Companies today are faced with the staggering task of developing return-to-office plans while navigating the ever-changing threat of COVID-19. What are the right return-to-office policies regarding vaccination requirements and in-person work exemptions that will best ensure the safety of the community at large? To help understand these evolving guidelines, on this episode of “On Aon,” host Andrea O'Leary, Aon’s Senior Director of Culture and Change, welcomes Aon’s Chief Medical Officer, Dr. Neal Mills. They discuss the challenges and possibilities that are still facing all of us as businesses respond to the latest developments in the COVID-19 pandemic.
Companies today are faced with the staggering task of developing return-to-office plans while navigating the ever-changing threat of COVID-19. What are the right return-to-office policies regarding vaccination requirements and in-person work exemptions that will best ensure the safety of the community at large? To help understand these evolving guidelines, on this episode of “On Aon,” host Andrea O'Leary, Aon’s Senior Director of Culture and Change, welcomes Aon’s Chief Medical Officer, Dr. Neal Mills. They discuss the challenges and possibilities that are still facing all of us as businesses respond to the latest developments in the COVID-19 pandemic.
Additional Resources:
COVID-19 Pulse Survey: U.S. Vaccination Trends
COVID Isn’t Gone: What Employers Need to Know About the Delta Variant
Aon Webinar: Tactical and Logistical Planning for COVID-19 Vaccinations
Looking for more from Dr. Mills? He shared insights on The One Brief about Delta and other COVID-19 variants. Dr. Mills and many other Aon clinicians have also played integral roles in the global Work, Travel and Convene coalitions.
See Dr. Mill’s recent media coverage in Fortune, The New York Times, Wall Street Journal, The Business Journals, CNBC Make It and CBS News.
Tweetables:
“This pandemic situation is so dynamic. There is so much information changing and it’s all happening in real time.” — Dr. Neal Mills
“We need to be more vigilant right now than we have ever been.” — Dr. Neal Mills
“The work and innovation that is going to come out of this collaboration is going to be staggering.” — Dr. Neal Mills
Voiceover:
Welcome to “On Aon,” a podcast featuring conversations between colleagues on, well, Aon. This week, we hear from Dr. Neal Mills about how businesses are responding to the latest developments in the COVID-19 pandemic. And now, this week’s host, Andrea O'Leary.
Andrea O'Leary:
Welcome everyone to the next series in the On Aon Podcast. My name is Andrea O'Leary, and I've been a colleague at Aon for eight and a half years. And currently I sit as a senior director in our Culture & Change group leading our large scale global cultural initiatives, so our large scale global transformation work that we've been doing here at Aon for nearly 10 years. With me today is Dr. Neal Mills, a medical doctor with two decades of practical experience, and more than 10 years in the insurance and healthcare consulting industry. Neal joined Aon four years ago and currently serves as Aon's chief medical officer. And we are so thrilled to have him here today to offer his insights on this topic that is weighing so heavily on all of our minds, COVID-19 and its variants. Thank you so much, Neal, for being here today.
Dr. Neal Mills:
You bet. Thanks for having me.
Andrea O'Leary:
Of course, of course. Before we get started, I'd like to ask you a quick warm-up question to get your feet wet into the podcast world. What is it about your profession that most inspires you?
Dr. Neal Mills:
I'm one of the few privileged physicians that because of the organization I work for, Aon, that I get to spend all of my time at the intersection of business and health. And seeing that innovation come and being able to see it over the horizon and what's coming for employers and help them anticipate how they can go about improving health outcomes as a result has been deeply rewarding. Loved it.
Andrea O'Leary:
Awesome. Well, I'm looking forward to hearing more from you today. I'm hoping to learn a little bit more myself as a result of our conversation, so let's get right into it. So the first question I've got for you is around returning to work. It is such a hot topic these days. What should companies be thinking about when it comes to returning to work?
Dr. Neal Mills:
Oh man, it seems like everything's back on the table for employers. There's been clients that we started this journey six weeks ago and because of so much new guidance from the CDC, the FDA, and OSHA, that halfway through, we needed to revisit the original decision points to make sure that we were still on track and that they were not only following the best practice guidelines, but that in some ways we were enhancing both the safety and surveillance of what we were going to do for the employees. And so that was, and still is, a staggering task because of just how dynamic information is.
Andrea O'Leary:
Yeah. I'm going to ask a couple of follow-up questions because you mentioned the FDA and I recently heard this week around the FDA approval of the Pfizer vaccine. So a two-part question, I guess. First, I'd love to know what is it with the FDA approval that really, I guess, is something that organizations or companies are thinking about as they're factoring in this return to work. So that's one. And then two, what about the two other vaccines in the US, the Moderna and the Johnson & Johnson, where are they at on the FDA approval spectrum?
