Question Index
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- A1: What is general medical guidance for plant managers for protecting employees against COVID-19 (car manufacturers, slaughterhouses, etc.)?
- B1: For healthcare workers, should RTW recommendations after COVID-19 diagnosis include other objective risk assessment options i.e. antibody titers (>1:50), exposure history, job tasks, chronic conditions etc., in addition to CDC’s recommended RTW criteria?
- UPDATE: Version 2.0, May 2, 2020 (updates highlighted)
- C1: What is recommended in terms of Personal Protective Equipment (PPE) in construction industries, specifically in regards to OSHA silicosis standards and COVID-19?
- D1: Does extreme heat and humidity impact the SARS-CoV-2 viral transmission?
- E1: How can an employer differentiate between heat-related illness and COVID-19 in high risk vulnerable worker populations?
- F1: When school buses start running again, what changes would you recommend to protect drivers and to make parents comfortable with putting their children on the bus? Partitions for drivers, increased space behind the driver, fewer students in bus, etc.?
- G1: Multiple companies (construction, volunteer firefighters, etc.) want to have their employees tested for SARS-CoV-2 antibodies, though none can articulate a reason or plan for what to do with that information. What do you think about antibody testing in the workplace?
- H1: What are return to work recommendations for individuals with high risk factors or comorbidities during SARS-CoV-2 pandemic?
- J1: What are the occupational medicine guidelines for conducting Audiometric Evaluations in light of the COVID-19 pandemic?
- I1: What measures can employers and employees in meat processing plants take to reduce the risk of transmission of SARS-CoV-2?
- K1: The occupational health department at an Academic Medical Center is being asked to do contact tracing for employees who become COVID-19 positive. We have 40,000 employees. We’ve never done this, and it will take away from things we are supposed to be doing. Has anyone else faced this issue?
- L1: HCW meets CDC symptom strategy guides but continues to test positive. What are the safe guidelines for RTW?
- M1: A colleague in manufacturing has done 100,000 temp screenings and found 1 positive. Is there value in temperature screening for facility entry? How are industry / manufacturing companies utilizing temperature screening? What is the scientific evidence supporting the benefit of the practice?
- N1: What are the occupational medicine guidelines for conducting PFTs in light of the COVID-19 pandemic?
- O1: What are the occupational medicine guidelines for conducting BATs in light of the COVID-19 pandemic?
- UPDATE: Table updated June 16, 2020
- P1: Is it possible to provide an evidence-based diagnostic framework for the diagnosis of COVID-19 as a work-related illness? Some states (such as CA) have implemented presumption laws for COVID illnesses. It would be beneficial to have a reference which looks at PCR and antibody testing as methods to validate COVID diagnosis in someone who was symptomatic but unable to verify with PCR.
- UPDATE: Version 2.0, May 27, 2020 (updates highlighted)
- P2: Based on the updated guidelines from OSHA, how does OSHA view the employer’s responsibility to record and investigate cases related to COVID-19?
- Q1: When contact tracing in the workplace, CDC recommends identifying close contacts, but their definition of close contact is a little vague. If both the infected person and the contact were wearing surgical type face masks, does that count as a close contact?When contact tracing in the workplace, CDC recommends identifying close contacts, but their definition of close contact is a little vague. If both the infected person and the contact were wearing surgical type face masks, does that count as a close contact?
- R1: Could you provide guidance on the use of plexiglass barriers for workplaces for “sneeze guard” droplet protection, specifically for a County clerk who works with the public. Is there any research on this? What is best practice? How large should the barriers be if used, what material, where should they be located? Should they hang from the ceiling or freestanding on their desks ? How far from the employee should they be located?
- S1: What are the occupational medicine guidelines for treadmill exercise testing in light of the COVID-19 pandemic?
- T1: What alternatives to face coverings or masks (e.g., face shields) are being considered or used for non-healthcare workers returning to work sites, who cannot tolerate wearing facial coverings? CDC guidance only states that facial coverings should NOT be worn by children under 2 yo and anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance. UPDATED: Version 2.0, August 2, 2020 / Version 3.0, November 9, 2020
- U1: How should employers who learn about a diagnosis of COVID-19 in an employee handle that information in order to avoid EEO liability under ADA? Current EEOC guidance advises the employer to maintain a "confidential record" separate from other HR files. Does this imply that employers who engage in contact tracing must establish an employee health service, staffed by credentialed medical providers?
