COVID-19 Update Thursday... · 2020-05-29 · Lisa Comerose, RN National Director of Clinical ... Divya Patel, BS National Director of Data Analytics Marsh & McLennan Agency. Marsh

COVID-19 UpdateNavigating the Coronavirus: Vaccines, Testing and Wellbeing

Thursday

May 28TH 2020

HOSTED BY:

Kate Moher

National Employee Health

& Benefits Practice Leader

Marsh & McLennan Agency LLC

Our Speakers

Monte Masten, MDChief Medical OfficerMarsh & McLennan Agency

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Betsy Nota-Kirby, MSNational Director, Health

Management ConsultingMarsh & McLennan Agency

Lisa Comerose, RNNational Director of Clinical

ManagementMarsh & McLennan Agency

Divya Patel, BSNational Director of Data

AnalyticsMarsh & McLennan Agency

Marsh & McLennan Agency LLC 2

Clinical Update

- Monte Masten


U.S. Prevalence as of 5/26/2020 (10 am EST)Total Cases 1,708,597

Deaths 99,847

Recovered 465,668

Active 1,143,062

Mild (98%) 1,120,201

Serious/Critical

(2%)

22,861

New Cases/Day 19,790

Deaths/Day 505

www.worldometers.info3

http://www.worldometers.info/



1. New York State Department of Health as of 05/07/2020 (link) 2. JAMA (link). 3. JAMA. (link) 4. El Pais (link) 5. Medscape (link)

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States with Lifted Restrictions

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Return to Work

- Lisa Comerose


Looking Ahead, Opening Up America Again

Proposed Gating Criteria

• Symptoms: Downward trajectory of influenza-like illnesses (ILI) and a downward

trajectory of COVID-19 syndrome cases both reported within a 14 day period.

• Cases: Downward trajectory of documented cases and positive tests as a percent of

total tests within a 14-day period.

• Hospitals: Capacity to treat all patients without crisis care, and robust testing

program in place for at-risk healthcare workers, including emerging antibody testing.

Source; https://www.whitehouse.gov/openingamerica/

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After Satisfying Gated Criteria, Phased Approach

Source; https://www.whitehouse.gov/openingamerica/

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Phase 1Social distancing guidelines get relaxed but

gatherings of more than 10 people should be

avoided.

Non-essential travel should be limited and at-

risk individuals should continue to shelter in

place.

Continue leveraging remote or telework and

plan for a phased approach to return to

work. Limit congregation in common areas

making special accommodations as needed.

Restaurants, sporting venues, churches, and

parks can reopen if they observe strict social

distancing guidelines.

Elective surgeries can resume when

appropriate on an out-patient basis.

Phase 2Social distancing guidelines get relaxed further,

limiting gatherings to no more than 50 individuals.

Non-essential travel can resume, but at-risk or

vulnerable individuals should continue to shelter in

place. Continue to encourage telework whenever

possible.

Common areas where personnel are likely to

congregate and interact, enforce moderate social

distancing. Strongly consider special

accommodations for personnel who are a vulnerable

population.

Schools and organized youth activities can reopen.

Large venues can operate under moderate physical

distancing. Gyms can open if they adhere to strict

physical distancing and sanitation protocols.

Elective surgeries can resume, as clinically

appropriate, on an out-patient and in-patient basis at

facilities.

Phase 3Vulnerable individuals can resume public

interactions, but should practice physical

distancing, minimizing exposure to social

settings where distancing may not be practical,

unless precautionary measure are observed.

Employers can resume unrestricted

staffing of workplaces. Large public venues

can operate under limited social distancing

rules. Visits to senior care facilities and

hospitals can resume.


MMA Compliance Centers Of Excellence

Mandatory COVID-19 Testing

• Many employers cannot require all of their employees to

submit to COVID-19 testing because one or more employees

likely fall into some sort of “protected class” and requiring

testing will violate one or more of their legal rights.

• An employer can require testing before employees enter

the workplace, and send home employees who test positive or

who decline to test. This shifts the conversation to whether the

employee can work remotely from home or should receive

paid/unpaid leave.

