Spencer Platt | Getty Images
Montgomery County, in southwest Ohio, is ground zero for the opioid crisis. The region has one of the highest overdose death rates in the country — mostly due to the illicit use of these narcotics. This statewide plague has rocked communities as prison populations for drug offenders swell. It has employers grappling with ways to hire and keep their workforces productive and in lockstep with economic demand.
It’s not surprising that the state has one of the largest female prison populations in the country. Experts agree addiction has been fueling this rapid growth. Thirty-five percent of all charges against women in the last decade were drug related.
“Now 70% of the children in Ohio child welfare programs have opioid-involved parents, and it is overwhelming the system,” says David Royer, CEO of the Alcohol, Drug and Mental Health Board of Franklin County in Columbus.
Statistics paint a bleak picture. About 5,000 people die from opioid overdoses in Ohio each year. The crisis is costing Ohio between $4 billion and $5 billion a year and hurting its competitiveness due to low marks on health. It has spurred Republican Gov. Mike DeWine to take a multiprong approach to the problem, including tracking the drug distribution chain in his state and waging a legal battle to stop the huge pill spill with the help of attorney Mike Moore, the man behind the multibillion-dollar tobacco settlement in 1998.
Ohio’s Republican governor, Mike DeWine
Tony Dejak | AP
The first targets are opioid manufacturers like Purdue Pharma, which makes OxyContin, and big drug distributor McKesson. The goal is to win billions in settlements and bankrupt the companies at the root of the problem.
It’s a quest that has inspired other states to follow suit. Now 48 states have filed lawsuits against Purdue Pharma, accusing the company of helping to ignite the nationwide opioid crisis. Moore is representing three of those states in addition to Ohio.
Beyond the courtroom, some of Ohio’s actions are being used as a model by other states and companies facing rising addiction rates. Among initiatives is the Ohio Opioid Education Alliance, a group formed last year that consists of 60 organizations that include companies, trade associations and small business owners that are committed to preventing the next generation of Ohioans from getting addicted to opioids.
“The alliance includes a worker coalition and an investor group and has raised $5 million to fund a variety of programs. One is a slick ad campaign created by Ogilvy to educate citizens about the risks of opioids and how they can get help for addiction and other mental health issues,” says Royer.
At a march in Norwalk, Ohio, Barry Bova holds a picture of his son Brad, who died of a heroin overdose.
Spencer Platt | Getty Images
Among its supporters in the private sector are Nationwide Foundation, Ingram-White Castle Foundation and American Electric Power.
As he explained, “states need to have a long-term public health strategy on this issue, not a short-term fix. This epidemic has spilled into the American workforce, because once you hire an employee, you inherit their family — and their issues.”
Today 75% of U.S. employers across the country have been affected by the opioid crisis, but only a startling 17% feel prepared to deal with it, according to research by the National Safety Council, a nonprofit that focuses on worker safety. It’s a devastating truth that has rocked companies of all sizes — from large Fortune 500 multinationals to small mom-and-pops.
Prescription painkiller abuse costs employers almost $42 billion in lost productivity alone every year, the NSC reports. If you add the health costs associated with addiction, that price tag rises astronomically.
Republican Gov. Mike DeWine is taking a multiprong approach to the problem, including targeting opiod distributor Purdue Pharma, maker of OxyContin, and big drug distributor McKesson.
George Frey | Reuters
All industries and professions are being affected, but the industries seeing the biggest hit: construction, manufacturing and retail.
“It’s time for employers to stop living in denial,” says Kathleen Herath, associate vice president for well-being and safety at Nationwide Insurance in Columbus. “Over the last six to seven years, U.S. businesses have seen a big increase in health costs due to substance abuse. Despite the trend, most are not addressing the problem.”
