In late 2020, a wave of relief swept the country as the Food and Drug Administration (FDA) granted Emergency Use Authorization for two COVID-19 vaccines. Since then, we have witnessed significant challenges around vaccination rollout, the emergence of virus variants and questions about whether these variants are not just more transmissible but also deadlier. In this context, employers continue to grapple with business uncertainty, operational challenges and, most importantly, how to keep their employees and the communities in which they operate safe. To achieve this, there are three key elements employers can focus on now — testing, vaccination and education — all delivered through an integrated “test-and-vaccinate” strategy.
Transforming the testing paradigm
At the start of the pandemic, COVID-19 testing was erratic at best. Testing supply was inadequate, and when tests were available, results took days. This presented major logistical hurdles for both patients and providers, as well as employers trying to support the safety of their employees and workplaces. A year later, testing capabilities have scaled somewhat successfully, but major gaps persist. Turnaround times for the commonly used polymerase chain reaction (PCR) test results are still slow, point-of-care testing is not widely available and remains expensive, at-home testing is neither universal nor timely in nature, and costs overall are excessive for large-volume, routine testing.¹ But innovations and improvements are emerging quickly.
For example, the US Government recently contracted to obtain rapid, at-home COVID-19 antigen tests, with efficacy similar to the PCR test and use for both asymptomatic and symptomatic people.² Importantly, this test does not require a prescription, and results are delivered to smartphones within 15 minutes.³ Rapid, cost-effective and accurate testing can help optimize detection and treatment by identifying positive coronavirus cases early. Furthermore, availability of accurate rapid tests opens access and can speed the time from onset of symptoms or exposure to diagnosis. For example, if each employee had access to rapid, accurate, affordable testing, employers could implement policies whereby team members reliably test themselves before coming into the workplace or attending large meetings, when they aren’t feeling well, or before and after they travel.
As these and other more reliable rapid tests emerge on the market, they will provide an opportunity to transform the paradigm from “wait and see” to “test and respond.”⁴ More generally, as affordable, convenient and accurate at-home testing options become available to employees more routinely, positive coronavirus cases can be identified early and managed. For employers, this provides an opportunity to cover testing as part of a broader test-and-vaccinate approach that can be leveraged over the near and longer term.
The need for a combined test-and-vaccinate approach is amplified by the challenging rollout of vaccines across the country, resulting in limited near-term access for many and persistent vaccine hesitancy. Vaccines may not be available for the general population until late spring or early summer 2021 due to supply constraints.⁵ In the interim, employers should continue to encourage layered and proven risk mitigation approaches such as social distancing, density limits and enhanced cleaning protocols appropriate to the risk context of their work sites, while awaiting widespread vaccination availability. Some employers are also facilitating access to vaccination for their essential workers through dedicated clinics or other means,⁶ while availability for all employees likely won’t be possible for two to five more months.⁷
Even when vaccinations do become more broadly available, adoption likely will not be universal, despite the fact that the percentage of US adults who are vaccine hesitant has decreased since December 2020 across many demographic groups.⁸ However, there is still a persistent minority of US adults who may choose not to get vaccinated, implying that much work remains in vaccine and vaccination education. This includes sharing insights on the vaccines’ safety profiles and emphasizing that a successful vaccination program must achieve herd immunity to break the cycle of pandemic transmission. Projections indicate that to achieve herd immunity, up to 80% or more of the US population must be vaccinated,⁹ underscoring the fact that all populations, including those within racial, gender, age and other demographic segments likely to be more hesitant,¹⁰ must be maximally engaged.
The fact that not everyone will choose to get vaccinated, combined with staged vaccination rollouts over the next six months due to access and eligibility constraints, further underscores the need for a combined test-and-vaccinate strategy that will persist beyond the next few months. In the near term, employers can offer more comprehensive testing, while facilitating access to vaccination once available. For the longer term, as coronavirus persists in the community, ongoing testing and access to vaccine boosters likely will be needed. Investing in routinized testing protocols as part of broader test-and-vaccinate efforts, particularly with the emergence of viral mutations, will help companies rapidly respond to the evolving phases of the pandemic we are seeing across the country.
Educating, communicating and engaging
Testing and vaccination in isolation aren’t enough; education and engagement are necessary to amplify your efforts and recognize impact. As powerful and trusted voices to your employees and in the community, employers can play an important role in education and engagement on public health measures to combat the COVID-19 pandemic.
These include reiterating the importance of social distancing and masking, providing insights about approved testing options and helping to break down barriers caused by vaccine hesitancy — especially for high-risk and vulnerable employees. Bringing together all this information is both critical and complex. With increased production of currently available vaccines and the expected near-term FDA approval of new vaccines,¹¹ employees will become increasingly hopeful but may remain at risk for misinformation. Employers can help employees manage through the noise by sharing validated and trusted public health information. Doing so will establish a foundation of trust and confidence in public health measures and support any test-and-vaccinate efforts that are implemented.
Activating your response
Employers can immediately activate three pillars to accelerate their impact with their employees and their communities more broadly:
- Educate employees early and often about the value and necessity of broad vaccination to achieve the goal of herd immunity, without losing focus on vulnerable and at-risk personnel
- Create a test-and-vaccinate plan for employees aligned to your specific business context, including both near-term and midterm initiatives, and longer-term standard practices
- Team with other organizations to provide access to a full suite of services for employees, including routine and emerging rapid testing, incentives to get vaccinated and, where possible, facilitated access to vaccination via employer-sponsored clinics or other public vaccination sites