It Was Never About the Mandate

On January 13, the U.S. Supreme Court blocked the Biden administration from enforcing a vaccine-or-testing mandate for large employers, calling it “a blunt instrument” and “a significant encroachment into the lives — and health — of a vast number of employees.” The Occupational Safety and Health Administration formally withdrew the rule on Jan. 26.

This wasn’t a surprise. And it never should have come to that.

For employers, COVID-19 vaccines and testing were and never should have been about a mandate. Instead, employers should embrace them as a preemptive investment into maintaining their workforce, attracting new talent, and providing for continuity in business – while also considering COVID-related health care costs and the costs associated with business interruption.

They are the smart thing to do, mandate or not.

Before the mandate was struck down, one of our salespeople spoke with the CEO of a 200-employee company about testing solutions. That company had just a 50% vaccination rate and was upset about potentially having to pay for a minimum of 100 weekly tests to comply with the mandate.

We understood his frustration. For months, many businesses were waiting to be told what to do, relying on yet-to-be-written rules from OSHA and other government agencies to determine their next steps. In doing so, they were losing sight of the current COVID environment and its threat to the sustainability of their businesses. And they were left unable to plan for what’s to come.

Our message to him was, and is, the same to everyone, and it will be the same, tomorrow, next week, next month and next year: Vaccinate and test. Don’t wait for a Supreme Court ruling to determine your plan of attack for COVID.

Virus testing, screening and vaccination need to be part of your P&L. They are costs of doing business and an investment, just like research and development, raw materials and insurance – or IT, which many also considered a “nice to have” once upon a time (not anymore).

A more apt comparison may be to your costs around health insurance and 401(k) matches. Vaccines and testing are employee benefits – something employees should rightfully expect from their employers. And it doesn’t matter if you employ 25 or 25,000.

This is the lesson we’ve learned from COVID: The workplaces that take testing seriously will win in the long run. They will have healthier, more productive, more efficient workers. They will face fewer disruptions. They will see lower health care costs. They will attract and retain more employees.

In other words, an ounce of prevention saves a pound of pain down the road.

Dirk Steinert, MD

Chief Medical Officer, Novir

Focus on prevention

In other words, an ounce of prevention saves a pound of pain down the road. 

When it comes to vaccinations, study after study is showing those who are vaccinated against COVID have a much, much smaller chance of getting seriously ill with COVID. They miss less work. They infect fewer co-workers. They are a healthier and more stable workforce for companies. 

Testing only adds to that safety net. Regular screening prevents unnecessary absences and other complications that could decimate a workforce and cripple a company.

Historically, we’ve frequently seen these cost-benefit analyses applied to influenza. One study from Italy found an “influenza vaccination strategy reduced absences from work by 23% and decreased the loss of working days by 30% and related cost.” Another found “vaccinated employees can serve as a barrier to limit the spread of influenza in the population, reducing the attack rate by 78% at an employee coverage of 90%.”

And that’s with the flu. Compare that omicron, which is spreading like no flu has ever spread – maybe like no virus has spread, ever. 

That is why I never wanted a mandate. We should not need one. 

Of course, this is not perfect. Vaccinations are not shields. They are seatbelts. They do not prevent accidents, but they protect you when you get in them. And tests are not 100%, and can only slow spread, not stop it, giving you a sense of where the virus is, and isn’t. Still, it is always better to vaccinate and test. 

Continuity costs

Another reason to vaccinate and test is continuity. Ask yourself: When it comes to the ability of your business to function at its best – or at all, in some cases – what is the cost of losing even one employee to illness? 

Businesses model the cost of work stoppages all the time. I bet you know what a one-day power outage would cost your business right now, and you have a plan to address it. The same holds true for natural disasters, workplace violence, and other crises. But what is your plan to handle the loss of a significant part of your workforce for a week or two or worse, with an illness? 