Guidance from the

EEOC supports this

advisement and

addresses concerns

under the ADA. [1]

[1] EEOC FAQs on ADA, Q/A #3 and 6, also

referenced by the DOL in its COVID-19 FAQs

for the FMLA.

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CDC May 2020 Update to Guidance on Test UsageUse of Antibody Testing

Antibody Testing currently has little role in the diagnosis of acute disease.

The uses of antibody testing fall into two broad categories:

Surveillance of populations

Testing of individuals for proof-of-prior infection

Source; CDC Activities and Initiatives Supporting the COVID-19 Response and the President’s Plan for Opening America Up Again May 2020 17


CDC May 2020 Update to Guidance on Test Usage Populations without symptoms and Antibody testing

Testing Populations without Symptoms should focus on

• Persons with an increased likelihood of infection

• Settings with at-risk populations including but, not limited to:

– Contacts of known cases (with or without symptoms). Includes testing contacts 1-2 weeks

before the onset of symptoms

– Residents and staff of long-term care facilities

– Other healthcare facility workers and first responders



CDC May 2020 Update to Guidance on Test Usage

Antibody testing provides a more complete picture of how much

infection has occurred already in the population.

Considerations with Testing:

– Case-based surveillance for anything with a wide spectrum of severity of symptoms

will always miss cases (since many people are without symptoms).

– A positive test result shows you may have antibodies from an infection with the

virus that causes COVID-19, or possibly from infection with a related virus from the

same family of viruses (called coronavirus), such as one that causes the common

cold.

– Employer must include 2 serial tests to confirm all positive results.



CDC May 2020 Update to Guidance on Test Usage Proof-of-Prior Infection (Immunity)

The use of antibody testing for a back-to-work strategy would likely benefit fewer

than 10% of the population currently per CDC.

Employer must include 2 serial tests to confirm all positive results.

• Example: New York City with the highest incident rates in the country:

o Survey conducted among customers of retail outlets found 22% had positive antibody test.

o Preliminary data at the CDC for the remainder of the clinical specimens in the NYC area found

about half that rate (estimated 11% were positive for antibodies).



Some Employers May Require Employees Get Tested for COVID-19 Before Coming Back to WorkTIME Magazine; May 7, 2020

21Source; https://time.com/5833633/employer-coronavirus-testing/

Florida’s Harris Rosen’s hotels near Disney

are testing 4,000 employees at their health

clinic and drive-thru testing.

Hotel Opens:

Employees regularly fill out questionnaire

about health and travel history.

All employees will get their temperature

taken when they arrive to work.

Those with fevers above 100.4 degrees

Fahrenheit will not be allowed on the

worksite.

Those with fever, receive testing.

https://time.com/5833633/employer-coronavirus-testing/


Returning to the Workplace

Per CDC guidance, people with COVID-19 who have stayed home (home

isolated) can stop home isolation under the following conditions:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html

Source; https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html

If you will not have a test to determine if

you are still contagious, you can leave home after

these three things have happened:

1. You have had no fever for at least 72 hours

(that is three full days of no fever without the

use of medicine that reduces fevers), AND

2. other symptoms have improved (for example,

when your cough or shortness of breath have

improved), AND

3. at least 7 days have passed since your

symptoms first appeared.

If you will be tested to determine if you are still

contagious, you can leave home after these three things

have happened:

1. You no longer have a fever (without the use of

medicine that reduces fevers), AND

2. other symptoms have improved (for example, when

your cough or shortness of breath have improved), AND

3. you received two negative tests in a row, 24 hours

apart. Your doctor will follow CDC guidelines.