Dr. Neal Mills:
Right. Well, according to some of our pulse surveys that we did back in the spring, it was really a small percentage of employers that were looking at making this mandatory. But since that time, not only has there, you're correct, been an FDA approval for those 16 and older for the Pfizer vaccine, we also have a great deal more data since 5 billion shots have been administered across the globe. So we have a much better understanding, not only of the safetiness, but the effectiveness of the vaccine.
Dr. Neal Mills:
And because of this FDA approval, many of those employers have revisited recently or currently visiting their decisions that they earlier made around the mandate. And Aon is expecting many more employers to step up and say, "We're now going to make this mandatory because we want a safe workplace." The vaccines are indeed effective around dramatically reducing the hospitalization rate. It reduces hospitalizations by at least 90%. And so not only are employers on the hook for those medical expenses, but at the end of the day, if they're going to engender the confidence of their employees that it is indeed safe to show up for work, this is one of the ways that they're going to have to go about doing it.
Dr. Neal Mills:
For the second part of your question. I can't believe I remembered the second part, but I do. You asked about the Johnson & Johnson and the Moderna. Moderna is thought to be approved perhaps before the end of the year, and the Johnson & Johnson data is also being submitted and reviewed and is anticipated there may even be a booster shot for the Moderna and Johnson & Johnson in the near future, and so also FDA approvals there. So I think that's just a matter of time.
Andrea O'Leary:
Okay. Yeah, I think that's great. And I think the point you brought up about healthcare costs and those hospital bills, especially by the reduction of those who are vaccinated being 90% less likely to end up in a hospital if they were to get COVID-19 is notable. It's extremely a high probability or a high helpfulness in terms of keeping people safe and obviously the safety of employees, but their wellbeing as well. So I think it's extremely important as we think about things such as return to work.
Dr. Neal Mills:
Yeah. And so tying that back to the original question around employers and mandates, I mean the FDA approval was the final step and the additional employers that are now stepping forward and saying, "We have all the evidence we need, we're confident in the FDA's decision and we're not going to mandate this for our employees."
Andrea O'Leary:
Yeah, yeah. Well, it'll be very interesting to see how it unfolds. Keeping on the topic of return to work, I'd love to hear just a little bit more from your perspective on how companies are enforcing some of these return-to-work policies.
Dr. Neal Mills:
Well, again, there's an entire cascading decision tree here around that return to work. Part of it is the vaccinations. And so employers will ask, "What is the array of options available to us around mandating vaccines?" So as soon as you talk about mandates, the first thing that comes up is, what is the exception process for those that have religious exemptions or conscientious exemptions? And who are the vendors that can support us down that pathway? And so there would be that component.
Dr. Neal Mills:
The next would be, who are the vendors that can help us verify? And under that cascading decision set it's, are we going on the honor system? Is it attestations? Is it for certain segments of our employees? Meaning maybe it's frontline staff, maybe it's office staff. And then, how are we going to go about verifying it? Do we want an electronic query done of the state departments of health? Which by the way that technology does exist and ready to go right now. Or do we want to see the physical white cards? Show me your card, show me that you really got vaccinated.
Dr. Neal Mills:
And then if you're going to do that, that somehow over time, your definition of fully vaccinated change since we know about those booster shots and the third doses. And so employers are also looking at the vendors that can help them run parallel solutions to what they're currently rolling out to make sure they stay on top of the guidelines. All of that, in addition, we have people raising their hand and saying, "I want an accommodation, I'm at elevated risk of COVID-19. Even though I'm fully vaccinated, I'm still at elevated risk." Think of those that are obese, that have diabetes, that may have cancer, or a whole host of other cardiovascular diseases. And they will expect to be treated fairly and equitably. And therefore you may need a vendor, or you may need in-house procedures that help you stay in compliance with the law when you honor these decisions that need to be made.
Dr. Neal Mills:
And so we do expect an expansion of the employees requesting accommodations to be able to work from home. So if you think about everything that's on the employer plate, all still has to be done in the context of them running their business. And so this needs to also be done well, and it's going to require significant resources.
Andrea O'Leary:
Well, and I think you bring up an important part about just this idea of complexity, because a lot of what you were talking about is the employee safety, which are obviously very important. You've got in many instances, clients' safety, or when people are doing visits with clients. And then a lot of the nonprofits I work for or work with are really thinking about the communities they serve and the safety there. And a lot of those communities tend to be individuals who either don't have easy access to vaccines or have higher rates of infection or death as a result of getting COVID-19.
