FDA and CDC: Vaccinated Adults Will Not Need COVID-19 Booster Shots
The FDA and the CDC issued a joint statement on COVID-19 vaccine boosters, stating that people who are fully vaccinated are protected from severe disease and death, including from the variants currently circulating the country, such as the Delta variant.
At this time, virtually all COVID-19 hospitalizations and deaths are among those who are unvaccinated, and unvaccinated individuals remain at risk.
Both the FDA and CDC agree that vaccinated adults do not require a booster shot at this time. The FDA, CDC, and the National Institutes of Health (NIH) are engaged in a science-based, rigorous process to consider whether a booster might be necessary, taking into account laboratory data, clinical trial data, and cohort data – which can include but is not limited to data from specific pharmaceutical companies.
At this time, the science does not demonstrate a need for COVID-19 vaccine boosters, but the FDA and CDC remain prepared for booster doses if more scientific research finds that boosters are necessary.
Tags: FDA, CDC, COVID-19, vaccine, booster
Home Alone: The Mental Health Impact of Working from Home
The COVID-19 pandemic has changed the world forever. Nearly every task imaginable has required safety reconsiderations – grocery shopping, exercising, visiting friends and family, traveling, and of course, working.
Many employers have adjusted to the pandemic by allowing their workforce to work from home (WFH) to mitigate viral transmission and protect employees. However, extensive isolation and other factors, some general and some unique to WFH employees, have created cause for concern surrounding mental health.
Prior to the pandemic, only 6% of the workforce worked from home full time.1 Currently, between 24-42% of the U.S. labor force is working from home full-time.1-3
What Stressors Do Remote Workers Face?
There are a wide range of stressors stemming from this pandemic that impact virtually everyone. In addition to direct fears surrounding the coronavirus, people across the nation must deal with extensive social isolation and disruption to family and support systems – including the loss of loved ones, as well as financial and long-term economic worries, and general uncertainty.
However, specific to WFH populations, employees may face other unique stressors. Many employees with children face additional caretaking responsibilities, with 50% of parents agreeing that it is difficult to work from home without interruption.4 Furthermore, suboptimal workplaces can lead to decreased mental wellbeing,5 and an estimated 78% of WFH workers don’t have a dedicated workspace.6
Most notably, workers face difficulty differentiating their work life from their home life when working from home.
The following trends have been noted among WFH employees:
Tags: work from home, WFH, mental health, remote worker
AMA Updates Impairment Rating Guidelines for the First Time Since 2008
The American Medical Association (AMA) recently approved updates to their Guides to the Evaluation of Permanent Injury, 6th Edition, the first update to these guidelines since 2008, which are effective as of July 1, 2021.
Over 40 states utilize some version of the AMA’s impairment guidelines as the accepted authority to assess and rate permanent loss of function, and physicians use these guides to assess a patient’s impairment and document findings. Impairment rating reports appropriately produced using the AMA guidelines are considered a gold standard for documenting permanent impairment in insurance and legal proceedings.
As these guides are key to rating and establishing impairment across healthcare and in workers’ comp, understanding changes to these guides is important for workers’ comp stakeholders.
However, it is important to note that these updates may not lead to immediate change across the nation. Currently 16 states require use of the 6th edition, 11 states require use of the 5th edition, and seven states require use of the 4th edition, which was published in 1993. While there is clear precedent in using the AMA’s impairment guidelines, this new update may be utilized in a patchwork fashion across the nation, based on regulatory activity conducted on a state-by-state basis.
A majority of the guideline changes focus on mental and behavioral conditions. This 2021 update adopts the Diagnostics and Statistics Manual of Mental Disorders version five (DSM-V), while the previous 2008 guides utilized the DSM-IV-TR, an older version of the DSM.
Because evidence-based medicine and science related to the evaluation of permanent impairment associated with mental and behavioral disorders has advanced significantly since 2008, these new updates have been anticipated since 2019, where a combination of patient lawsuits and advocacy efforts from groups like the American Psychiatric Association and American Psychological Association pushed for change.