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https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html

https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html


Back-to-Workplace Strategies

StrategyImplementation Scale

(Easy to Difficult)

Effectiveness Score

(low 0 – high 5)Cost

Social Distancing 5 $

Cleaning/Disinfecting 4 $$

Masks 3 - 4 $

Employee Communications 4 $

Enhanced paid sick leave policies 4 $$$$

Screening Questionnaires 2 $$

Temperature Screening 2 $$

Antibody Screening 2 $$$$

Virus Screening (i.e. Diagnostic) 3 $$$$

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Behavioral Health

- Betsy Nota-Kirby


State of Mental Health Prior to COVID-19

Americans experience symptoms of

depression, anxiety and stress. Those who

have both a chronic and behavioral

health condition(s) can cost up to 3

times more to treat.

63%Of employees reported that workplace

stress had significant impact on their mental

and behavioral health. This can have a

direct impact on work productivity and

employee retention.

80%Of workers with a mental health condition

attribute their non-treatment to shame and

stigma. Relatedly, the average person

waits 8 to 10 years after the onset of

initial symptoms before seeking

treatment.

31%Of employees would be afraid of being

labeled as weak, and 22% fear it would

impact their promotion opportunities.

Source: Catalyst For Payment Reform: State of Mental Health Report Marketplace

1 in 5

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The Costs of Mental Health Inpatient Treatment Prior to COVID-19

70%of Americans with

depression are in the workforce

$105 billionis the cost of

untreated mental illness in the U.S.

each year

35 millionworkdays lost each year due to mental

illness

$6,990 for 8.4 days for depression

$4,591 for 5.2 days for drug use disorder

$5,908 for 6.2 days for alcohol use disorder

$4,356 for 5.5 days for bipolar disorder

*This does not include lost days from work

Because most employees are not

seeking treatment or are unable

to access care, employers are

losing an estimated $225.8B

annually due to stress, anxiety,

depression and substance use

disorder.

Source: National Alliance of Healthcare Purchaser Coalitions, 2019

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- U.S. National Library of Medicine National Institutes of Health


COVID-19 and Need for Action for Mental Health

The United Nations recently released a policy brief which stated “The mental health and

wellbeing of whole societies have been severely impacted by this crisis and are a priority

to be addressed urgently.”

Specific population groups showing high degrees of COVID-19-related psychological

distress are:

• Frontline healthcare workers and first responders

• Older adults and people with pre-existing health conditions

• Women, children and adolescents

• People caught in fragile humanitarian and conflict settings

27Source: United Nations Policy Brief: COVID-19 and the Need for Action on Mental Health May 13, 2020


Source: Optum 2020

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To What Extent Have COVID-19-Related Work/Life Changes Impacted Your Wellbeing?


Source: Optum 2020 29



Source: Optum 2020


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Source: Optum 2020


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Marsh & McLennan Agency LLC Source: ESI America’s State of Mind report 2020

Percent Change in Prescriptions Filled Per Week For Mental Health Medications

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By select weeks from

January 19, 2020 to

March 15, 2020


Mental Health and Overall Wellbeing are Mutually Supportive

A foundation of mental health

Purpose

Social

Financial

Community

Physical

The Essential Elements of Wellbeing are Foundational to Overall Mental Health

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Strategies for Mental Health

Promote and/or develop company policies and practices focused on whole person wellbeing

Mitigate organizational stress

Offer programs on mindfulness

Rebrand EAP to reduce stigma around mental illness

Ensure organizational readiness by offering Mental Health First Aid to human resources, managers and supervisors

Promote greater use of tele-behavioral health services

Become a NAMI StigmaFree Company to reduce stigma around mental illness

Leverage the MMA Mental Health Communications Toolkit for employers

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Mental Health First Aid Training

The National Council for Behavioral Health manages the Mental Health First Aid Training organization.

• 8-hour certification class for traditional in-person training OR a 2-hour, self-paced class followed by a 4-hour, instructor-led class using video conferencing technology.

• Teaches participants how to identify, understand and respond to signs of mental illness and substance use disorders.

• Provides skills needed to reach out and provide initial help.

• Training is offered through a third party. Visit https://www.mentalhealthfirstaid.org/to locate a local training course.

