The Workplace Transformed: Balancing Safety and Personal Autonomy as We Return to Work and School

With Vivian Lee, President, Verily Health Platforms and Vindell Washington, Chief Clinical Officer, Verily Health Platforms

The COVID-19 pandemic has dramatically altered daily life and makes returning to normal an enormous challenge. The virus tests our ability to participate in our most cherished activities, from eating at restaurants to working out at the gym. Most pressing now is the return to work and school, as employment and education are among the most important drivers of our economy and sense of well-being, both future and present, and organizations are grappling with how to return safely. Because many infected individuals are asymptomatic and can unknowingly spread COVID-19, there is no simple way to identify who may be placing others at risk. Accordingly, a thoughtful strategy is needed as we return to essential activities for our social, economic and intellectual well-being.

Before we return to campuses and offices, our day-to-day activities and spaces must be redesigned. Verily’s work with communities, public health officials, and educational and business leaders has revealed the need for a comprehensive program that integrates multiple sources of information to inform and deploy these return programs. To meet that need, Verily has embarked on Healthy at Work, which includes COVID-19 testing, daily symptom screening, population analytics and ongoing safety controls. The program includes a simple user interface through which employees or students can track their symptoms and set up tests, as well as surfaces data-driven insights to employers and administrators to support ongoing decision-making and safety.

Introducing Healthy at Work

Evaluating tradeoffs

As we have designed Healthy at Work, we have engaged with experts and institutions facing inevitable trade-offs. People want:

  • Privacy
  • The right to live without disability caused by illness, and
  • Physical freedom, including the ability to work.

These values cannot easily be satisfied at the same time during the pandemic because the virus is best contained by extreme limitation of interaction and social activity. Accordingly, we are working with businesses and educational institutions who are putting in the hard work to design return to work and school policies, allowing as much freedom as possible while protecting people’s health and personal information.

Each business and school has unique circumstances. And each organization is part of a community that has its own specific needs. A technology company, a university and a manufacturing facility, for example, all have different risk factors and will likely need different approaches to mitigate those risks. A business in a high-transmission area will have increased risks and a need for more testing compared to a business in a lower transmission area.

Our decision to enter this arena was based on years of work at the intersection of health, technology and analysis intended to improve health outcomes. Most notably, Healthy at Work is informed by our Baseline COVID-19 Program, which started as an effort to assist the state of California with community based testing and has now evolved to testing over 500,000 people in over 140 locations across the United States, including an option to volunteer for research. It also borrows the approach of Verily Pathfinder, our programmable web application for symptom checking, based on CDC guidelines. People appreciate user-friendly systems that enable convenient scheduling and feedback, and many people are interested in contributing to research that can help others deal with the pandemic. Additionally, while technology can make a big difference, implementation of testing and risk assessment is dependent upon a collaborative relationship among the many people whose lives are affected by the results and the actions we take.

While Verily took these factors into account when building Healthy at Work as a program in which we all learn together, Verily also complies with state and federal guidelines. Governments and their public health officials have authority over reopening strategies because each business is a part of a larger community with the health of that entire community at stake. If an outbreak occurs within a local business, the effects will be felt well beyond that business. The Baseline Covid-19 Program, focused on community based testing has taught us about the benefits of coordinated activity between public health and business, so that the most effective decisions can be made based on evolving data.

PCR testing at a Project Baseline site

Steps forward

Given that reopening regulations vary at a federal and state level, corporate and educational leaders and industry experts must work together to establish a strategy and best practices for returning to shared spaces — one that fits their circumstances and community — while mitigating as much risk as possible. This risk is based on many factors including:

  • The type of work performed
  • The physical layout of a given work space
  • The prevalence and transmission rates of COVID-19 in the community

We believe that empirical observations linked to statistical modeling will be critical to helping calculate various risks and estimating the benefits of testing strategies and specific interventions in the workplace or school. We have developed algorithms that take into account coronavirus-related risks, and how testing strategies will best inform risk assessment so that institutions can consider and decide on appropriate interventions. Healthy at Work is designed so that the algorithms will improve as we implement the program and learn from our experiences — we’re paralleling efforts from organizations like the CDC in using data to inform decision-making.

For example, if the virus is spreading quickly in a given community, people may be more likely to become infected from home than from the workplace. This means more stringent social distancing at work will be necessary, but not sufficient; more frequent testing would be needed to detect asymptomatic people bringing infection risk from home to the workplace. Since we’re all learning about this new virus, we plan to keep the public informed as we enhance our testing strategies and programs, through our blog and publications.

We’re using our background in laboratory science and testing workflows to contribute to the global effort to develop better, less expensive tests; optimize the strategy for who should be tested; and determine how tests should be conducted. With more testing comes new challenges, such as wait times and lab processing, but we must commit to continuing this essential action to combat the pandemic. We do expect the specific strategies for testing to be tailored to the local characteristics of the epidemic, the specific needs of a business or school and the evolving quality, costs and turn-around time of tests.

But health risks are not the only concerns. We must also be careful and diligent about data privacy and protection. Adhering to legal standards is essential, but not enough.

We are committed to effective approaches to privacy, confidentiality, and the ethics of this complex situation as the program is implemented. Our corporate approach to privacy is publicly posted and we’re working with a team of skilled internal and external experts to evolve it to meet the needs of the industry and our constituents.

We want to ensure that we’re not only following the latest guidance from the Centers for Disease Control and Prevention, the Food and Drug Administration, and state and local authorities, but also meeting the highest level of ethical conduct in this program that is operating in a complex and evolving environment. Our engagement with publicly available efforts like the Johns Hopkins report on the ethics of contact tracing will continue.

We are optimistic about our Healthy at Work program, but also recognize the complexity, the uncertainties and the magnitude of the issues we’re endeavoring to address. We plan to continue working closely with employers, educators, employees, students and public health experts. We’ll use scientifically-backed research to help Americans and their families safely return to work and school at a pace dictated by the evidence.

cardiologist, trialist, outcomes researcher, former FDA Commissioner