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Preparing for the Next Stage of the COVID-19 Pandemic at RIMS Content Roundtable

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In last week’s “RIMS Content Roundtable: COVID-19 Vaccines and Distribution,” a group of RIMS members gathered for an exclusive Q&A with Dr. Adrian Hyzler, chief medical officer at Healix International, who focused on progress with COVID-19 vaccination efforts and moving toward a “next phase” of the pandemic.

“Where we’re headed is: this pandemic will end—all pandemics end—but it doesn’t end all of a sudden, it goes out with a whimper…it sort of just seeps away at different rates around the world,” Hyzler said, noting the rates of vaccination and controls implemented country by country will curb the coronavirus at different paces. “But it’s now going to be an endemic disease, meaning it’s something we live with. We’re not going to get rid of this disease.”

He believes recognition among public health experts that COVID-19 will become endemic rather than be eradicated prompts new conversations about expectations and preparations around the world.

“The new dialogue is: what is the acceptable level of COVID and what is the acceptable level of deaths from COVID? Because COVID is a respiratory disease and people die of respiratory diseases every year, especially in winter. That’s something we live with,” Hyzler said. “We’re going to have to get to a point where there are going to be people who die from COVID every year, but they’re not going to overrun hospitals, and they’re not going to affect care of other diseases.”

Getting to the stage of “a disease we live with” requires mass vaccination, and he stressed the importance of the widespread effort to encourage people to get COVID vaccines as soon as possible. Scientists are not yet sure what percentage of the population will need to be fully vaccinated to control the pandemic sufficiently and, he said, “that’s vaccinated across the whole population evenly, and that’s not the case—we know there are communities where they are vaccine-hesitant, we know there are religious groups that are not as confident about the vaccine, and they tend to cluster, so those are always ready for outbreaks.”

Rather than discuss the sometimes controversial or scientifically debatable concept of “herd immunity,” Hyzler encouraged thinking about “community immunity.”

“‘Community immunity’ is good because it’s more about what we can do for each other,” he explained. “Getting vaccinated, for a 28-year-old, is not necessarily about that person, it’s about what it can do for the community—the older people, the people who have preexisting conditions that make them vulnerable.”

This kind of community orientation and widespread adherence to best practices will be critical in getting to any next phase of the pandemic, and to staying there. Reflecting on his experience of the acute lockdowns implemented in the U.K., for example, Hyzler stressed the lessons learned about the impact of mass adherence to mitigation and prevention measures. “Even with the variant that’s come out here that is very transmissible and has become common in the States, we’ve shown that non-pharmaceutical interventions—which are masks, distancing, isolation, hygiene—they work,” he said.

Many of these non-pharmaceutical interventions will not be going away any time soon—indeed, they may be just as critical moving forward. Hyzler predicted, “I think, into next year, we may still be wearing masks in many situations and there may be a great move to more things outdoors, since we know how much safer that is, and I think we’ll have learned a lot of things from this… Hopefully we’ll also be more ready for something that will happen again.”

As the world moves toward mass vaccination to help curb COVID-19, companies should be preparing for the next stage of the pandemic and creating detailed plans for safely returning to work. To that end, Hyzler noted some large private companies have publicly offered resources to help other enterprises protect employees and operations amid the pandemic and prepare for a return to workplaces.

For example, Ford has published two versions of a “Return to Work Playbook,” one for manufacturing and another for non-manufacturing companies. According to Ford, in addition to providing these documents to employees, “the company is also providing a copy to its suppliers, business partners and relevant third parties to ensure they are all aware of its health and safety practices when they are on site at Ford facilities or are interacting with Ford personnel.” Companies outside of Ford’s supply chain can also benefit, however.

“Add in some CDC advice, and look at what people [around you] are doing, because there are little things you can do that are very specific to your area or your workforce,” Hyzler recommended. “Then, take the information [from the playbook] that’s useful and mold it into a mini version of a playbook, if you’re a smaller company.”

