVID-19 as "A pneumonia outbreak associated with a new coronavirus of probable bat origin." There was also early discussion of pangolins. Some may feel the "animal" news this week is not really news at all. And, while the WHO is pronouncing that it is "extremely unlikely" COVID came from a lab in China, that potential has seemingly not been eliminated from discussion.
What has been news for the last 60 days has been the deployment of vaccines against SARS-CoV-2 and COVID-19. In The Future's So Bright, there is a beginning of an overview of the fantastic speed with which vaccines have been developed, tested, and deployed. In that, we are notably fortunate. Some caution us to remember that the development was more rapid than we thought. The New York Intelligencer explains that we have had a vaccine since January 2020. It cautions us that the time that has passed was for the testing and the trial, not for the development itself.
However, the development of SARS-CoV-2 vaccines has been nothing short of astounding. The trip from last April Fool's Day when experts opined that we faced at least 18 months of development to the December deployment was outstanding. The New Yorker told us last spring that it might be the "fastest ever," and in retrospect they were right. The effort, cooperation, and focus has been nothing short of astounding. The doubting Thomases were simply wrong with their April Fools 2020 projections.
We now face a growing number of variants. It is interesting that many found it inappropriate to refer to SARS-CoV-2 with geographic shorthand as has been our history (the "Spanish flu," and others). A great many found such references in the Spring of 2020 as offensive. But, publications like The Washington Post ("U.K. Coronovirus Variant"), the British Broadcasting Corporation (BBC) ("South African Variant"), and National Public Radio (NPR)("the variant from Brazil") are seemingly more comfortable with geographic identifiers for "variants" of the disease. The distinction is palpable but difficult to understand.
Publications like the New York Times and the Centers for Disease Control have been more academically focused on using the actual names of these variants: B.1.1.7.; B.1.351.; and P1. A few in the news world, such as STAT, have stressed the theme of avoiding geographic names. STAT takes issue with the geographic shorthand referencing for disease and seems to suggest some hypocrisy in the practice with variants.
Part of our inclinations, however, may be in the underlying human psyche. It is easier to remember familiar terms than new terms, and "B.1.1.7" just does not roll off the tongue any easier than "SARS-CoV-2." That is likely why the majority of the world ignores the name of this virus and short-hands with its effect: "COVID-19." Perhaps the variants could be likewise shorthanded with some easier-to-remember shorthand like "COVID-19-1" and COVID-19-2?" STAT has a point, hypocrisy may undermine credibility and confidence.
And now, we turn to the next problem. What if you build it and they don't come? There is an outcome that Ray Kinsella perhaps never feared (Field of Dreams, 1989). But, on the February 2021 edition of the Workers' Compensation Hot Seat, there was a spirited discussion of vaccines and their deployment (this was pre-recorded, and there remains time to register for the February 11, 2021 broadcast).
This discussion includes Dr. Hong Cheung and attorney Bert Randall. Dr. Cheung explains the concept of vaccine efficacy. Of note, he is impressed with how effective these SARS-CoV-2 vaccines are. He noted that the efficacy of the flu vaccine has consistently been lower. That is consistent with WebMD's report that flu vaccines have been about 40%. The Pfizer COVID-19 vaccine is 95% effective. The Moderna is 94% effective. Johnson and Johnson claims to be "85% effective overall." All of these numbers far exceed that 40% from decades of flu vaccine research and testing. Imagine decades of development for 40% efficacy, and millions enthusiastically inoculated annually in the U.S. each year, according to USA Facts. Is it anachronistic that so many accept and embrace a 40% effective vaccine against a seemingly less-lethal infection, but there is seeming resistance to a far more effective vaccine against this more recent threat?
Dr. Cheung helps with some challenging discussions. First, the "vaccine" may be effective and yet you may still get COVID-19. The point of this vaccine includes the prevention of infection, but it is also of use in preventing the more troublesome and life-threatening symptoms and effects. Thus, some percentage of those who are inoculated will nonetheless become infected. It seems fair to say that vaccines are not a cure in every case, but that they are a positive protection in every case. There may be room to debate how much benefit any particular person will enjoy, and what each person's actual risk is without the vaccine, but it seems probable that however prepared your body is to fight this disease, it will be more prepared with the vaccine.
