Remember “El Paso” by Marty Robbins? At the end you were pretty sure he was going to die because he “felt the bullet go deep in his chest.” Somehow he made it back to the bar where the guy whose girlfriend he tried to steal (before he stole the guy’s horse) let him and her profess their love while he (Mr. Robbins) was apparently bleeding to death.
The only way you know he survived is that he recorded a song about the mishap.
Well, likewise, the only way you know the author of this blog post about COVID survived is that he wrote the blog post about it. it is a richly detailed, harrowing, painful seemingly unending tale that will scare anyone who reads it into wearing a mask anad taking other safety precautions beyond just the “six foot rule.” Makes Mr. Robbins’ bullet wound sound like a mosquito bite.
I would recommend forwarding Mr. Bujalski’s posting to your employees if they have any doubt whatsoever about whether COVID is a “hoax.” (Mr. Bujalski is very much on the mend but nowhere near 100%, and I’m sure he would appreciate a visit to his blog to send him best wishes for a full recovery.)
When I created this blog, it was my intent to post thoughts, insights, or musings at least once a week. Unfortunately, it has been over two months since I last posted an entry here. The circumstances that interfered with those intentions are suggested in today’s title.
It is important to note that from the beginning of the public health warnings regarding the coronavirus, my wife and I took every advised precaution. We were dedicated “maskers.” We washed our hands frequently. We avoided unnecessary social contact, and when we needed to go out (grocery store, take-out food), did our best to maintain six feet or more between us and other people. If anything, I was compulsive in adhering to the guidelines, perhaps taking them to extremes: I wore nitrile gloves to the grocery store and washed the purchased fruit and vegetables when I got home. Sadly, we had to cancel two planned trips to see grandchildren in other states. We were careful.
Yes, we were careful, but not 100% isolated from the outside world. We’ve given much thought to where we might have been exposed to the virus. As dining out restrictions were lifted in NC, we did venture out to dinner once a week, typically on a Wednesday. We wore masks into a restaurant, only took them off to eat or drink, then wore them as we left the restaurant. The staff at these restaurants always wore masks. The restaurants never had many people, and we were at least 8 to 10 feet away from other diners.
(Editor’s note: 8 to 10 feet helps, but there is no magic in a specific distance in indoor spaces. Just probabilities of infection that decline fairly linearly with distance.)
One other possibility: My wife attended pottery classes at a community college. Everyone wore masks, and attendance was limited to allow for social distancing. However, there was a pair of “shared goggles” that people wore when using the grinder to smooth edges of fired pieces. While most of what we’ve read suggests that it is unlikely that COVID can be transmitted via the eyes, we’ve considered this as a possible source…
I am saddened to report the loss, over the weekend, of perhaps the best health/science writer of her generation, Sharon Begley. Though a “never-smoker,”, the cause of death was lung cancer.
To appreciate the full scope of her accomplishments over her 43-year career at Newsweek, the Wall Street Journal, Reuters and STATNews, peruse this obituary. A highlight (along the many other highlights, including 5 books) might be:
She won more awards and accolades than could fit in an obituary. The accomplishments she was prouder of were making complex ideas accessible to anyone — and beautiful — through her articles and books, and in doing so, training and inspiring generations of science journalists. She taught by example, showing that you could be tough-minded while being kind, that you could be literary without any big-personality bull.
And kind she was. We found common ground and shared hilarity in our respective exposes of the wellness industry and its many foibles. We bonded over this and became good social friends over the last four years of her life, as she and her husband Ned joined our group for bridge and games nights, while Ned played ultimate frisbee with us.
But let’s get to the “kind” part and — rather than duplicate what other obits have said — focus on her contributions to the wellnss industry.
One of her gifts as a journalist was interviewing people in such a kind, low-key, manner that they would accidentally tell the truth. While she wrote many articles on wellness, one article exemplifies this talent, as we bridge players might say, in spades: Top Wellness Award Goes to Workplace Where Many Health Measures Got Worse.
In it, she documented the dishonesty/corruption of the Koop Award, and the harms to the employees of the Boise School System caused by the “award-winning” Wellsteps program. Over the course of two years, Boise teacher risk scores deteriorated by 20%, self-reported health status declined, and costs increased.
Needless to say, the perps wouldn’t talk to me, but she got them to spill their guts before they even realized they had just self-immolated. Specifically, Wellsteps’ CEO, Steve Aldana, admitted to:
- knowingly using regression to the mean to fabricate a claim of risk reduction among the highest-risk employees
- recognizing that trivial self-reported changes in (for example) fruit and vegetable consumption had no effect on healthcare costs
- recognizing that wellness programs increase overall costs
- violating US Preventive Services Task Force guidelines.
She got Ron Goetzel to admit to bestowing an award on Wellsteps for improving employee health despite knowing they harmed employees. (Mr. Aldana served on the awards committee but was the only committee member vendor who hadn’t won one of its own awards, so his award was predictable — and actually predicted.)
