As states re-open, keeping the workplace safe from Covid-19 infections will be challenging. Despite all the preparations, companies should be prepared to encounter Covid-19 cases in the workplace.
Experience from other countries who have reopened sheds light on this area. In general, organizations are drawing on their own experience with coronavirus infections to formulate their strategies. Early in the Covid-19 crisis, South Korean officials evacuated an entire office building and subjected all infected individuals to quarantine after detecting a major outbreak. Later, these same officials used this incident to create subsequent battleplans in their reopening strategy.
In addition to general reopening considerations, overwhelming consideration should be given to avoiding a “superspreader” from contaminating the workplace. If past statistics are accurate, 80% of the infections are caused by these superspreaders who comprise 20% of the infected individuals. Sometimes these infections are spread at so-called “superspreader events” where one or more superspreaders can foster a major outbreak at a particular locale. Examples of superspreaders have been established all over the world and include the choir in Washington state where 53 of 61 individuals became infected, the congregants in the South Korean church, the marchers in the Spanish Women’s parade, and the revelers at Mardi Gras.
In general, superspreading is related to variations in individual transmissibility and also individual susceptibility or exposure. Multiple theories abound as to why certain individuals are more infectious than others. Possibly, individuals may have a higher viral load of the coronavirus in their pharynx and possibly be prone to more droplet expectoration. Excess aerosolization may be another reason as some people have been shown to exhibit more droplets when speaking than others. Importantly, an absence of mask wearing will also contribute to more droplets in the air with simple talking and breathing.
The nature of the events may be equally contributory to the zealous droplet spread in that singing in choir practice may force more particle expulsion toward the vicinity of others. With group singing, the individuals in a choir have their mouths open constantly themselves and prove to be easily vulnerable to the infection. In festivals and parades, the constant close mingling and greeting without any interval hand washing opportunities also becomes easily conducive to high disease spread. Additionally, multiday events such as Mardi Gras can be even more disastrous as infected individuals can then infect others in different crowds on subsequent days.
The way to minimize the potential effect of superspreaders in the workplace is to understand why they occur and prevent the “spreader” from becoming a “superspreader”. The keys are identifying individuals before they can spread the infection and minimizing the likelihood that their contagiousness will infect any other individuals. The best identification of any infected individual is a thorough symptom monitor with questions targeted at as many common Covid-19 symptoms as possible. This questionnaire should be frequently administered to capture new development of Covid-19 symptoms. Some questions regarding potentially afflicted domestic contacts should also be included. Positive answers to these questions should provoke rapid quarantine for possibly infected individuals and potentially exposed coworkers.
Aggressive testing of these individuals with focused contact tracing for other possibly contaminated individuals is also warranted to decrease likelihood of superspreading infections. Strategic spacing with mandatory mask wearing and minimal interactions with other co-workers will also minimize the likelihood of the development of superspreaders. Meetings could be conducted with individuals sitting side-by-side instead of face-to-face (think European sidewalk cafes). Other interventions include monitoring the direction of airflow, keeping windows open and decreasing time indoors if allowable.
Companies will likely see Covid-19 infections in their workplace eventually. The disease is too common and vaccinations will not be widely available for 6-12 months. However, with proper planning, each infection does not need to become a superspreader event.