A major difference between the DSM-V and DSM-IV-TR includes the removal of a highly criticized assessment known as the Global Assessment of Functioning (GAF).
Many professionals considered the assessment to be flawed and arbitrary, and the DSM-V removed this assessment in 2013, but because the AMA’s guidelines previously focused on the DSM-IVTR, this assessment was still utilized as a necessary component for measuring psychological impairment for several years.
Now that this assessment has been removed, the averaging of final impairment ratings is likely to change on a case-by-case basis, as other, more up-to-date assessments are utilized.
In addition to this change, new psychological tests and batteries for standard neuropsychological assessment will be used for impairment ratings. Furthermore, the DSM-V removed the word “malingering” (the exaggeration or feigning of illness to escape duty or work) altogether, while also addressing the complexities of patient motivation when it comes to recovery.
Tags: American Medical Association, AMA, impairment, mental health
More Recreational Marijuana Legalization, More Positive Workplace Drug Tests
Earlier in 2021, three states – Virginia, New York, and New Mexico – legalized recreational marijuana, and now Connecticut joins them after Governor Ned Lamont signed Senate Bill 1201 into law at the end of June.
The new Connecticut law legalizes recreational marijuana for adults aged 21 and over, effective July 1, 2021, and allows adults to possess up to 1.5 ounces of cannabis on their person, and a maximum of five ounces in their homes or locked in their car trunk or glove box. Retail sales will begin at the end of 2022 at licensed dispensaries. This law will also allow for limited home cultivation of cannabis and will expunge various marijuana crimes from January 2000 through October 2015.
The permissive nature of this law mimics other recreational marijuana bills recently enacted, and the total of states that now allow for legalized recreational marijuana is 19, plus the District of Columbia.
According to the National Council on Compensation Insurance (NCCI), several other states are considering recreational legalization this year, with pending legislation in Pennsylvania, Rhode Island, and Wisconsin. Other states such as Florida, Hawaii, Minnesota, Nebraska, and North Dakota have also considered but did not pass such legislation.
It is not outside the realm of possibility that more states will continue to legalize the recreational use of marijuana, which would have a significant impact across the country, including healthcare and workers’ compensation. At the moment, the question of determining employee impairment in states where marijuana use is permitted is still in the air, with various states mulling legislation to address these concerns.
What is known is that workplace drug testing has seen increases in marijuana use.
Quest Diagnostics, an organization that manages millions of workplace drug tests for employers, issued a new report in June that analyzed over 9 million drug tests from 2020. Marijuana positivity increased 16% across urine analysis from 2019-2020, reaching 3.6% across the general workforce.
Marijuana positivity rates were lower in states with only medical legalization or no form of legalization, while positivity rates were higher in states with legalized recreational use, indicating that employees indeed are taking advantage of recreational laws. In states with legalized recreational use, positivity rates increased 118.2% from 2012-2020.
There is no denying that the use of recreational marijuana continues to grow in popularity, with more employees using it and more states passing laws. While the implications for workers’ comp are still being discussed, the time to have these conversations is drawing more and more near as this movement continues to spread across the nation.
Tags: marijuana, recreational, legalization, Connecticut
Silvia Sacalis to Join Panel Presentation at Florida RIMS Conference
The Florida Risk Management Society (RIMS) is holding their 2021 educational conference from July 27th through July 31st in Naples, and Healthe’s VP of Clinical Services, Silvia Sacalis, BS, PharmD will join the panel presentation Care and Program Considerations for Under-Represented Populations.
This educational session will explore the diversity of today’s workforce, focusing on older workers, millennials, minorities, women, and first responders, presenting key takeaways for each population.
Dr. Sacalis will join Alice Wells, CWCL, AIC Director of TPA Operations at Johns Eastern, and Greg Nichols, P.T. President of SPNet Clinical Solutions.
The session will take place at 3:15 PM on July 29th in Plaza II.
Tags: Florida, RIMS, conference, Silvia Sacalis, Healthesystems