One of our customers, a medical products manufacturer on Milwaukee’s Northwest side, instituted an employee antibody testing program in the early days of COVID – before any vaccine and access to antigen rapid tests. Their first round of tests for about 130 employees showed 10 employees tested were positive for COVID-19 antibodies. Only four of those people were known to have had the illness previously. Another four positive cases showed evidence of “recent antibodies” and may be infectious; they were sent home immediately with recommendations to get a PCR test and monitor for symptoms. 

A potential shutdown was averted.

Another one of Novir’s clients, a local food manufacturer, was faced with having to shut down production lines due to illness in the early days of COVID. Of course, they were concerned about the health of their employees and loss of production and revenue. But they were as concerned about their shelf space – losing their spot in grocery store freezers to a competitor because of out-of-stocks. 

Working with local health officials and Novir, this manufacturer preemptively implemented a company-wide COVID-19 testing program, and it paid off, preventing any disruption to output. The shelves remained stocked, there were no shortages, and years of hard work to win that space were not lost. 

And think of the insurance costs testing and vaccinations can save you. 

What is the cost of just one of your employees ending up in the hospital with COVID and long-haul symptoms? $500,000? $1 million? What will that mean to your annual renewal? And what if you’re self-insured? The risk is even greater. 

One recent study found there were 690,000 “vaccine-preventable COVID-19 hospitalizations from June through November 2021 in the United States,” with each of those preventable hospitalizations costing, on average $20,000 – some much, much more. That is billions of dollars in the aggregate – and money taken away from the bottom lines of you and your business. 

Beyond dollars and cents

Let’s take dollars and cents out of it. Think of COVID-19 testing and vaccinations as a way to help during the labor shortages many of you are feeling. 

Survey after survey shows employees want to work at a place where they feel like their employer cares for them. They want to feel safe – all the time, and especially now. 

Throughout the pandemic – from the early days to when vaccines became available to the recent spike in omicron cases – employees and employers have expressed concern with workplace transmission of COVID. 

One survey from Mercer showed a close connection between employer support and the health and resilience of employees. From it: “Employees who say they received good support from their employers are much less likely to view their personal experience of the pandemic as mostly or entirely negative compared to those who received little or no support – 25% vs. 49%. And almost half (45%) of those receiving good support say they are less likely to leave their job as a result.”

Also, “The ability to customize a package of benefits to meet individual needs is highly or extremely valued by 55% of employees.”

We believe a strong testing program is an important part of that package.

The tight labor market only makes this issue more acute for employers. You can’t just keep up with the Joneses these days. You have to go one better. Think of this when you consider whether or not to charge employees for COVID testing. You may think cost sharing with your employees is a fair request. It’s just a few bucks! But then your competitor fully funds it. Advantage: competitor, in the eyes of that employee. 

Then there is the community responsibility we all have. Hospitals are overcrowded with COVID patients. My colleagues and I see this every day in a variety of clinical settings, including the ICUs. Don’t we all have a responsibility to do our part to help? 

I say we do – with or without a mandate. 

Beyond COVID

We also think this is about more than COVID. 

We think employers have acquired the “DNA” to take what they’ve learned during the pandemic and identify, detect, treat, or even potentially prevent costly workforce health issues much earlier with inexpensive and reliable screening solutions for all sorts of infections and diseases, post-COVID. Think flu, strep and other illnesses that can infect a workplace and disrupt your business. 

There is an incentive for businesses and organizations to be proactive, and those that have been have the advantage of familiarity and experience in dealing with healthcare more proactively across their organizations.

We see a new point-of-care model being established – one outside the clinical environment and instead in the workplace, where employers can serve millions of their employees with more proactive healthcare benefits, leading to healthier lives, improved efficiency and lower healthcare costs. This is enabled by access to inexpensive screening solutions and aided by technology, giving employers access to data more quickly for improved response to healthcare issues, with real-time insights. 

This “distributed healthcare” at the organizational level is the future.

We will move beyond COVID at some point, as this virus becomes endemic. It’s time to start preparing for this now. Don’t wait for the next Supreme Court ruling.