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Fully virtual Training session

coming soon.

https://www.mentalhealthfirstaid.org/


MHFA Carrier & Private Training

Some carriers or other private entities have certified MHFA instructors available to provide private instruction. All trainers have completed the Mental Health First Aid USA training program. Note: Any trainer offering virtual training will be required to complete new instructor training program.

Carrier Programs:

• Cigna (pilot)

Private Training:

• MMA Minnesota HMC Team

• State of Virginia

• State of Georgia

• Select MMA Regional Offices

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Community-Based TrainingState of Georgia

The Mental Health America of Georgia manages the Mental Health First Aid Training.

Options for Training:

1. The Mental Health First Aid training is provided in a one-day, 8-hour format for employers with 15 - 30 participants with a dedicated training room and audiovisual equipment visit.

http://www.mhageorgia.org/mental-health-first-aid/ and click on the green button to locate trainings.

2. MHAofGA also provides additional Outreach Wellness Learning (OWL) mini-training resources. OWLs are 1-hour seminars covering a variety of topics: Mental Health 101, Mood Disorders, Workplace Wellness, Effective Stress Reduction Techniques, etc.

3. MHAofGA distributes a monthly newsletter highlighting programs and upcoming activities. To subscribe: http://www.mhageorgia.org/fundamental-matters/.

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http://www.mhageorgia.org/mental-health-first-aid/

http://www.mhageorgia.org/fundamental-matters/


National Alliance on Mental Illness (NAMI): Initiatives for the Workplace

StigmaFree Company Initiative: Be recognized as a StigmaFree company through NAMI’s partnership initiative. Resources provided include sample CEO and leadership announcement correspondence, videos, posters, guides for employees, and more. Individuals can also take the pledge to become StigmaFree at https://nami.org/stigmafree

Campaign manifesto: There’s a virus spreading across America. It harms the 1 in 5 Americans affected by mental health conditions. It shames them into silence. It prevents them from seeking help. And in some cases, it takes lives. What virus are we talking about? It’s stigma. Stigma against people with mental health conditions. But there’s good news. Stigma is 100% curable. Compassion, empathy and understanding are the antidote. Your voice can spread the cure. Join NAMI, the National Alliance on Mental Illness. Together we can #CureStigma.

NAMI Programs: NAMI offers six different educational programs, two support groups, and four presentations for a variety of audiences.

In Our Own Voice is a free 40-, 60- or 90-minute presentation which provides a personal perspective of mental health conditions, as leaders with lived experience talk openly about what it's like to have a mental health condition.

COVID-19 Resources: https://www.nami.org/Support-Education/NAMI-HelpLine/COVID-19-Information-and-Resources

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https://www.nami.org/Get-Involved/Take-the-stigmafree-Pledge/StigmaFree-Company

https://nami.org/stigmafree

https://www.nami.org/Find-Support/NAMI-Programs/NAMI-Family-Support-Group

https://www.nami.org/Find-Support/NAMI-Programs/NAMI-In-Our-Own-Voice

https://www.nami.org/Support-Education/NAMI-HelpLine/COVID-19-Information-and-Resources


NAMI COVID-19 Information and Resources

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Mental Health America COVID-19 Resources

As the number of cases of COVID-19 increases, so does the associated anxiety. For the past several weeks, Mental

Health America (MHA) has been using its unique database to monitor daily this increase in anxiety.

According to MHA screening data, there was a 19 percent increase in screening for clinical anxiety in the first weeks of

February and a 12 percent increase in the first two weeks of March. MHA will continue to monitor anxiety screening

rates.