Andrea O'Leary:
And so there's a lot of complexities even across all industries or different areas of organizations and companies really trying to think about, what are the things that make sense when we're thinking about return to work? What's the right policies we should be putting in place to really ensure the safety of really the totality of the community that exists around these organizations?
Dr. Neal Mills:
Well, and that triggers something else that I hope our colleagues will consider. And a year ago, we were really struggling with testing capacity in the US, both PCR and reliable antigen tests. And we've had employers come forward and very appreciative of us helping them do their due diligence around checking their vendors to make sure that they could indeed detect the Delta variant, number one, but also revisiting their strategies around the surveillance for COVID-19.
Dr. Neal Mills:
And so in some scenarios, there are employers looking at decisions that they made just a few minutes ago that now need to be revised around surveillance testing, in your fully vaccinated, as well as your unvaccinated or partially vaccinated. And some employers are moving forward with going ahead and testing their fully vaccinated workforce as well. And so there's a whole cascade around that. Who's the vendor that can do this? Do we do it onsite, near site, at home? Does it need to be proctored by a clinician? Can it be proctored by a health tech?
Dr. Neal Mills:
So a great deal of work has to be done there. And of course, all of this is costing employers anywhere from hundreds of thousands to millions of dollars to roll these out. And then that triggers the question, what is the best decision or their opportunity cost here? How could that money be spent better if you're keeping your employees at work? So some really tough decisions for employers as we go into the fall.
Andrea O'Leary:
Yeah, yeah. Well, and the interesting thing about a lot of what you said too, is that it's ever changing. And so it's like we're using the information we know right now, and then next week we're going to learn some new information. And so sometimes it feels like you're like the hamster on the wheel, just running chasing something. But it's so complex, which leads me to my next question, which is, this COVID-19 story is evolving so quickly. What we think we know one week, the next week we know something entirely different. So what are the important details to know right now? Which for our listeners, just so you're aware, we're recording this on August 24th. But what are the important things for people to know right now about COVID-19?
Dr. Neal Mills:
I think the biggest complexity that employers are trying to grapple with, and unfortunately many employers have said, "We're going to have to delay our return to work because this is so complex that we're not ready." And so now they're looking at either October or January of 2022, and that's because the situation is so dynamic. So I think that would be the key word. There is so much information changing and it's all happening in real time. All with the backdrop of surging infections. The last average I saw was 137,000 new infections detected daily on average right here in the US.
Dr. Neal Mills:
That dynamic situation is making them revisit all of their decisions around what they had hoped to do and what now they're realizing that realistically they can do. Also, I mean, this has triggered a great deal of hesitancy around people that maybe were originally willing to come back when COVID-19 infections were low, but now employers are wanting to hear additional communications around what the employers are committing to when it comes to establishing a safe workplace in light of all the changing guidelines and this Delta variant that we keep hearing about.
Dr. Neal Mills:
When you're walking out of the door of your home, check yourself, are you with your mask? Is this a meeting that you necessarily... maybe it's a social opportunity. Are you maximizing all of your opportunities to reduce your risk of being exposed to the virus? I think the ideal is, is that we still, even though we have this pandemic fatigue and we're tired of staying on top of the regulations and the mandates around mask wearing and vaccines, we need to be more vigilant right now than we've ever been because the CDC modeling suggests that the COVID-19 infections are still climbing and we may be heading towards 200,000 infections a day.
Dr. Neal Mills:
And I think we are seeing some well-known individuals raise their hand and say, "Even though I'm fully vaccinated, it was about six months ago. And now I'm having to go in the hospital to help manage this because I can't do this on my own and I need medical treatment." And so the vigilance has to stay up, even though it's painful to do that. And so we have to be present in our lives and make sure that we're not taking unnecessary risks.
Andrea O'Leary:
Yeah. You mentioned something with people, for example, who've been vaccinated, but six months have passed, they've maybe got COVID-19 but they're finding themselves at times still in the hospital, because it's been tough to manage. Boosters are a thing now. And we've been hearing about now between the end of the year, people are going to have the opportunity to get boosters on various vaccines. Can you just speak a little bit more about which vaccines boosters might be available? Is there yet been recommendations of a timeframe after your original vaccination that you should be considering getting booster shots?
Dr. Neal Mills:
My goodness. Okay, this is almost like a word salad, because there's going to be so many words that I'm going to throw everybody. So my apologies in advance. And all of this is subject to change, obviously. So I'll put a little asterisk at the beginning and the end as well. But the FDA did indeed offer approval for the Pfizer vaccine for those that are ages 16 and older. And in the last week, we've also seen new FDA and CDC guidance that most adult Americans should be getting a booster shot. And that program goes live September 20th of 2021. And essentially the indication is eight months after you'd been fully vaccinated with the Pfizer vaccine, then you should get a booster shot.
