More than 98% of Americans now live in an area with a “low” or “medium” COVID-19 Community Level, the CDC’s new gauge of local virus risks. Masks are coming off. Safety mandates are loosening. Offices are reopening. People are reconnecting. There is relief in the air.

We’re not yet in a “new normal,” but we can begin to see “the next normal.” And what it looks like is functioning with COVID-19—even while protecting employee health and preparing for surges from virus variants. 

We spoke with Dr. Ezekiel Emanuel, who helped shape the White House’s new National COVID-19 Response Plan, Martine Ferland, the CEO of the consulting firm Mercer, and Daryl Brewster, CEO of Chief Executives for Corporate Purpose, at the Health Action Alliance’s March 9 briefing for business leaders. The interviews below were edited for length and clarity. 

‍

DR. EZEKIEL EMANUEL

‍

What is the "next normal," and how will we know when we get there?

Well, in our COVID-19 Roadmap, we put in a dashboard that looks at COVID-19 cases, vaccination rates, hospital occupancy, hospital staff shortages, deaths, and a few other elements that we would like to monitor. We're currently seeing 1,400 to 1,500 deaths a day which is still way too high. Almost all the experts on our panel suggest that we probably need three or four more weeks. We need to see the COVID-19 cases coming down, we need to see the mortality continue to drop, hospital occupancy has to continue to drop.

We’re improving, there's no doubt about it, but “improving” does not mean “improved.” And one of our worries is a premature jumping to easing everything by allowing people to come together and then spreading whatever virus remains incident in the community. We've seen that movie before, so we can't be overconfident. 

‍

In your report, you state really clearly that the failure to control workplace exposure has wreaked havoc on the workforce throughout the pandemic. What are you proposing to better protect workers in the next normal of COVID-19?‍

There are a number of things workplaces can do. Vaccine mandates—I've been a big advocate of this all the way back to [last] April. We know vaccines are very, very important, for reducing the risk of death and hospitalization and maybe even long COVID. 

Second, you can put in improved indoor air quality. We know that the virus is transmitted by aerosols, so put in Merv-13 filters in your HVAC systems. If that's not possible, try having HEPA filters in the workplace that can exchange the air five or so times an hour. These are very important measures that you can put into place.

Masks are another one. We continue to use masks. If you're going to require masks, you make sure that your workers have high-quality masks, like N95’s or KN95’s, and not use cloth or surgical masks.

And then, I think advocating beyond that. Congress should fund resources so that the country can have good surveillance of COVID-19 and other respiratory illnesses so that there is advanced research on therapeutics and vaccines. 

You should also make sure that, if any of your employees are immunocompromised or at higher risk because of age or comorbidities, you have some support for them in case they get infected, that they can get some of these therapeutics that are being woefully underutilized. 

‍

How can businesses support better utilization of these therapeutics?‍

We've got several good therapeutics: Paxlovid from Pfizer, Evushield, and a monoclonal from GSK. And all of them are being underutilized. Evushield can be given to immunocompromised patients, and it lasts for about six months. It's a very important treatment for [immunocompromised] people. If someone gets COVID-19, getting Paxlovid may be very important to protect them. I think the best way is to figure out, through your medical officers or a local health care system, how you can direct patients to them to rapidly get these medications through a physician.

‍

The new White House plan, which I know you're familiar with, includes mention of updated OSHA guidelines to ensure safer workplaces. Do you have a sense of what that guidance might look like and when businesses can expect to see it? ‍

I think it's still evolving, and I am not sure on the timing. One of our fears is that it might take months to come out, which obviously is not helpful for businesses that are having to navigate re-opening now.

‍

Can you talk a little bit more about some of the recommendations that you're proposing to protect workers in the next normal of COVID-19?‍

The workplace—where people spend at least a third of their days—has to be safe. We have woefully ignored indoor air quality. We don't have standards for it, we don't grade buildings on the basis of indoor air quality. Those are the things we've called for and, we think, need to be done so that businesses can check on the quality of the space that they lease and that they can take measures to upgrade that.

In addition, paid sick leave is really important. It's important for part-time workers and for gig workers, too, because you don't want someone introducing a virus. It's not just COVID, you know. Part of the next normal is going to be worrying about flu, worrying about RSV and other respiratory pathogens. Actually giving people sick time, so they don't infect others in the workplace, can improve your productivity and your presenteeism.

I would say two other things, which I've done as an employer in my various roles at the University of Pennsylvania. One is flexibility. Yes, we are now requiring them to come into the office. We think it's been very valuable when people do come in and can share. It's not only valuable for exchanging information and working together, it turns out it's very valuable for social support. People actually get a lot of meaning and social support from their colleagues. Doing that is, I think, one way of countering some of the mental health consequences of [isolation from] COVID-19. 

The second thing, it's not just money that's motivating people. I can tell you, putting together that roadmap, my team worked huge numbers of hours, 80 hours a week for prolonged periods of time. Why did they do that? It’s because they thought they could make a difference. Figure out what people think is meaningful and make it more central in their job description.

‍

Is there anything businesses can do to help reduce the political nature of public health issues and really reinforce trust in science and public health?‍

Well, this is a wider social issue of reduced trust and reduced respect for expertise in these areas. I think emphasizing the facts and emphasizing the importance of expertise—and the fact that you as a business are going to be guided by people who actually have knowledge and expertise in this area.