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While Washington and state legislators are now taking action, their slow response to the epidemic has allowed the problem to spiral out of control, helping to fuel a $13 billion industry. Today a vast network of pain clinics has sprung up across the country. Access to opioids has never been easier, thanks to bitcoin and the Dark Web. Today addicts can easily buy opioids through their apps with on-demand delivery in minutes. It has touched everyone — from those in the boardroom to the assembly line.
“It [opioid overdoses] claimed more lives in America than motor vehicle crashes and gun violence last year,” reveals Rachael Cooper, senior program manager at the NSC. “It’s been increasing yearly due to a wave of heroin and fentanyl usage.
In this Nov. 2, 2017, file photo, Cincinnati Fire Department medics nasally administer naloxone to a woman while responding to a possible overdose report at a gas station in downtown Cincinnati.
John Minchillo | AP
Now businesses are trying to cope with the fallout. Nationwide Mutual Insurance based in Columbus has taken a lead in developing a corporate approach to address opioid addiction in the workforce that is being emulated across the country. It has all levels of employees involved — from the C-suite and managers to the rank-and-file. The company’s multipronged approach includes clean drug testing before making a hire; setting up a centralized drug hotline for employees managed by a case manager; and a second-chance policy that keeps drug addicts employed if they agree to treatment and random drug testing for two years. The company also trains managers on how to spot drug abuse among their workers and how to deal with the problem.
Its practices are taught through the Ohio Opioid Education Alliance. One that has made a big difference is giving every employee a drug disposal pouch that provides an easy way for them to deactivate and dispose of unused, expired or unneeded medications in their own home.
“It’s makes a big difference,” says Herath. “The key is to prevent misuse and get the drugs out of the house before it destroys their lives and the lives of their family.”
According to Herath, all these measures have yielded great results. In Nationwide’s experience, 100% of the workers who completed a two-year program maintained sobriety, and 60% were rehabilitated and came back to work.
It’s a case study of hope for U.S. employers willing to invest in the future of their workforces.
Chris Swift, the CEO of The Hartford who sees the toll this epidemic is having on company bottom lines, agrees this is a crisis that needs immediate attention. His company is working with the state of Connecticut and the federal government to develop national practices for this type of substance abuse. The Hartford website now also has a calculator that can determine the cost of addiction in a workplace based on size of employee base, industry and state.
As he explains: “We look at this as a long-term disability and a key employee benefit. Our research shows 56% of substance abusers are employed.”
What to watch for in May’s health care jobs numbers
A view outside Bellevue hospital during the coronavirus pandemic on May 1, 2020 in New York City.
Noam Galai | Getty Images
As hospitals, physician practices and dental offices have reopened for non-emergency care over the last month, it seems a good bet that health-care workers furloughed during March and April will be among those most likely to be recalled by their employers, but the May jobs numbers on Friday may not show much of a snap-back.
“We expect the education and health services industries to recover quicker than will the overall labor market this year,” analysts at Moody’s Investors Services wrote in research note Wednesday, adding “next year, these industries will likely add about 370,000 jobs, or 11% of total private-sector jobs created.”
While private employers added 166,000 education jobs last month, according to payroll processing firm ADP’s May employment report, it was a different story in health care. The private sector shed another 333,000 health care jobs in May, bringing losses over the last three-months to more than 2.4 million.
Dental jobs could see May bounce
Dentistry saw the biggest employment losses in the health care sector care in April, shedding more than 500,000 jobs, but preliminary data from the American Dental Association show the dental sector could see a healthy bounce back in the May jobs report.
By last week, 90% of dental practices had reopened, up from 65% in mid-May. More than three out of four practices report paying their staff fully, with patient volumes at about 52% of pre-Covid levels by the end of the month.
“All of all of my predictions are turning out to be overly bearish. I’d expected a slower recovery and slower rebound in patient volume, and slower bounce back in hiring,” said Marko Vujicic ADA chief economist and vice president.
