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By Dr. Peter J. Plantes

June 30, 2020

Consider the case of Tony, a 47-year-old lab site manager for a nationwide laboratory. He supervises 10 employees at his town’s laboratory site. Employees at his lab are expected to wear face masks at all times in the office setting. If an employee shows symptoms or develops a temperature, then they are expected to self-isolate and get a COVID-19 viral PCR test.

Tony is married to Sarah. They have 2 children: third-grader Stacey and college sophomore Sue. Since the local elementary school has not yet set a reopening date, families in Tony’s town have organized a 2-week long camp in lieu of school activities to start the day after the town’s annual Labor Day celebration. Sarah is planning to visit Sue at her out-of-state college, which has already reopened, after the camp ends. 

During the town’s Labor Day celebration on September 7, few people are wearing masks, and it becomes a super spreader event for COVID-19. When Stacey goes to camp on September 8, no kids are wearing masks, but many of them went to the town celebration. Stacey becomes infected on September 10, but she, like 45% of COVID-19 infected individuals, is asymptomatic. She infects her parents on September 12.

What happens to Tony, his family, his coworkers, and his employer? That depends on whether his employer has hc1 Workforce Advisor. 

Without hc1 Workforce Advisor

During September 11–16, after the COVID-19 incubation period of 4–12 days post infection, 5% of the town’s population is seen in the local emergency room (ER). The next week, 7.5% of the population comes through the ER with symptoms of respiratory distress.

On September 15, Sarah starts feeling mild symptoms, but she doesn’t have a fever (like 35% of COVID-19 cases). She doesn’t want to go to get a test because she hears a lot of people at the ER, hospital, and urgent care centers are sick with severe COVID-19. Besides, she hears from neighbors that they were turned down for tests because they did not have fevers nor significant symptoms. Sarah concludes she only has a cold or allergies and does not want to get exposed to COVID-19. No one else in the family appears sick.

Sarah takes some cold medication and feels better within a few days. She visits her daughter Sue at college as planned for the weekend of September 19–20 while shedding the virus at the highest rate. They’re family, so of course Sarah and Sue do not wear masks or socially distance at the college. 

Like his younger daughter Stacey, Tony remains asymptomatic through his entire 3-week course of infection, so he continues to go to work and never gets a PCR test. He subsequently infects 2 of his 10 employees at a small group meeting on September 16 where he is instructing them on COVID-19 protections in the workplace, such as how to properly put on, take off, and store their surgical face masks. He infects 3 more on September 18 while they all are standing around the blocked-off water cooler with their face masks down, drinking bottled water and sharing stories about the crazy COVID-19 times. By September 25, 3 of the 5 infected employees are experiencing significant symptoms.

Outcomes for Tony’s family, coworkers, and employer:

  • Sue infects 10 classmates. She is seen twice in the ER visits over the next 3 weeks (the second visit lasts 36 hours), but she is never admitted to the hospital. She is still on her father’s medical insurance, which pays for these 2 out-of-state and out-of-network ER visit costs of $4,400 and $12,700. She almost has to drop the semester, but pulls off a low B average despite her illness. Her classmates mention her at every alumni reunion when all the COVID-19 stories are recirculated. Sue was ‘Patient Zero’ on the University campus where 200 eventually became infected.  
  • The 5 employees Tony infects subsequently infect 12 other family members, all on the company’s medical insurance plan (17 total). One is eventually admitted to the intensive care unit. After 7 days on ECMO (extracorporeal membrane oxygenation), the patient dies. The total bill is $347,657. Four others are seen in the ER: 1 is admitted for 3 days costing $30,000, 1 is admitted for 7 days for $45,000, and the other 2 have ER charges totaling $6,656. 
  • In early October, Tony’s town is identified as one of the country’s “hot spots” for COVID-19. County health department contact tracing identifies Tony’s lab site, and testing confirms a 50% prevalence in employees. Everyone in the lab is placed on “home quarantine” for 14 days to assure no further spread. Tony’s employer loses 35% in operating income from that lab site for October. 

Cost: One person’s life and more than $500k in medical bills and lost productivity

With hc1 Workforce Advisor

With the hc1 Command Center in place, 5% of employees are tested on each of the 20 business days per month so that each employee has one PCR viral test per month. No general antibody testing is conducted in compliance with EEOC regulations. 

On September 10, hc1 Workforce Advisor begins to pick up Tony’s town (a sub-county PUMA) as having a rapidly accelerating Local Risk Index (7 vs 7 rating of >2). An alert is broadcast to his employer’s management team on September 13 that 7 of the office’s 100 employees, including Tony, should be accelerated for their periodic PCR test because of the dramatic rise in that PUMA. 

Tony has no symptoms and is still working. However, he is alerted to keep tight distance and mask compliance at work. His PCR test is done on Monday, September 14, and results come back to the Command Center on September 16 as positive for COVID-19.  An immediate alert comes out at noon on September 16 to isolate and home quarantine Tony and to test the 10 employees that work for him.

Before knowing his results, Tony still infects 2 employees at the September 16 COVID-19 safety meeting, but he is sent home to quarantine before he infects anyone else. When Sarah finds out Tony has tested positive, she assumes that she and Stacey must be positive as well, so she cancels her trip to visit Sue at college and keeps Stacey home instead of sending her to camp. 

Outcomes for Tony’s family, coworkers, and employer:

  • Sarah knows she’s at risk, so she doesn’t visit Sue. Sue doesn’t get sick, so she never infects the other 10 classmates and doesn’t rack up expensive ER bills. She is able to earn all As for the semester and eventually graduates summa cum laude. At her 35th alumni reunion, Sue receives the Distinguished Donor Award, having given the university $15 million from her earnings as a tech giant CEO.
  • The 2 employees Tony infects do not subsequently infect any other family members due to rapid advisement to isolate when their exposure to Tony was known. One of the infected employees is seen in the ER. The ER charges add up to $2,656. 
  • No interruption of operations occurs on Tony’s team. The 7 healthy members volunteer extra shifts until their work colleagues return 12 days later, after 2 subsequent negative PCR tests. There are no operational financial losses. 

Cost: Less than $5,000 and nobody dies

Case made! Get open. Stay open. Stay safe. Request a demonstration of  hc1 Workforce Advisor

About the Author

Peter J. Plantes, M.D. has three decades of experience creating service and delivery solutions that enhance marketplace success and clinical performance for clinical practice groups, academic faculty group practices, hospitals, health systems, and health care organizations. His success stems from his ability to blend and synergize clinical knowledge, operational expertise, financial performance, and collaborative methodology with his deep commitment to serve patients and improve the health of the community. Dr. Plantes has served in CEO & Physician Executive roles for a number of large healthcare clinical delivery networks including regional community networks, academic practices, national hospital networks, international health systems (Chile, Colombia),  and corporate managed care/HMO networks.

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