MONDAY, Nov. 9, 2020 — In a graphic illustration of the danger the new coronavirus poses to essential workers in America, a new study shows that as many as 74 million of these workers and their families are at increased risk for COVID-19.

It gets worse: Of that number, up to 61% are at increased risk for severe COVID-19.

“Public policymakers face important decisions about how to balance the economic benefits of keeping workers employed and the public health benefits of protecting those with increased risk of severe COVID-19,” said lead researcher Thomas Selden, from the U.S. Agency for Healthcare Research and Quality.

These issues are important when deciding to close segments of the economy and how to distribute vaccines, which will initially be available only in limited supply, he said.

“These decisions become all the more difficult when the prevalence of infection rises in parts of the country,” Selden noted.

The researchers also looked at the increased risk for COVID-19 among those living with essential workers who could not work at home.

Many parts of the United States face rising infection rates, Selden said. “We used data collected before the pandemic to examine how many workers were in essential jobs, how often they were able to work at home, their risk of severe COVID-19 outcomes in the event they are infected, and the health risks of their household members,” he said.

“We found that 72% of all workers were in jobs deemed essential, and over three-quarters of all essential workers were unable to work at home,” Selden said.

Not only that, but as many as 61% of these workers had underlying health issues that put them at increased risk of severe COVID-19 should they become infected, he added.

“Because so many workers are in essential jobs and unable to work at home, and because so many adults have increased risk of severe COVID-19, we found that between 57 million and 74 million adults with increased risk of severe COVID-19 were either essential workers unable to work at home or they lived in households with such workers,” Selden said.

The findings were published online Nov. 9 in JAMA Internal Medicine.

The risks to essential workers in all disciplines who could not work from home were clear from the beginning of the pandemic, said Dr. Robert Glatter, an emergency medicine physician at Lenox Hill Hospital in New York City.

“But the risk of transmission to household members living with essential workers became equally important when considering potential for disease progression along with community transmission,” Glatter said.

Since scientists know that asymptomatic transmission of the virus is a major way it spreads, steps like self-isolation and self-quarantining in separate rooms in the home, along with wearing masks, might reduce the risk of transmission, he noted.

Another option includes having essential workers self-quarantine or self-isolate in hotel rooms, which could significantly reduce the risk to household members, Glatter added.

“Household members who are obese, smoke, [are] older than 65, have diabetes, heart disease, chronic kidney disease, asthma or COPD are at much higher risk for adverse outcomes — including death — if they contract COVID-19,” Glatter said.

It’s vital to factor in the increased risk to household members “when assessing overall potential for community transmission and disease progression of COVID-19 among essential workers who can’t work from home,” he stressed.

Selden hopes these findings will help policymakers when that are making decisions about the economy and public health.

“To the extent that we can reduce the prevalence of COVID-19 in our communities through a combination of common sense, vigorous public health and, eventually, a vaccine, then we can reduce the extent to which policymakers have to choose between the economy and keeping the population safe,” Selden said.

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