‍

Two years into this pandemic, what have we learned and what do we hope that we carry forward, in terms of strengthening the relationship, that critical relationship, between business and our public health community?‍

Business is integral to our society to all of our lives and in many, many ways. You know, we needed the pharmaceutical industry to respond to develop therapeutics and vaccines. We needed producers of PPE which we didn't have, and we had to home grow them and stimulate them. We need business to give workers time off and to make healthy and safe work environments, and we need business to advocate with the federal government for the best policies. I would say, going forward, your best efforts should be to ensure that the federal government doesn't forget this. 

We can't move on from this. We have to actually do the things that are in our in our roadmap, so that we are ready and much more prepared for the next pandemic. We lost $7.5 trillion, it's estimated, from this pandemic. We don't want to have that again. If we could even reduce that loss by 50% or 70% by an investment today, the ROI would be enormous.

The business community’s advocacy, your preparation in your own work environment, is going to be critical to being ready for the next threat. And it's not going to be a once-in-a-century event; it's going to be more frequent, unfortunately.

‍

MARTINE FERLAND & DARYL BREWSTER

‍

Mercer previously released guidance on how businesses can successfully operate in this new normal. You focused both on returning to work safely and on achieving success in an environment that has been fundamentally changed by the pandemic. Can you tell us about some of the key recommendations you're encouraging businesses to consider?‍

‍Martine Ferland: Recent surveys tell us that, in the US, most employers are looking to get their workforce back now, or at least in the next three, four or five weeks—so, therefore have these safety protocols in place. Many employers have inquired about ventilation and air quality. Those safety plans also need to be intuitive and adaptable. We need to be flexible as conditions change.

So that's one thing, workplace safety. The second one is mental and emotional health.

We've seen lots of people exiting the labor force. How do we shape the new workplace, how do we adapt? And honestly, everyone's talking about hybrid models. But we've not been in an environment we've really been able to test it out. I'm hopeful that we're now seeing at least a six or seven-month window, as things get better, as we get into warmer months, where we can give it a real go in that flexible environment, really test it out. But for that, we need people to come back and therefore, there's some transition work to be done there. How do we nail it when it comes to hybrid working? People are tired of uncertainty, and “flexible,” if you leave it at that, can be quite unnerving for people. So, clarifying your expectations—is it two days, three days, what is it? Really valuing the individual and the team, having that communication, having it on a one-to-one basis with each and every one of them on what the new deal is and what will make them successful here.

‍

Are there any examples from clients that you work with or companies that you're engaged with that you think are really doing a great job in planning for this next phase of hybrid, flexible work?

‍
Martine Ferland: I’ll flag three other things that I see as best practices that employers are currently focused on. Behavioral health was a big challenge before the pandemic started, but this story has become even worse. So, recommending training for people-managers. How do you support them, how do you train them to be better equipped to get through that? And look at your programs and the benefits you're offering to support mental health. We also talked about long COVID, what kind of policies do you have for leave and disability care for long COVID or [to care] for family members? And finally, before you start disbanding your crisis management team or your pandemic response team, capture the learnings. Learn for the next time, organize yourself, so that we have less impact on people and less impact on the economy of the country.

‍

Daryl, you work with so many businesses that are deeply committed to social impact and thinking about a new normal that builds on what we've learned during the pandemic. What are some of the important, innovative ways that companies are adapting for the future, with a focus on their people? 

‍
Daryl Brewster: I think we've really seen innovation in three areas for businesses. First, around their people. One of the companies I'm on the board of, a public company, had nurses there during COVID, and we've kept them on. They’re checking people every day and they're asking not only questions about physical health like, are you sick today, but also checking on mental health, like, how are you feeling and by the way, how's your family feeling as well? 

I think a second area is diversity. Diversity within our organization, diversity of thought, and recognizing people in different areas. One of our biggest issues on the shortage of workers right now are women who need childcare. Only half of the people in America have access to childcare, so they're not coming back to work, and that's a big issue right now.

I think the third is strategically, really looking at their total business on an integrated basis. We've seen a ramp-up of interest around environmental, social and governance issues. Those are really about managing risk, and this was a known risk. Are you prepared for those risks? 

‍

How do you recommend that employers address concerns from employees that they may have around loosening restrictions too soon, or from employees that worry they may contract COVID-19 at work and bring the virus home to their children or loved ones who might be unvaccinated or immunocompromised. What, specifically, can businesses do to shore up their health and safety and also make sure employees feel safe and supported? 

‍
Martine Ferland: I think it's too early to completely dismiss that there are still concerns and anxiety out there in the population. And, as we've been reminded, of course, people are still vulnerable to severe impact from the virus. So, I think acknowledging those concerns and really being on the listening end for employees and looking at all the programs that you have to support. I talked about communicating clearly the safety protocols and honestly about still being in this grand experiment and not completely out of the pandemic. Recognizing this we've been productive for two years but there's an end to that because I think we're running on fumes now from a cultural point of view, from an innovation point of view, from a social isolation point of view, and there's a benefit to getting back together. And we see it. People are getting back together outside the workplace. So, you know, communicating clearly and then having flexibility around the personal circumstances of someone.

‍

If you were to give one piece of advice for businesses to thrive in the new normal, what would that be?

‍
Martine Ferland: Be people-centric. And being people-centric means you need to listen and be adaptable.

‍
Daryl Brewster: Building on that, I think, addressing not only the physical side, but also the mental health side. Understanding where the needs are and building flexible, but fair accommodations.

‍

‍