The Delta Variant: What We Know, What We Don’t Know, And What Employers Should Do About It

Employers are in a bind. In the U.S., the COVID-19 case counts and hospitalizations were on a steady decline during June. Businesses were tentatively welcoming employees back to the office—unmasked—and the market environment was stabilizing. The Delta variant, however, is challenging that sense of normalcy. With the cluster of cases spread among vaccinated party-goers in Cape Code over July 4 (CDC MMWR) and decreasing vaccination rates across the country, employers who have or were planning to bring employees back into the office need to figure out ways to be proactive and not reactive.

Here are some things we know and don’t know.

1. The Delta variant is likely very contagious.

In an internal document, the Centers for Disease Control and Prevention (CDC) indicated the Delta variant is as contagious as chickenpox and shown to break through protections from the vaccines more than other versions of the virus. And those with breakthrough cases carry just as much of the virus in the nose and throat as unvaccinated people. Even though these cases are much less severe, these vaccinated individuals likely can transmit the virus. That means that even if your employees are vaccinated, someone could infect them and then in turn their children or vulnerable family members. (NYT)

2. The vaccines are still pretty darn good.

Even though the Delta variant can break through the highly effective Pfizer-BioNTech and Moderna vaccines at a higher rate, the percentage is still very low. According to what we know now, breakthrough rates are less than 1 percent. Although breakthrough cases are not consistently tracked, from January to April, the CDC reported only 0.01% breakthrough cases (CDC). Although this was before the spread of the Delta variant, a more recent CNN analysis that accounts for the Delta variant found that less than 0.004% of fully vaccinated people had a breakthrough case that led to hospitalization and less than 0.001% of fully vaccinated people died from a breakthrough COVID-19 case (CNN).

This means that the more your employees are vaccinated, the less likelihood that your worksite will be a transmission site or that your employees will get seriously ill, which has prompted many businesses to start mandating vaccines. FacebookGoogleMicrosoftTyson FoodsVMwareAdobeGoldman SachsMorgan StanleyWalmart and Union Square Hospitality Group are among the growing list requiring in-office workers to get vaccinated and will (mostly) take them at their word. Last week, the Biden administration announced that a jab would be required for all federal employees and contract workers, who must either attest to truthfulness of vaccination or participate in weekly/biweekly testing, wear masks indoors, socially distance, and have travel restrictions (Federal News Network).

3. Masks work, but our tolerance for wearing them is waning.

Masks reduce risk of transmission of airborne particles. A study published in the JAMA Internal Medicine exploring mask filtration found that N95 masks filter at least 95% or more of tiny 0.3 micrometer particles. The study found that KN95s (masks approved by the Chinese government) have filtration efficiency ranging from 53 – 85%. Surgical masks with ear ties/loops showed a filtration efficiency of 37 – 69%. Another analysis found that cotton masks with multiple layers and a high thread count can filter out these particles with between 65 – 90% efficacy.

However, during the 75 days between May 13 and July 27 when vaccinated individuals could confidently wear masks indoors according to CDC guidelines, many employees remembered how much easier it is to work in person without one (and let’s be honest, many of us never forgot it in the first place). So reminding (or convincing) workers to wear masks indoors in high transmission areas may feel painful, impossible, or both. Consider emphasizing how masks can help, wearing high-quality masks yourselves, and providing them for employees.

4. Businesses really, really should keep their employees from getting COVID.

We know that COVID impacts older, more medically complex individuals at a higher rate. Many of these individuals are likely retired and rely on Medicare for their healthcare coverage. However, a significant number of those who have contracted COVID have employer-sponsored coverage. And besides having to miss work now, there is the potential for long-lasting impacts of a COVID infection, both on healthcare costs and for job performance.

Chronic conditions represent an increasing driver of healthcare costs in the U.S., and adding another chronic condition to the list of heart disease, diabetes, and cancer is bound to increase healthcare costs. Employers will continue to have to decide how to cover that increased total cost of care, such as depressing wages or passing on more costs to employees.

The Department of Justice and Health and Human Services released new guidance noting that long-COVID can be a disability under federal law if it substantially limits one or more major life activities. The guidance only addresses one test of disability and explicitly notes it “does not address the ‘record of’ or ‘regarded as’ parts of the disability definition, which may also be relevant to claims regarding long COVID.” Aside from the legal definition, at a practical level, several of the common long-COVID symptoms can negatively impact an individual’s ability to return to work and to be productive. For example, ongoing effects include brain fog, dizziness, inability to focus, fatigue, anxiety and depression, and inability to exercise or be active. Many individuals with long-COVID have reported that more flexible work schedules and adjusted expectations for ever-present digital communication offered by their employers have helped them in their recovery. Employers can help their long-COVID-impacted employees recover and return to health by understanding the diversity of symptoms and offering appropriate flexibility when needed.

So, what should employers do about it?

Encourage employees to get the vaccine and set expectations for non-vaccinated employees to continue to take precautions. Consider providing paid (or additional) sick leave for employees to get the shot or asking your local health department to come give the vaccine on site. Share information from trusted sources, such as a local primary care physician, nurse, or a wellness coordinator. Be patient, explain options, and then set expectations for non-vaccinated individuals to wear masks and be tested consistently.

Allow workers flexibility. Not all jobs have flexibility to work from home (notably many employees that work in grocery stores, hospitals, factories that kept our country going during the worst of the outbreak, who are disproportionately non-white), but if your workers prefer to work from home—and can reasonably do so—don’t pressure them to do otherwise. Other adaptions to consider are altered work schedules or encouraging employees to take scheduled time off.

Provide support for mental health needs as well. Many workers are facing increased anxiety, depression, and other mental health challenges during what has been a very disruptive couple years. Encourage them to take breaks, invest in their well-being, and provide thoughtful outreach. Also, many employees may not know that their employers have Employee Assistance Programs or other resources to help with acute mental health needs. Remind them what is available.

So, make plans, but be flexible. Promote the vaccines, and invest in your employees’ physical and mental wellbeing. And when we learn more, adapt.