- V1: Are medical experts finding any correlation between continued high blood pressure after recovery from COVID-19 if there is no prior medical history of hypertension?
- W1: What do you recommend in terms of office-based testing for SARS-CoV-2 in the occupational medicine ambulatory practice setting?
- X1: Behavioral health issues are noted in employees suffering from COVID-19 symptoms. Do you have recommendations for employers on how to bring these employees safely back to work?
- Y1: Runny nose and congestion have been recently added to the COVID-19 symptom list. What are the recommendations for evaluating employees with this symptom, which could also be allergy-related?
- Z1: As the employee recovers from the COVID-19 disease, some are noted to have persistent viral shedding. For contact tracing purposes, is the presence of antibody against SARS-CoV-2, a valid marker for non-replicating virus? Do antibodies against SARS-CoV-2 decline overtime with the possibility of reinfection?
- A2: We've seen massive outbreaks at certain workplaces. Are you aware of common mistakes made by the employers that led to those outbreaks? Are those investigation reports (CDC, CDPH, OSHA) usually available to the public?
- B2: A subset of employees recovering from COVID-19 continue to experience lingering mild to moderate symptoms including malaise, dizziness, loss of taste and smell, etc. As the duration of symptom resolution is unknown, what is your recommendation to the employer on how to deal with these cases?
- C2: What guidance can you provide regarding how to keep employees safe who have to visit other locations as part of their job responsibilities? (Aside from screening/attestations, testing, quarantine etc).
- D2: How should the annual seasonal influenza campaign be addressed in times of COVID-19 in healthcare and other settings?
- E2: For the COVID-19 vaccine, please comment on antibody‐dependent enhancement and other potential adverse effects of COVID-19 vaccines.
- F2: What are your thoughts about testing following high risk travel? Should testing be done within 72h of travel or should that employee wait 5 days after his/her travel?
- G2: Can you comment on the COVID PCR monitoring program at Amazon or other similar large companies? Should workers be tested randomly or is there an epidemiologic formula to ensure the proper sample size and frequency of testing?
- H2: CDC has stated the identification of a close contact should not consider whether the individuals are wearing masks. Is there evidence of transmission of COVID at the workplace when both COVID case and the co-worker are wearing protective masks ? or conversely of protection by masks at the workplace? This would not include the healthcare setting of caring for COVID patients.
- I2: There are articles regarding SARS-CoV-2 reinfection as the immunity against the virus does not last forever. Will the immunity last longer for vaccinated individuals in comparison to those who have recovered from disease and noted to have immunity?
- J2: What are key considerations in preparing a COVID-19 vaccine policy for a multinational non-healthcare, non-critical infrastructure employer?
- K2: What are the best tactics to incentivize employees to get the COVID-19 vaccine? Can an employer require employees who work in certain high-risk areas to get the COVID-19 vaccine?
- L2: Regarding COVID-19 long haulers who have symptoms consistent with severe chronic fatigue syndrome that prevents them from participating in ADLs returning to regular work. Is there an appropriate/ extrapolated way to create an impairment rating for such individuals?
- M2: We have a routine periodic COVID testing program for our health care employees and providers. Those who have been vaccinated will continue to test. What about those with PCR proven COVID who have returned to work? Due to the number of false positives, I was asked to put in a policy: We will not test those back with COVID and RTW for the first 90 days after they return.
- N2: Have surveillance testing guidelines (spirometry, audiometry) been updated in response to new COVID variants with increased transmissibility?
- O2: If an actual COVID-19 infection occurs after dose #1 of COVID vaccine but prior to dose #2, how does that impact the timing of dose #2? 10-day interval post 'recovery' as indicated by CDC, extending optionally out to 90 days? Should more time be given to allow for immune recovery and response ala the 28 days recommended as the minimum interval between dosing?
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Disclaimer: The Forum does not necessarily represent an official ACOEM position. The Forum is intended for health professionals and is not intended to provide medical or legal advice, including illness prevention, diagnosis or treatment, or regulatory compliance. Such advice should be obtained directly from a physician and/or attorney. Questions are answered with the best available data or recommendations at the time.