In addition to the Ford playbooks Hyzler mentioned, check out these publicly available resources from the private and public sectors that may offer help in managing COVID-19 risks and creating a return-to-work plan for your enterprise:

Ford’s Return to Work Manufacturing Playbook [PDF]
Ford’s Return to Work Non-Manufacturing Playbook [PDF]
IBM’s Return to Workplace Playbook [PDF]
Kaiser Permanente’s COVID-19 Return to Work Playbook
CDC’s Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19)
CDC’s “Daily Activities” Guide for Returning to Work
OSHA’s Protecting Workers: Guidance on Mitigating and Preventing the Spread of COVID-19 in the Workplace

Participants in the roundtable event were able to debrief with fellow risk professionals in breakout rooms, sharing impressions from the session and experience addressing related risks within their own organizations. For more opportunities to discuss return-to-work plans, vaccine considerations and other COVID-related risks with other risk professionals, all RIMS members can continue the conversation on Opis, the society’s community engagement and networking platform. Among almost 200 education sessions, the upcoming RIMS Live 2021 virtual conference will also offer dozens of COVID-related education and networking events from April 19 to 30, and registration is now open. To hear more insights directly from Dr. Hyzler, you can check out his appearances on the RIMScast podcast.

Japanese Companies Look to Cut Costs by Curbing Smoking

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Concerned about lost productivity and higher employee healthcare costs, many employers are taking serious steps to eliminate smoking among employees. In Japan, a number of companies and educational institutions are now even basing hiring decisions on whether an applicant smokes.

Some scientific evidence suggests that employers’ concerns about the added costs costs are valid. A 2018 study conducted by Ohio State University found that smokers in the U.S. cost private sector employers an average of $5,816 extra per year, excluding additional costs that the employees themselves may pay. These employer costs include “excess absenteeism,” “presenteeism” (lower productivity on the job), “smoking breaks,” “excess healthcare costs” and “pension benefits,” with time devoted to smoking breaks making up the majority of costs. Stopping smoking eliminates lost time for smoke breaks entirely, unlike other high-cost factors like healthcare and absenteeism, which could continue after an employee stops smoking.

Smoking is more prevalent in Japan than in the United States, especially for men.

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Although the rate has been falling steadily, a 2018 national study showed that 28.2% of men and 9% of women in Japan smoke, compared to 15.8% of men and 12.2% of women in the United States, according to the Centers for Disease Control and Prevention.

In April, more than 20 Japanese companies signed onto a corporate partnership to promote anti-smoking steps. Starting in spring 2020, for example, insurance company Sompo Japan Nipponkoa Himawari will not hire any new employee who smokes, and will require its high-level officials to sign a document pledging not to smoke during work hours. The private sector in Japan is not alone in pushing for less employee smoking—Nagasaki University announced last month that it would stop hiring faculty who smoke and banned smoking on campus, and Oita University has “put priority on nonsmokers” when hiring.

Part of this effort is incentivizing quitting.

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Employees who quit smoking at Japanese company Rohto Pharmaceutical Co., for example, get tokens they can use at the company cafeteria or for other benefits. Marketing firm Piala Inc. is also offering an extra 6 paid days off to non-smoking employees, and 4 of its 42 smokers have reportedly quit smoking thus far.

While programs to incentivize quitting may seem intuitive, according to Ohio State’s Micah Berman, lead author of the school’s study, these efforts may also be pricey for employers. “Employers should be understanding about how difficult it is to quit smoking and how much support is needed,” he said.
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“It’s definitely not just a cost issue, but employers should be informed about what the costs are when they are considering these policies.” These can include the costs of direct incentives like the ones noted above, or the additional healthcare cost of prescription drugs or counseling to help quit. However, in the long-term, companies that implement cessation programs—especially those that have a large number of smoking employees to start—are likely to see the benefits outweigh initial investment costs within 4 years.

Companies may save money by encouraging employees to quit smoking, especially in lost time and healthcare spending, but they should examine the costs and benefits of instituting formal or informal policies to change their employees’ habits. Running afoul of legal protections, as well as making workplaces unfriendly to employees who smoke, being perceived as interfering with employees’ activities outside of work and other considerations may outweigh employers’ concerns for their workers’ health and excess spending.

Japanese companies have stated that they believe these steps are legal, and some U.

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S.-based companies, including Scotts Miracle-Gro and Weyco, Inc., have reportedly made similar efforts to discourage their workforces from smoking. Some companies in the U.S. may be unable to explore such potential programs, however. According to legal experts, “around half of [U.S.] states currently legally protect employees from being denied positions, or having employment contracts terminated, due to tobacco use.”

Pregnancy-Tracking Apps Pose Challenges for Employees

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As more companies embrace health-tracking apps to encourage healthier habits and drive down healthcare costs, some employees are becoming uncomfortable with the amount and types of data the apps are sharing with their employers, insurance companies and others.