The vast majority of physician practices had reopened by the end of last month, as states lifted the moratorium on non-emergency care, but doctors continue to feel the financial strain of the pandemic shutdown. Some 95% of practices have resumed seeing patients in the office, but about half of primary care doctors surveyed by the Larry A. Green Center last week said that the volume of visits remained down more than 50% from pre-Covid levels.
Nearly 28% of mostly small practices surveyed had skipped or deferred clinician salaries by month’s end, while more than 35% of practices had laid off or furloughed staff. Just over one-in-five said that bills for telehealth visits had been denied. The full results of the survey will be published Friday.
“I think it’s going to be a hard and slow recovery … those who close due to lack of payment may not be able to return. I think what we are seeing is a permanent shrinking of the primary care platform,” said Rebecca Etz, associate professor of family medicine at Virginia Commonwealth University and co-director of the Larry A Green Center.
The situation is not much better for physician practices that fall under a hospital system.
“The 60% employed by hospitals and health systems are likely to be vulnerable to prolonged hiring freezes,” said Etz, noting that 11% of physician practices reported that they had rescinded job offers to incoming medical residents.
Hospitals slow to rehire
In April, the hospital sector cut nearly 135,000 jobs, as patient volumes and medical care revenues plunged during the national Covid shelter-in-place order, and health care facilities across the country postponed virtually all non-emergency procedures.
Over the last month, health systems have seen a rebound in demand for rescheduling postponed elective surgical procedures, but overall volumes have remained well below pre-March levels.
Through mid-May in-patient volumes were down about 20%, but emergency department visits were still down 40% from late February, according to research from health care division of financial payments firm TransUnion.
Hospitals around the country have ramped up advertising and community outreach to assure people it’s safe to come back to their facilities, but they continue to see patients putting off care. At the same time, new social distancing and coronavirus disinfecting procedures will also hamper their ability to handle patient volumes at pre-Covid levels.
“The ones we talk to are being extremely mindful of not jumping the gun in terms of necessarily bringing everybody back immediately,” said James Bohnsack, chief strategy officer of TransUnion Healthcare. “They’re having to be mindful and kind of rethink their strategies around expenses overall, which is mostly driven, as you can imagine by the staffing.”
Top of mind for many hospital executives is that the recovery in patient volumes over the summer could be short-lived. Most executives anticipate a significant second wave of coronavirus later this year, according to research from consulting firm LEK, and two-thirds of hospital leaders expect that they will have to cut back on non-Covid care once again when that wave hits next winter.
China stocks up food, oil as coronavirus spurs fears about shortages
A customer wearing face mask buys flour at a supermarket on May 12, 2020 in Taiyuan, Shanxi Province of China.
Zhang Yun | China News Service | Getty Images
The world’s second largest economy, which has limited arable land, is facing pressure to shore up its food supplies as prices for food started ticking higher last year, prior to the virus outbreak.
Lockdowns and movement restrictions aimed at containing the coronavirus have triggered transportation and logistics bottlenecks.
Those blockages have highlighted the vulnerability of global supply chains, and fears of food shortages have come to the forefront of countries, both in developed and emerging economies.
Consumers in China are worried about further repercussions from the pandemic as it continues to spread globally.
“People there (in China) are panicked that coronavirus will eventually shut down the world’s ports, making it impossible for them to import,” said Arlan Suderman, chief commodities economist for INTL FCStone in a tweet on Monday. “As such, they are hoarding supplies now while they are cheap and available.”
“Fear is a powerful motivator. It’s driving policy in China currently. Fits well with those hardliners that want to rebuild food reserves,” he added.
Food prices surge
China is the world’s largest consumer of pork, a staple protein for the country.
In the first four months of the year, meat imports in China rose 82% compared to a year ago. These include pork, beef and poultry.
“We expect food stockpiling to continue especially in cities exposed to logistic disruption. The confluence of expected food price increases alongside an economic contraction and rising unemployment will push up the risk of civil unrest,” said Kaho Yu, senior Asia risk analyst at Verisk Maplecroft, a consultancy.
