Transcription:
Returning to the Office Amidst the COVID-19 Pandemic

It's Your Health Radio, a special podcast series presented by Henry Mayo Newhall Hospital. Here's Melanie Cole.

Melanie: We know that more and more people are returning to in-person work instead of work from home. Today, we're talking about returning to the office amidst the COVID-19 pandemic and what do you need to know.

Welcome to It's Your Health Radio with Henry Mayo Newhall Hospital. I'm Melanie Cole and joining me is Dr. Jordan Michelena. He's a family medicine physician at Henry Mayo Newhall Urgent Care. Dr. Michelena, it's a pleasure to have you join us again today. So I want to jump right into this because I know the anxiety of family members and friends that are doing just this and some of us are heading back to work in person. What can we do right away to help lessen some of that anxiety?

Dr Jordan Michelena: Well, thank you for having me on today. I think the primary thing that we have to focus on is prevention as we have been for the last year and a half, right? And there's three different ways to prevent ourselves from catching COVID. You got your primary, you got your secondary and tertiary ways. And what we can do as workers is focus on the primary aspect of that, which is to wear our masks appropriately, wash our hands, make sure that we are getting vaccinated, social distancing, as we have, try to keep ourselves from others who are sick. Those are things that we as employees or workers or people going back into the office can do ourselves.

But the employers also have to bear some responsibility to inform us of their policies, which would include emphasizing the use of wearing masks, which is kind of more of a secondary prevention. And then move along to pre-work screening, which would be to screen those individuals who are coming to work and make sure that they don't have that potential of being infected and bringing that virus into the workplace.

Melanie: Well, I'm really glad that you brought up employers as well. So can employers, and I guess it depends where you live, require that we wear masks or that we receive the vaccine before returning to work?

Dr Jordan Michelena: The OSHA guidelines is that the employers should emphasize what their policies are in their individual workplace, because some workplaces may be at more risk of getting COVID as other places. For instance, I work at an urgent care, so I'm a bit more risk than somebody who's working from home, who doesn't see other people on a regular basis.

And so I know that it's required for us to get vaccinated, it's required for us to wear masks while we're at the workplace, because we're at an increased risk area. Now, if you're out on a construction site where maybe you're not around another person for five hours out in the open air, more than 10 feet or 6 feet away from each other, maybe that workplace doesn't need that requirement, doesn't need a mask requirement or a vaccine requirement. So it would really be tailored down to the individual work and individual employer and employee, obviously in guidance with their medical officer or medical director or with the physician.

Melanie: Yeah, it's a different level of risk at different jobs for sure. Now, it depends on where you work, obviously, and you work in a place that is going to say, you know, masks and vaccinations, and we want to take care of our employees. How should companies recognize that even the vaccine and masks may not eliminate an employee's anxiety? Can you give employers some words to use, some counseling from an expert in urgent care about that anxiety? What if an employee doesn't want to come back to work in person because they're really anxious and they're afraid of getting sick even if they're vaccinated? Do you have some words that you use for people that can help soothe some of that anxiety or suggestions for that employer to say, "Listen, you know, we're going to separate out the desks. We're going to put panels in. We're going to make sure everyone is met," you know, anything you can tell employers that can help reduce some of the anxiety?

Dr Jordan Michelena: Well, first off, just like you were saying, I would emphasize the fact that, "Hey, we're taking every precaution that we can to make sure that this work environment is safe for you. We're staggering work times. We're putting up barriers to protect each other, putting in new ventilation systems to help circulate the air better and away from everybody. We're having social distancing as well." Those are all important. So emphasize those things. Emphasize the vaccine as well. It's 97% effective in keeping people from severe illness and from spreading COVID. So that would be a good way to start as well, to emphasize that and give people a leave of absence or give them some time off to get the vaccine and to recover from any potential mild side effects that may be happening from like body aches or headaches or fevers that can happen for a few days after the vaccination. And so just emphasize all of the things that you're doing to protect your employees.

Melanie: Yeah, that's a really good point that you just made. Now, we saw, luckily, during the pandemic COVID as many doctors I've interviewed, Dr. Michelena, have said that we saw a reduction in colds and even in the flu because people were quarantining and they were isolating and they were masking and all of these things. Now, you go back to work and even if we are doing some of those things, colds are to be caught and it's flu season. And so what do you want people to know about this perfect storm that could happen with all of these things converging at the same time and what we can do to sort of recognize, well, this is a cold, but COVID is this. And so can you give us a little way to sort of sort that out and maybe some recommendations on the importance of the flu vaccine right now?

Dr Jordan Michelena: Exactly. The flu vaccine is probably more important now than it was last year, because we've all been away from each other for a year now. And in the urgent care, I've been seeing this with children, is that they'll come into the urgent care, we'll test them for COVID, they will be negative. And so they're coming in the appropriate time with symptoms that are similar, and it's a cold, you know? And so they've been away from each other for a year. They've all been able to get new viruses that they haven't had before. And so then they're all trading those at school.

Same thing would happen at work. As adults, maybe we're a little bit better at not trading germs, but it's still possible. And so I would say the vaccine for the flu, very important vaccine for COVID, very important just because if you're going to get something from those, they're going to be less severe if you catch them. And it will be easier to identify if you have one or the other.