This is especially true for apps that track fertility and pregnancy. As the Washington Post recently reported, these apps collect huge amounts of personal health information, and are not always transparent about who has access to it. The digital rights organization Electronic Frontier Foundation even published a paper in 2017 titled The Pregnancy Panopticon detailing the security and privacy issues with pregnancy-tracking apps. Employers can also pay extra for some pregnancy-tracking apps to provide them with employees’ health information directly, ostensibly to reduce health care spending and improve the company’s ability to plan for the future.

Given the documented workplace discrimination against women who are pregnant or planning to become pregnant, users may worry that the information they provide the apps could impact employment options or treatment by colleagues and managers. Pregnancy-tracking apps also collect infinitely more personal data than traditional health-tracking apps and devices like step-counters or heart rate monitors. This can include everything from what medications users are taking and when they are having sex or their periods, to the color of their cervical fluid and their doctors’ names and locations.

Citing discomfort with providing this level of information, the Washington Post reported some women have even taken steps to obscure their personal details when using the apps, for fear that their employers, insurance companies, health care providers or third parties may have access to their data and could use it against them in some way. They use fake names or fake email addresses and only give the apps select details or provide inaccurate information. Fearing the invasion of their newborn children’s privacy, some have even chosen not to report their children’s births on the apps, despite this impacting their ability to track their own health and that of their newborn on the app.

Like many other apps or online platforms, it may be difficult to parse out exactly what health-tracking apps are doing with users’ information and what you are agreeing to when you sign up. When employers get involved, these issues get even more difficult. By providing incentives—either in the form of tangible rewards like cash or gift cards, or intangible benefits such as looking like a team player—companies may actually discourage their employees from looking closely at the apps’ terms of use or other key details they need to fully inform the choice to participate or not.

While getting more information about employees’ health may offer ways to improve a workforce’s health and reduce treatment costs, companies encouraging their employees to use these apps are also opening themselves up to risks. As noted above, apps are not always transparent as to what information they are storing and how. Depending on the apps’ security practices, employees’ data may be susceptible to hacking or other misuse by third-party or malicious actors. For example, in January 2018, fitness-tracking app Strava released a map of users’ activity that inadvertently exposed sensitive information about military personnel’s locations, including in war zones. Given the kinds of personal details that some apps collect, health app data could also put users at risk of identity theft or other types of fraud.

Tracking, storing, and using workers’ personal health information also exposes employers and insurance companies to a number of risks and liabilities, including third-party data storage vulnerabilities and data breaches. This is especially important in places governed by stringent online data protection regulations like the European Union’s General Data Protection Regulation (GDPR). In addition to the risks of reputation damage, companies that are breached or otherwise expose employees’ personal information could face significant regulatory fines.

People using health-tracking apps, especially fertility-related apps, should weigh the costs and benefits of disclosing personal information against how apps and others are using this information. Companies who encourage their employees to use these apps and collect their personal health details should also be as transparent as possible about how they are using it, and implement measures to protect workers’ personal data to the fullest extent possible and ensure that managers are not using this data to discriminate against workers.

Data Breaches Taking Slightly Longer To Detect, Study Finds

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Despite rising global awareness of data breaches in various industries, organizations experienced an increase in the number of days to identify a data breach over the last fiscal year. According to a new study conducted by the Ponemon Institute and published by IBM, it takes an average of 197 days for a company to identify a breach – up six days from 2017 – and an average of 69 days to contain it (which also showed a three-day increase from 2017).

“We attribute the increase in days to the growth in the use of IoT devices, extensive use of mobile platforms, increased migration to the cloud and compliance failures,” study authors said in 2018 Cost of Data Breach Study: Impact of Business Continuity Management.

This year’s study included 2,634 employees from 477 companies in 17 industries in 13 countries and two regions. The study found that the average total cost of a data breach in 2018 is .

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86 million; $1.45 million is attributable to the most-costly component, which is lost business cost. The least expensive component is data breach notification at The least expensive component is data breach notification at $0.16 million.

Ponemon also included a framework for measuring the cost of mega breaches, which are breaches involving at least 1 million compromised records. There is also a special analysis of the cost to recover from a data breach.

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Some notable findings include:

  • The average cost per compromised record at the surveyed organizations was $148 in fiscal year 2018, up from $141 in 2017 but down from $158 in 2016.
  • The larger the data breach, the less likely the organization will have another breach in the next 24 months.
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  • Healthcare organizations took an average of 55 days to detect a breach, but 1,037 days to contain it.

To download IBM’s survey, click here.