Dr. Neal Mills:
There was also clarification for those of us that are immunocompromised, and I might add there's millions of us that are. That 28 days after your second dose of the Pfizer or Moderna shot, and so think about all of us that were vaccinated back in February, we now need a third dose. And the reason that's indicated is for those of us that are immunocompromised and fully vaccinated, we're seeing higher viral loads and symptoms that lasts longer with the infection. And the hope is that those third doses will get your immunity to match those that are naturally healthy. So a lot of words out there. Sorry about that.
Andrea O'Leary:
No, it's great to know. And like you said, it's what we know right now and it may change in a week as we get more information or more knowledge. But I'm hopeful we're moving in the right direction for being more informed as a country, but also as across the globe as well. All right. So our next question, which is one that I know a lot of people are going to be glad that I've asked, understanding that none of us were fortune tellers, although I'm sure many of us wish we were, when do you feel the pandemic will actually end?
Dr. Neal Mills:
That's a huge topic of lots of debates amongst physicians and clinicians throughout our communities. I think it is realistic to hope that we can better curb COVID-19 infections and how that's driving hospitalizations. Once we have more of us that are immune either through infections or vaccinations. Now the vaccination route is much more appealing, it's way less costly to society. But the combination of those that have prior infections, plus the vaccinations, or maybe even a combination of the two, I think that we will have better immunity and that can reduce hospitalizations. And I think it's realistic to hope for that.
Dr. Neal Mills:
COVID-19 is going to be around probably for years to come. The expectation is it may become more endemic and something like flu, where we do see these waves and the waves are more severe with more hospitalizations and geographies where there's fewer vaccinations. But it's still reasonable to hope that if we could just hover around 1 million vaccines a day, we could better curb how that virus is impacting our society right now.
Andrea O'Leary:
Yeah. I think that you said the 1 million vaccinations a day, I think that's a great goal that we should be striving for because from, I think, many of us, when we started in the pandemic, we thought, "Oh, it's only going to be a couple months." And now we're looking at two years before we know it. And to your point, I think the more that people can take the step to get vaccinated and reduce the opportunity for some of these variants to be as strong and as impactful as they've been, I think it will yield to the pandemic ending sooner rather than later in whatever timeframe that is.
Dr. Neal Mills:
Well, and the more time we have, better treatments will emerge. And we've seen a little bit about that from the FDA just over the last few weeks. But another component is we may even come up with better booster shots that have perhaps messenger RNA that is specifically geared towards the Delta variant. And so with more time, and by basically with more vaccinations, we may be able to slow down how fast that virus is mutating and even have better booster shots, specifically designed towards the variants we're coping with right now.
Andrea O'Leary:
Yeah, yeah. Well, that's great. Well, Neal, thank you so much for the time today. Before we sign off, I'd like to ask you one more question just to get to know you a little bit better. What will be the next big thing that you focus on at Aon in the work that you do?
Dr. Neal Mills:
Well, I'm super pumped about this. I'm exhilarated that you've asked. One of the things that I recognized when we first started tackling COVID-19 back in March of last year, so that would have been 2020, was I finally became aware of the fact that there were clinicians doing similar work to what we're doing here in the US. And I actually thought that we had the most clinicians in the US since the healthcare economy here is one of the biggest in the world with three and a half trillion dollars. And what I recognized is there are 70 clinicians in Brazil, and across the globe, there are more than 100 clinicians employed by Aon.
Dr. Neal Mills:
So we started meeting once a month as clinicians supported by Su Desai and Kyla Wiles here as project managers and running everything smoothly. And there has been this explosion of ideas and project sharing, and sometimes even recognize that we're taking care of the same clients that are multinational. And the work and innovation that's going to come out of these clinicians collaborating for the first time at Aon at this scale is going to be staggering. So it's going to be fun.
Andrea O'Leary:
Well, I think that's fantastic for someone who loves the idea of diverse minds and diverse perspectives coming together, I know that there's going to be some really innovative new age ideas that come out of that group. So kudos to you for being able to come together with those great minds to think about really how to change the game in the healthcare world.
Voiceover:
This has been a conversation “On Aon” and how businesses are navigating the ever-changing threat of COVID-19. Thank you for listening. If you enjoyed this week’s episode, tune in in two weeks for a special edition of "On Aon" on the Ryder Cup, featuring Bones Mackay and Paul McGinley. To learn more about Aon, its colleagues, solutions and news, check out our show notes, and visit our website at Aon dot com.
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