Protecting workforces from seasonal illness in 2020 and 2021: flu in the time of COVID-19

Data from the southern hemisphere shows that incidence rates of flu have significantly fallen in 2020 as a side effect of the restrictions put in place to combat COVID-19.

The risk of catching a cold or the flu is heightened in shared spaces, like offices. As such, we have found that employees are less concerned about seasonal illness when working from home compared to being in the office — 12% versus 32%.

However, we also found that 46% of employers don’t think that their staff take enough sick days.

These findings raise two challenges: How can employers protect their staff against seasonal illnesses both in the office and when working remotely? How can employers ensure that staff don’t work when they are ill, which can reduce their productivity and can prolong the length of their illness?

To help us answer these questions, we spoke to Dr Sneh Khemka, Aetna International’s VP of Population Health & vHealth.

What makes seasonal illness different this year?

“The first problem is that if you get a sniffle during the winter months — which many of us do — people may automatically think it’s COVID-19,” explains Dr Khemka. “So, a key issue is differentiating between what is a common cold; what is a different type of viral infection, for example RSV in children (respiratory syncytial virus); what is influenza; and what is COVID-19.”

While concerns around contracting COVID-19 are understandable, there is a danger that many employees will misdiagnose themselves as having the illness. There are several issues related to this:

• Many people will want to get tested if they believe they have COVID-19, putting increased pressure on health care systems. The more people who think they have COVID-19, the more demand there will be for tests, potentially leading to shortages, and the more other health care services will suffer as resources shift to meet this demand.
• Another possibility is that people who think they have COVID-19 will actually have another condition that goes untreated. Dr Khemka explains: “Many people are fearful of being tested for whatever reason — either denial or not wanting to expose themselves — and they may not seek help for conditions that they should.”
• In the UK, there’s also evidence that people who believe they have had COVID-19 are less likely to use the government’s track-and-trace app. Considering the lack of evidence around COVID-19 immunity and the fact that people may have thought they had the virus before testing rolled out, this could lead to people unknowingly spreading the virus.

Dr Khemka adds: “And so we end up with people who are worried about COVID-19, but don't actually have it, either going out and getting unnecessary tests; or they're going to be scared about going out to get tested, so they stay at home, nurse their illness and try to get through it themselves.”

Either way, this is added pressure on individuals, simply because they don’t know what they’ve got — if anything. For employers, this means a more nervous and less productive workforce, and potentially a workforce hiding medical problems yet to be diagnosed.

Reduced sick leave: a double-edged sword

There is a misconception that fewer sick days is always positive for business. While a healthy workforce is the goal, the reality is that employees often work when they should be off sick. For employers, this means decreased productivity and, when working in an office, increased chance of transmission to other staff. We know that this is a concern for HR managers and we also know that there is more work to be done to build healthier attitudes to sick leave.

In our previous global Polarised Corporate Health Perceptions survey, 72% of employers said that their staff do not take enough sick days. In our most recent research of the same employer-employee perceptions gap, this dropped to just 46%. This change suggests one of two scenarios:

• that there are positive changes happening to improve perceptions of taking sick leave and therefore the utilisation of sick leave
• that the shift to remote working brought about by COVID-19 has made employers either complacent or ignorant of the reality — that staff continue to work when they are sick, but it isn’t as visible.

Whether one or both of these is true, there is still work to be done to address the challenges facing businesses during winter months. Below is a summary of these key issues:

Employees working when ill

“If you have a viral-type illness, cold or seasonal illness when you're working from home, people are much more likely to be present at work because you're in the comfort of your own home: you can be in home clothes, near your sofa, near a cup of tea and you don't have to have a suit on,” explains Dr Khemka. “People will find it much easier to do work tasks such as telephone calls because they don't have to do it in person, so they're more likely to work while they're unwell, rather than say ‘Sorry I'm unwell, I can't work’.”

Employees working longer hours

Working from home means there is a lack of differentiation between the working day, and the non-working day. As a result, staff are working two-three hours longer each day when working from home — making it harder for them to switch off and rest.

Spending time away from work is essential for maintaining health and well-being; the impact of long workdays on your employees can lead to stress and poor mental and physical health outcomes.

Mental health and seasonal illness

Social isolation, financial worries, concerns about weight gain and musculoskeletal (MSK) pain due to home working and the pandemic are negatively impacting people’s mental health as well as their general well-being and productivity.

Dr Khemka explains that there is a well-established and proven relationship between mental health and physical health, citing that a chronic physical condition can vary by 30-40% depending on your mental health status.

Poor mental health is linked to the immune system being weakened which makes us more susceptible to infections, so current stress and anxiety may make staff more prone to seasonal illness, potentially make its impact worse and even further impact your mental health.

Sedentary lifestyles

While some people have lost weight due to remote-working, others have gained weight. Many have gained control of their day and used commute time to exercise, but others have become more sedentary. It may also be the case that those who are suffering from increased stress and anxiety are less motivated to be active.

“People who are overweight or obese, generally speaking, tend to suffer worse with flu or COVID-19, than those with normal bodyweight,” says Dr Khemka. “If you have been putting on weight during lockdown and that puts you into that category, it's going to make it doubly worse for you and you should do what you can to reverse it.”

What can do employers do to support employees?