But her kindness wasn’t used just for the purposes of extracting self-incriminating information. When Steve Aldana called her a “lier”, her reaction was: “I need to find out what I got wrong, correct and acknowledge it,” as opposed to my own reaction, which was to quote him verbatim. Of course, she never heard from him again.
And the truly kindest thing she ever did was, despite the delicious irony, decline to write anything more about Ron Goetzel after he suffered his heart attack. I should be so kind! (On the other hand, he still maintains enough of an ejection fraction to summon the energy to attempt to sully my reputation, so I still defend myself.)
Two other articles — subsequently picked up by major media outlets — probably helped galvanize opinion to prevent employers from genetically testing employees and their dependents for hidden disease as part of workplace wellness programs:
- Opposition grows to ‘workplace wellness’ bill that would scale back genetic privacy
- House Republicans would let employers demand workers’ genetic test results
She also helped put the kibosh on yet another Goetzel-infused idea, this one to create a so-called “fat tax,” which would require employers to disclose the number of overweight employees, the idea being this would encourage employers to use more punitive and expensive wellness programs. (She handed this one off to a colleague.) It would likely have backfired, but wiser heads prevailed, largely thanks to this article, and Ron’s idea was stillborn.
- Do workplace wellness programs improve employee health?
- Think preventive care saves money? Think again.
Sharon, we miss you already and it’s only been 2 days. Thank you for your great contributions to the workplace wellness field. They played a major role in curbing its excesses, and also for generally improving the health-and-science literacy of the population for more than four decades. And for that time you didn’t double my rather aspirational 6-hearts bid even when you had the other five hearts in your hand.
June 14, 1956 to January 16, 2021
Within minutes of Quizzify’s blast email predicting that the EEOC’s rules released two weeks ago would be DOA, it is now a lock that they are toast. The White House made two announcements last week confirming this:
- They froze all non-emergency Notices of Proposed Rulemakings (not a misprint — two plurals)
- They rejiggered the EEOC, promoting the two pro-employee Commissioners to the Chairmanship and Vice Chairmanship.
This means the huge loophole in the announced rules, allowing most outcomes-based wellness programs, will be closed.
Is this an existential threat to the wellness industry? At first glance, it would seem to be. But you can join our webinar to learn so this existential lemon can be turned into existential lemonade.
Leading wellness attorney Barbara Zabawa and I are hosting a webinar on this topic on Monday, February 1st, 1:00 EST. You can register here (and get access to the recording and slides as well.) Focus will be on how to ignore the new rules, and maintain your program as is. Yep, just like with surprise bills, we’ve figured out how to game the system.
The EEOC has just released their rules for clinically based wellness programs.This step is called the “Notice of Proposed Rulemaking,” or NPRM, to be published in the Federal Register’s mellifluously named Notices of Proposed Rulemakings for public comment. “Public comment” is code for “the perps with the most to lose will flood the thread with disinformation.” Expect the US Chamber of Commerce, the vendors and Ron Goetzel and his cronies to weigh in heavily, each more shamelessly than the next. They have a lot of (your) money at stake here.
When NPRMs are posted for public comments, you know who never makes public comments? The public. So it’s up to you and me to pick up the slack, and point out that these perps have no clothes. Feel free to grab posts from TSW to add to the comments.
And the envelope please…
Most importantly, incentives for participation-based programs need to be cut back to “de minimis.” And, unlike when the rules were first floated (and true to the intent of the judge who found that forced wellness programs were not voluntary), de minimis has been defined. It looks like the IRS definition — water bottles, t-shirts, small-denomination gift cards. I had thought perhaps $200 would be OK. That is clearly outside the realm of de minimis. That could change if the perps flood the comments.
My own opinion: it is perfectly ok, even desirable, for organizations to offer employees screening. Just don’t make them do it. I myself voluntarily get my Hb a1c screened every year, to make sure I’m playing enough ultimate frisbee to offset my consumption of LA Burdick’s insanely good chocolate.
And it is perfectly OK to educate employees on why they should want to get screened (or, in the case of younger, healther employees, why they shouldn’t). Screening would then be truly voluntary.
However, many organizations want to maintain their current participation-based programs with their current incentives or penalties…and many vendors want to keep their revenues intact.
So far, so good, but…
That was all about participation-based programs. Health-contingent, or outcomes-based, programs are a different story altogether. The EEOC is basically pro-employer these days. So they have figured out how to circumvent the spirit of Judge Bates’ December 2017 decision vacating the old rules in which forced programs were defined as “voluntary,” without violating the letter of his decision. But this massive loopholecould circumvent the ruling only for outcomes-based programs, not participatory ones.