Frustratingly, after you get the vaccine, you must still wear the mask, socially distance, and keep washing your hands. This was Dr. Cheung's advice and it mirrors what medical webpages are publishing. The fact is that many people get this virus and never know it. They suffer no symptoms and thus are merely carrying the disease, spreading the disease. As the inoculation becomes widespread, it is possible that greater populations of people will become infected and yet not know due to an absence of symptoms. There is a danger of greater virus spread if the distancing and masking, and other precautions are simply abandoned.
Dr. Cheung stresses that many people need to be vaccinated. He reiterated the "herd immunity" that has been discussed on sites like WebMD. He stresses that vaccines have the potential to prevent us from contracting COVID-19 (prevention). There is a high probability that the vaccines will reduce or eliminate the serious effects of COVID-19 (mitigation), with the benefits of fewer hospitalizations, and less economic impact (personally and societally). There is the expected effect that either or both of these will impede the virus' ability to spread and mutate. And, unfortunately, there is the potential that prophylactic efforts like vaccines, distancing, and masks may be with us for some time to come.
Mr. Randall addresses the reactions of business. He mentioned that there was discussion early in the vaccine rollout of mandating employee vaccination. That has tempered in recent weeks from his perspective. There are various legal issues he mentions as perhaps influencing employer decisions. There is the potential for vaccine-related complications to themselves be workers' compensation issues. Beyond this, however, there are potentials for such mandates to cause friction with religious liberty and the requirements for disability accommodation under both federal and state law.
He perceives a resulting alternative tendency of employers encouraging vaccination for employees, or even incentivizing, but not mandating. His discussion of the nature of incentives is intriguing, as is the potential challenge employers might face from the standpoint of employees being treated equally, that is some way to participate in the incentive without accepting the vaccination. He mentioned the potential that employees might earn that inoculation incentive by instead participating in training regarding either infection avoidance or mitigation strategies.
Mr. Randall concedes that businesses face competing challenges. An inoculated workforce might mean safer employees, but forcing it could lead to employee claims or lawsuits. Similarly, a workforce making its own choices about inoculation may be less able to assure the customer a safe environment and businesses may face liability claims from that customer. In some perspectives, the mandate of the inoculation question may present a Hobson's choice.
This February 11, 2021, Hot Seat production is a "must watch" for those struggling to understand the vaccines and various employment issues surrounding them (and it is available for replay after that date). As the U.S. is fortunately in the vaccine stage of SARS-CoV-2/COVID-19, these issues will be potentially (or eventually) on each of our horizons both personally and professionally. Admittedly, some are disinclined to vaccines.
A recent survey revealed 15% of healthcare workers surveyed had refused the vaccine for various reasons. Among Emergency Medical Service employees in some communities, the refusal rate has been reported as high as 60% in Akron, Ohio, 50% in Miami, Florida, and 50% in Riverside, California. Some might ask "What do they know that we don't know?" They may be anti-vaccine generally, uncertain of safety testing, skeptical of the rapid development of this vaccine, or suffer from a variety of other unstated questions or doubts.
Their reasoning is not clear. According to Stat, tens of thousands participated in the clinical trials of these vaccines. There were side effects and complications for small percentages of those. But, as important, there have been "43.3 million doses administered" in the U.S. according to National Public Radio (NPR). That is almost 10% of the population. Progress continues at greater than one million doses daily. Worldwide, the volume is 152 million total with over 5.5 million injections occurring daily, according to Bloomberg. Dr. Cheung notes there are tools being used to track complications, side effects, and more. He was encouraged by the speed of this effort and the vast amount of data now being generated as increasing portions of society join the inoculated. It seems that with each passing day, we can be more confident in the vaccines and less worried about complications.
Is vaccination a simple subject? Is the decision to accept/reject it simple? Is the management of a business in this pandemic any simpler? The answers are likely "no," "no," and (sorry) "no." Well "I Never Promised you a Rose Garden." You owe it to yourself to tune in today to the Hot Seat and learn more about the personal and professional implications of this stage of the SARS-CoV-2 pandemic. And, remember the Hot Seat is available for playback if you run across this post in the future.