It is clear that there are many issues at play during the 2020-21 flu season — and staff are not feeling supported, especially those in the office. In fact, only 36% of employees say provision for ‘general wellness’ in the office is good compared to 55% of employers. This gap in perceptions highlights the fact that employers need to step up, either to better communicate the resources available to staff or to improve provision. And they know this: 60% of employers agreed that they could do more to reduce the number of sick days employees take by offering better health and wellbeing support.

Dr Khemka details seven key areas in which employers can really make a difference:

1.    Improve general hygiene practice in the office

All staff, particularly those working in an office where transmission risks are high, should be mandated to follow hygiene best practices. From regularly washing hands for 20 seconds to cleaning surfaces using anti-bacterial cleaning products, there are plenty of ways employees can protect themselves — and others — from flu, colds and indeed, COVID-19.

Read: 10 tips to prevent and manage flu and other seasonal viruses

2.    Provide well-being support services

“Mental health support is essential. A lot has happened about mental health support and initiatives that allow collaboration and extra access to mental health support — whether that's self-help, CBT, counselling or access to psychiatrists.”

3.    Improve access to medical professionals

“Employers can offer people access to general practitioners where their normal doctor may not be able to see people. Many employers offer access to virtual health services — such as our own vHealth — to help employees access primary care, including referrals to specialist services such as mental health support, remotely.”

4.    Increase health insurance benefits

“Increased insurance is another way to ensure that employees, and their families, who wouldn’t normally have access to medical insurance can access it, so they have the financial support to pay for treatment if they need.”

We know there is demand: our 2020 Expat Family Wellness Survey showed that 60% of expats took out new cover or increased their existing cover due to COVID-19.”

5.    Offer free flu vaccinations

Flu vaccinations. “If ever there was a reason to get a flu vaccination, this year is the reason to get it — and the year to get it in. What you don't want is to have influenza and then get COVID-19 on top of it — or have one after the other. This could really affect you and make you quite unwell.

“In the corporate world, flu vaccinations are often organised by the employer through on-site vaccination clinics or similar initiatives. But this is no longer an option for many businesses, which will impact participation rates. However, some innovative companies are trying to solve this, either by supporting employees financially or facilitating home vaccination services where nurses come to vaccinate you in your home.”

Read: Flu fighters: How flu vaccines and workplace hygiene can benefit you and your workers

6.    Educate staff around the symptoms of colds, flu and COVID-19

The symptoms of a cold may include a runny nose, sore throat — and potentially a bit of a dry cough — and maybe itchy eyes.

“The flu is something very different,” says Dr Khemka. “You will run a temperature, lack energy and have general malaise. You may have aches and pain in your joints, back or hips. You're significantly more unwell than if you have a cold.”

When it comes to COVID-19 Dr Khemka describes the symptoms as typically being:

• A high temperature
• Loss of sense of smell and therefore taste
• A progressive, dry or even wet cough
• A sore throat
• Upset stomach
• Shortness of breath.

“If you think you may have COVID-19, it is important that you get tested. And here’s why: One, you need to know what you've got to deal with. Two, for contract tracing which is necessary for public health. So, don't be afraid to go and get tested.”

Employers can play a part in educating staff around these symptoms and the benefits of testing.

Your flu and COVID-19 questions answered by an Aetna Medical Director, including How to tell if I have flu or COVID-19?

7.    Don’t neglect other health issues

“Employers also have a duty of care to ensure their employees remain healthy wherever they work. This includes ensuring they have an appropriate musculoskeletal setup with positioning and ergonomic support work.”

Dr Khemka also advises employees to go to the hospital for serious medical issues. His advice for staff is: “If you think that you are having heart pain or other early signs of something worrying, seek medical attention. Hospitals and clinics have processes in place to protect those with non-COVID-19-related illnesses from coming into contact with COVID-19. Don't seek health care where you feel it's inappropriate, but don't act differently to normal.”

How will COVID-19 change corporate wellness culture?

“While we’re working from home, yes fewer people will take sick days — including those that should but don’t — but that’s only short-term, a blip,” says Dr Khemka. “But there are things that are going to change our psyche and our relationship around health long-term.”

“People will become more aware of health conditions, more educated about COVID-19 and more educated about the need for health and well-being. I think the world will react to COVID-19 by trying to make itself healthier — ready to deal with the next pandemic — and employers will play a really important role in that.”

We have already seen evidence that this is the case. Our Expat Experiences Survey 2020 found that 60% of respondents are eating more healthily during the pandemic, and 43% are exercising more. But employers need to — and are increasingly — taking responsibility for the health and well-being of their employees. It's not just about provision of medical benefits or insurance, it's about providing those things that the employee now expects: access to health care services, wellness services, digital therapeutics, mental health services and chronic disease management.

Dr Khemka concludes: “Now is a time for employers to shine — to show how committed they are to their employees. If ever employees were in an hour of need, it is now.”

Why not contact us to see how Aetna International can support your employees’ physical and mental health now and after the pandemic? Get in touch in your region.

More information

• Visit: COVID-19 resources: Support for health, work and life
• Read: Help your workers avoid flu in the age of COVID-19
• Read: vHealth Director’s top 10 ways to help avoid flu during the COVID-19 pandemic
• Read: Supercharge your immune system to fight flu and COVID-19
• Share: Seasonal flu + COVID-19: Protect yourself, protect others
• Share: COVID-19 + flu: Don’t take a risk with your health

Aetna® is a trademark of Aetna Inc. and is protected throughout the world by trademark registrations and treaties.