This loophole allows you to continue to be able to subject employees to fines of thousands of dollars in outcomes-based programs. Most employees hate being forced to submit to these programs (“I’d like to punch them in the face,” said one), and they invariably lose money. However, the losses in program fees and employee morale — all admitted by the wellness industry trade association — is more than offset by the “immediate employer cost savings,” as Bravo puts it, generated by collecting the penalties from employees who refuse to let unlicensed wellness vendors play doctor.
However, most outcomes-based programs, while arguably complying with these new rules under the Americans with Disabilities Act, violate the Affordable Care Act. With the well-documented, Validation Institute-validated exception of US Preventive Medicine, they invariably fall short of the ACA’s standard of being “reasonably designed to reduce risk or prevent disease.” That hurdle was set low enough to allow even the worst outcomes-based wellness vendors to clear it, and yet they don’t. They violate guidelines with impunity, forcing employees to undergo tests that no doctor would ever order and that get D ratings from the US Preventive Services Task Force (USPSTF).
Just too many epic fails, all documented for the last five years on this blog and sometimes in the media, including Koop award winners like Wellsteps, arguably the industry’s worst program now that Interactive Health has gone bankrupt. Ironically, Wellsteps is also among the best-documented programs. Why they insisted on publishing their own self-immolation is anyone’s guess. No one can argue that programs violating the USPSTF guidelines and, as we’ll see, harming employees, could possibly be considered “reasonably designed to prevent disease.”
This is not just about the money.
Outcomes-based programs can and do harm employees. Sometimes wellness vendors — I’m looking at you, Wellsteps — even admit their harms.
Yale employees sued Yale, for example, due to the psychological and physical harms of their program. One Yale breast cancer survivor was almost forced into getting a mammogram, even though she had already undergone a double mastectomy. Had it not been for Yale’s union and the AARP’s support, she would have been fined $1250.
TSW has published many stories of harms, summarized here. Not to mention what happens when you fine your employees for not losing weight. Guess what — they respond in very predictable fashion, packing on the pounds before the weigh-in and then crash-dieting to take them off. And our #1 most-searched phrase? “How to cheat in a corporate wellness program.” https://dismgmt.wordpress.com/2019/01/07/breaking-shocking-news-employees-cheat-in-wellness/
Still, if you insist on keeping an outcomes-based program, the “hack” we’ve figured out of the new regs applies to outcomes-based programs as well. Seriously.
So if you have a program (and very few people with outcomes-based programs read this blog, or else they would have already dropped them), you’ll want to attend the webinar to figure out how to preserve it. And if you don’t have a program, you’ll want to attend just to understand what the EEOC tried to do with this massive loophole and how we got the better of them.
As though the current COVID isn’t transmissible enough, this new strain spreads about 70% more easily. Hence 70% more urgency to educate your employees/members here and now. (Not quite sure that’s the way the math works, but close enough.)
The strain has already been found in 3 states. And the two countries in which it is already firmly established –Britain and South Africa — have already suffered dramatic increases in case rates.
It is believed that the vaccine(s) will protect against that strain too. Unfortunately, the anti-vaxxers have launched a disinformation campaign featuring enough lies to make a wellness vendor blush. And that doesn’t even include lying about the new strain, at least not yet.
Here is an example of an antivax myth perpetrated by someone on a health-and-wellness listserve, no less, that is so embarrassingly stupid that — even though this site is devoted to publishing embarrassingly stupid things that wellness vendors say — we aren’t going to mention any names:
According to actual infectious disease experts (Dr. William Schaffner at Vanderbilt, Dr. Anthony Fauci), and government and FDA documents in regards to vaccines, Pfizer has caused 6 deaths (within 3 days of vaccination)
- Randomly, about 6 deaths would be expected in 9 months and 40,000 adults
- Within 3 days of the vaccination, no one died
- No deaths were attributable to the vaccination at all, and (drumroll)
- 4 of the 6 deaths were in the control group.
It kills us to withhold the perp’s name (we will make it available upon request) but because COVID is life-threatening, we thought it would be better to focus instead on the positive, such as it is.
The “positive” is that the coming “surge” within your own organization — and, don’t kid yourself, it is coming, due both to holiday gatherings as well as the new strain — can be mitigated, if you choose to do so. You have four choices:
- Send out information and link employees/members to your “COVID resource center” which has more information — and hope that no one relies on social media instead for their “information”;
- Within the next week or two, write concise and thoughtful sets of COVID educational trivia questions about both safety precautions in light of the new strain and myths about the vaccines, put them in an elegant user interface, and get a major medical school, like, to use one random example, Harvard, to let you put their name on the questions to ensure credibility;
- Retain Quizzify, which has already done exactly that and is ready to go tomorrow with two full quizzes, and a customized and linked landing page like the one at the bottom, for your organization
- Do nothing.
If history is any guide, the overwhelming choice will be #4. Those people should also have their names named, but we won’t. Instead, we’ll just observe that every time one of your employees takes ill with COVID, remember that you could have done something about it, starting tomorrow.