Already, food inflation in the country has been ticking higher.
Last Tuesday, China announced that food prices rose 14.8% in April from a year ago. Even though it was lower than the 18% increase in March, it was still at a high level.
Pork prices rose almost 97% in April in what has been a persistent trend since early 2019 due to the African swine fever epidemic in pigs that decimated China’s hog herds.
In comparison, non-food prices rose just 0.4% in April, official government data showed.
Soybean supplies are particularly vulnerable to supply shocks as China, the top importer of the commodity, needs the oilseed to make animal feed and cooking oil.
In April, China’s soybean imports fell 12% from a year earlier, customs data showed, due to bad weather causing the delay of cargoes from top supplier Brazil.
As for rice, China is the world’s largest producer of the staple grain with most of its supplies being consumed domestically.
Even so, concerns about food security of the staple grain have led to panic buying and spurred the state to acquire more stocks from the market for its national reserve.
In April, Chinese authorities assured the population that it was stepping up state buying of rice and that there were enough stocks, state news agency Xinhua reported.
“We expect China to continue stockpiling crops to ensure sufficient supply over the next six months by scouring the globe for available supplies,” said Yu in a recent report.
The consultancy puts China in its “high risk” category in terms of food import security, which means that its food imports risk being subjected to disruption.
Crude oil reserve building
Likewise, China has been building up its crude oil stockpile, and went on a buying spree in the first quarter of this year, data show.
Although crude oil imports fell in April compared to a year ago, they still rose from March. But analysts say limited storage facilities could put a cap on imports.
“Major crude oil importers such as China have been known to build their strategic reserves when prices are low, as seen in previous oil price routs,” Lei Sun, senior consultant at Wood Mackenzie, said in a March report. “China is expected to continue importing crude to fill its reserves taking advantage of lower oil prices.”
However, the country has less room to import than it did in the last two years, due to limitations in storage capacity, he said.
As supply lines continue to be disrupted due to the coronavirus outbreak, Yu at Verisk Maplecroft said he expects Beijing to double down on building more storage capacity, on top of energy development at home.
“Energy is also core to the country’s economic engine. Throughout the pandemic, Beijing has been prioritising maintaining a stable coal supply with an eye on power generation for industrial activities,” said Yu. “We also expect Beijing to speed up the resumption of large scale energy infrastructure projects.”
Putting food and energy first
Food and energy security have always been important for China, but the pandemic has underscored these concerns.
In April, President Xi Jinping spoke about food and energy supply security several times, noted Yu.
In the same month, state agencies — such as China’s National Development and Reform Commission, the National Food and Strategic Reserves Administration and other ministries — issued a policy notice aimed at ensuring adequate food production, storage capacity and logistics, Yu noted.
Also in April, China’s National Energy Agency issued a list of policy areas to focus on this year. They included power supply, grid networks, oil and gas infrastructure, and coal projects.
The developments underscored the government’s concerns, he said.
“Both Xi’s rhetoric and associated policy announcements from various ministries show how food and energy security are high on the government’s agenda,” said Yu.
“All of them are aiming to avoid potential pandemic-linked supply shortages and to increase self-sufficiency of critical resources over the long term. The COVID-19’s disruption on trade and industrial activities has reignited Chinese leadership’s long-running concerns over resource security.”
Microsoft, UnitedHealth offer companies free app to screen employees for coronavirus
UnitedHealth Group and Microsoft’s ProtectWell coronavirus symptom screener
UnitedHealth Group and Microsoft
UnitedHealth Group and Microsoft are offering companies a coronavirus screening app called ProtectWell that provides a daily symptom screener to help clear employees to go to work or direct them to be tested if they are at risk for infection.
As U.S. companies struggle to bring employees back under stringent new safety requirements, health-care and tech companies are rolling out new services that go beyond temperature checks. The apps are designed to help protect the safety of employees returning to work as well as to entice customers to return to restaurants and stores by ensuring wait staff and clerks are infection-free.