Contact tracing is very important as well, and your employer can help you with this. And so tracing people who have been diagnosed with COVID and tracing those to people who have been exposed to those individuals so that they can instruct them to stay home or instruct them on what it is that they need to do to protect other employees at work. I think that's also very important in the prevention of spread of COVID. But also with colds and flus, you know, we know that masks for flus work. We know that hand washing and sanitizing your hands work. We know social distancing works for those things as well.

It makes it difficult to make the diagnosis when you have more and more viruses out there that are very similar to each other. But fortunately, we do have some good testing techniques as well, so we have rapid tests that can be done with antigen testing and then also some PCR testing, which depending on how many people are getting testing can be turned around-- I know at urgent care we do get them turned around in about 24 hours. And so they can be pretty rapidly diagnosed with COVID.

Same with the flu. There's some good testing techniques for the flu that you can know in about 15 or 20 minutes as to whether you have the flu. And so, early identifying the symptoms and then seeing your doctor either via telemedicine or in person, if that's appropriate, then that would help to increase our ability to prevent spread of other viruses like the flu or cold in addition to COVID.

Melanie: Well, one of the things, and I've heard about an uptick in RSV as well in kids. And obviously, when people stop wearing their masks and all of these things, for working parents who have children that are too young to receive the vaccine. We don't know when that's going to happen, right? It could happen anytime now with five years old and up, but it hasn't happened yet.

So for working parents, they don't want to bring anything back. And while they may be masking and vaccinated, there's still this risk of a breakthrough infection. There's still this risk of even transmission to their kids. Do you have any advice during the pandemic, Dr. Michelena? Physicians and such weren't even going home, you know, staying other places. But now, people seem to be kind of back to some sense of normalcy. Do you have advice for working families with kids too young to get the vaccine and what you want them to know about protecting their families?

Dr Jordan Michelena: So it's the primary prevention and secondary prevention aspect of it. So you want to identify your symptoms early, right? So if you're starting to get symptoms or identify people around you who haven't been sick, right? And so if you've been around somebody who's been having coughs and colds and fevers, then that puts you at increased risk of being exposed to COVID. And so first you have to identify it before you walk into your house, do I have that potential that I was exposed to COVID today? You know, just like before you go into work, you would be like, "Well, do I have that potential that I've been exposed to COVID recently before going into work?"

Then, wash your hands before you touch anything at home, change your clothes, make sure that you try to sanitize yourself before you go and start touching things at the house, start hugging your children. I know that's hard because they're going to see you when you get home and they'll run up and give you a big kiss or something. But you kind of have to be a little bit cautious and take those things into account.

Melanie: I agree. And it can be scary time. And as we wrap up, mental health for adults and our children is just so important right now and at crisis levels for some people. As we start to return to work in person, let us know what you would like patients to know about our mental health and keeping a positive attitude, protecting ourselves and our families. And if our bosses want us to go back to work in person, how we can take care of ourselves, self care, mental health? Whatever you'd like to tell us any final thoughts to wrap this up so that we do go back to work in person, some sense of normalcy with safety in mind.

Dr Jordan Michelena: Right. With mental health, it's always something that's kind of in the forefront of our thoughts as physicians. Whenever you give a diagnosis, how is the patient going to accept this diagnosis? Or how can this affect other aspects of their life? Same with the COVID pandemic, the stress of, okay, some people were unemployed, "Where am I going to get money to pay for rent or pay for my payment or utilities?" You know, the stress of, "Oh, am I going to be safe if I go into the grocery store?" Right? All of those things are kind of things that drive stress and anxiety in our life and can affect our mental health and underlying conditions that we may already have.

And so, I think that that is something that we always think about. But how can you alleviate those thoughts is sometimes kind of intervene on them in your mind. Use some meditation techniques. Use counseling. There's mental health providers. I know that when more and more people seek mental health providers, there's less and less appointments available, but utilize as much of that as you can. And it doesn't necessarily have to be a mental health provider, it could be a chaplain or, somebody in the community that you trust or other family members. Sometimes the best people to talk to are people who have gone through COVID and their experiences of it as well to kind of get an idea of the disease. Sometimes when you know, what a disease is like, then it sometimes relieves the anxiety of the disease.

And then finally, know that there are effective ways of preventing serious illness from this disease, from COVID-19. Wear your mask, wash your hands, stay social distances. And now, we have this vaccine that is FDA approved for kids 16 and up or 18 and up. And we're giving it to pregnant women, so it's extremely safe. We don't experiment on pregnant women, and so it's a safe vaccine that everyone should be willing to get. And I think doing those things will help to alleviate some of the stress, knowing that this disease is something that we can manage and that we can address and something that we can prevent. And if you do catch it and you're vaccinated, the most likely thing you're going to have is kind of a flu-like symptoms and very rarely would you have to be hospitalized for it. And then if you are, there are medicines that we can use to help address it. And so I think with every day, we're progressing forward and treating the disease, and I think people should be reassured by that and help use that to decrease their anxiety.

Melanie: Well, you have definitely decreased mine. What great thoughts and good points that you gave us today. A lot to think about, Dr. Michelena. And you stay safe and thank you for all the great work that you're doing. If you have concerns, we encourage you to check the Henry Mayo website at henrymayourgentcare.com and click on the virus link at the top of the page for more information.

That concludes this episode of It's Your Health Radio with Henry Mayo Newhall Hospital. For more health tips like this and updates, follow us on your social channels. And stay safe out there. This is Melanie Cole.