MHA has compiled a range of resources and information including:

• Mental Health Information for Disease Outbreaks

• Financial Support

• Tools and Information on Anxiety

• Tools to Connect with Others

• Resources for Immediate Response

• Webinars, Live Events, And Workshops

• And much more

To access these resources, visit https://mhanational.org/covid19

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https://mhanational.org/covid19


COVID-19 and Your Mental Health

Downloadable Resource in the GoToWebcast

Platform, covers:

• Signs of Anxiety

• Managing Anxiety

• Your Concerns are Valid

Available online:

https://hr.iu.edu/relations/coronavirus/COVID19-and-Your-Mental-Health-

Infographic.pdf

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https://hr.iu.edu/relations/coronavirus/COVID19-and-Your-Mental-Health-Infographic.pdf


Returning to the Workplace (RTW) Toolkit

Return to the Workplace

Employer Considerations

FAQs

Face Mask Article,

Utilization and Limitations

FFCRA RTW Template

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MMA Mental Health CommunicationsToolkit

Through our comprehensive Mental Health Toolkit, your employees can learn more about a specific condition they may be facing and review national resources and tips to help facilitate healing.

The Mental Health Toolkit encompasses five common topics that can affect an employee both in and out of the workplace. It also includes an educational piece that directs employees where to go for care depending on their unique situation.

1. Stress2. Anxiety3. Depression4. Sleep Disorders5. Substance Abuse

To access the Mental Health Toolkit, click https://mma.marshmma.com/MA_Mental_Health_Toolkit

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https://mma.marshmma.com/MA_Mental_Health_Toolkit


Data Analytics

- Divya Patel


PATH & Artemis Health, COVID-19 Story

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47

5/25/2020.


PATH & Artemis Health, COVID-19 Story – Heart Disease

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PATH Behavioral Health Story

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Resources


Resource Roundup

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Resources from Today’s Presentation

Resource What is it? Where to access

John’s Hopkins COVID-19

Status ReportAbility to drill down to county level and learn up-to-date

health care details. https://coronavirus.jhu.edu/us-map

Clean Hands Campaign CDC campaign. https://www.cdc.gov/handwashing/campaign.html

Mental Health First AidWork with your local MMA team to schedule a virtual

course (anticipated availability July 2020). https://www.mentalhealthfirstaid.org/

National Alliance on Mental

Illness (NAMI), StigmaFree

Resources provided include sample CEO and leadership

announcement correspondence, videos, posters, guides

for employees, and more. https://nami.org/stigmafree

Mental Health AmericaResources and tools to help with anxiety, financial

support, mental health information, and more. https://mhanational.org/covid19

MMA Coronavirus Resource

PageMMA sourced content to support employers with

educational resources and tools related to COVID-19.https://mma.marshmma.com/coronavirus-

outbreak-resource-page

MMA Mental Health

Awareness ToolkitEncompasses five common topics that can affect an

employee both in and out of the workplace.https://mma.marshmma.com/MA_Mental_Health_T

oolkit

https://coronavirus.jhu.edu/us-map

https://www.cdc.gov/handwashing/campaign.html

https://www.mentalhealthfirstaid.org/

https://nami.org/stigmafree

https://mhanational.org/covid19

https://mma.marshmma.com/coronavirus-outbreak-resource-page

https://mma.marshmma.com/MA_Mental_Health_Toolkit


Resources on MarshMMA.com

• Dedicated page added to

MarshMMA.com.

• Includes resources,

helpful links, upcoming

events and post-event

replays.

• Use the sign up link to

receive email notifications

when the page is updated.

Sign up for real-time updates

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MarshMMA.com

This document is not intended to be taken as advice regarding any individual situation and should not be relied upon as such. Marsh & McLennan Agency, LLC shall have no obligation to update this publication and shall have no liability to

you or any other party arising out of this publication or any matter contained herein. Any statements concerning actuarial, tax, accounting or legal matters are based solely on our experience as consultants and are not to be relied upon as

actuarial, accounting, tax or legal advice, for which you should consult your own professional advisors. Any modeling analytics or projections are subject to inherent uncertainty and the analysis could be materially affective if any underlying

assumptions, conditions, information or factors are inaccurate or incomplete or should change. Copyright © 2019 Marsh & McLennan Insurance Agency LLC. All rights reserved.

Documents

COVID-19 Update Thursday... · 2020-05-29 · Lisa Comerose, RN National Director of Clinical ... Divya Patel, BS National Director of Data Analytics Marsh & McLennan Agency. Marsh