Microsoft and UnitedHealth, which use the program for their own workers, are now offering the service to U.S. employers free of charge. The program will include resources and guidelines on Covid-19 testing schedules for different workers within an organization, based on their potential on-the-job exposure to the virus.
“A worker in a nursing home, for example, … we would want to be doing the symptom checking every single day, and then be put into a testing schedule that allows them to get tested, anywhere from three to… every five days,” said Ken Ehlert, UnitedHealth Group chief scientific officer. “Different folks in the population need different levels of testing.”
The ProtectWell app provides the worker with his or her test results and notifies the employer when a worker tests positive for the coronavirus.
“When we think about the broader perspective of enabling a safe return to work, it’s imperative that employers also have that ability to be able to … act on that information, so that they can ensure that the workplace is safe” said Dr. David Rhew, Microsoft chief global medical officer.
The app will not provide tracking and contact tracing information, and while Microsoft’s health-care bot will drive the symptom screening within the app, UnitedHealth will maintain control over the health data itself. Under occupational health and safety rules, workers’ personal health information needs to be kept separate from personnel records.
“The challenge is about data management — how we aggregate testing information, safely permission it to reach the right people, use it to make workplace decisions,” said Dr. Rajaie Batniji, co-founder of benefits firm Collective Health, which launched its own Covid back-to-work service this week.
Batniji says a testing program, when combined with social distancing and disinfecting practices, can help businesses lower the risk of a workplace outbreak to less than 5%.
The firm’s Collective Go service is partnering with Bay Area start-ups Genalyte, Color and Everlywell to provide employers with on-site and at-home molecular testing for current infections, as well as antibody tests that can show whether a person was previously infected.
“We’re seeing improvement … with regard to accuracy and scalability” of the antibody tests, said Batniji, but he adds that the firm is continually assessing the latest data on the reliability of various Covid-19 tests.
On Thursday ,the Food and Drug Administration raised concerns about the accuracy of Abbott Labs’ ID Now rapid Covid-19 tests, after a study from New York University suggested that the test resulted in a high number of false negatives.
UnitedHealth’s Ehlert notes that availability could also be an issue for some employers to adopt wide-scale testing, so it will be important to prioritize testing programs for workers who are most at risk of getting sick.
“We are working within the capacity of trying to get the best tests available, make sure we have enough of them, and prioritize them,” he said.
Race to provide testing
With the sharp drop in nonemergency diagnostic screening and testing due to the pandemic, new workplace programs could provide a much-needed boost to diagnostic testing firms and hospitals as they try rebound from the financial disruption caused by delayed procedures over the last two months.
New Orleans-based Ochsner Health System set up its own lab for processing Covid testing for its patients and staff and is now working with area employers to help them establish testing and health monitoring programs. CEO Warner Thomas says the return-to-work service will allow the hospital to redeploy clinicians who have been idled, while postponed elective surgery and other procedures are beginning to be rescheduled.
Quest Diagnostics CEO Stephen Rusckowski told analysts last month that reopening presents “substantial opportunities” for providing to testing for employers and municipalities “for overall surveillance within the population and returning to work.”
LabCorp CEO Adam Schechter told CNBC that different parts of the economy will require varying levels of testing to bring workers back and has been in talks with employers to provide on and off-site screening for workers, including temperature checks.
It’s unclear just how much employers will actually lean into widespread workforce coronavirus testing, but for many American workers it could become a job requirement while the threat of the pandemic remains, which could be for the foreseeable future.
“As a doctor, if I wasn’t up to date on necessary vaccinations or screening, it’s considered a safety issue for patients and co-workers,” said Batniji. “This is a first for many (and) a cultural change for most Americans.”
Correction: This story has been revised to correct the attribution of a quotation from a Microsoft official. The quote was from Dr. David Rhew, Microsoft’s global chief medical officer.
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