12 Business Questions on COVID-19

Answered by Dr. David Aronoff

Questions were posed by the Tennessee Business Roundtable and member executives.

Answers were provided by Dr. David Aronoff, VUMC.

Q1: Does age play a role in someone being asymptomatic for COVID-19?

A1: Yes; younger people are less likely to have symptoms than are older adults.

Q2: Please comment on best practices for childcare options, as that is so cirtical for employees with children.

A2: This is not a simple one.

  • Daycare facilities may be open but they are likely reducing capacity. The CDC has some guidance for operating a daycare facility during COVID-19.

  • Businesses may need to be creative about childcare options, supplementing expenses for home care of children for example.

  • Fostering more work-from-home options with flexible hours might help too.

Q3: What are your views about whether schools and colleges can open and operate safely with the amount of COVID currently in our state and country?

A3: This is a moving target.

  • In-person classes might be very difficult when disease activity is high (>10 new cases per 100,000 persons per day, for example), and/or [is] on-the-rise.

  • Virtual classes, selective in-person classes for students who truly need in-class education, protecting vulnerable teachers and staff, etc., are going to be important.

  • The way Tennessee is heading [may not indicate likelihood of] in-person classes in August.

Q4: How does COVID-19 “end”? A vaccine, virus mutation, herd immunity?

A4: All of the above are possibilities, but likely, [a] vaccine will be needed.

  • So far, < 10% of Tennessee’s population has been infected; around 1% of the state population has had confirmed COVID-19. True herd immunity from natural infection requires a majority of the population to have been infected AND immune.

  • We still do not know how durable immunity is following infection.

  • Effective oral drugs to treat or prevent serious COVID-19 infections might be here before anything else.

Q5: Do we have data on age and COVID-19 infections over time?

A5: Age over 60 is a major risk factor fr doing badley, and over 80 years of age is really tough going.

Q6: Is there a lag in COVID-19 test reporting? My son waited eight days for results.

A6: The TAT (turnaround time) for tests can be several days. This has a lot to do with resources being limited due to high demand. The tests do not take long to perform, but if [test-processing] supplies are low, TAT can take a while. As the number of cases has increased across the country, we unfortunately have seen [prolonged] laboratory TATs.

  • We encourage people to stay home after they are tested: If they are symptomatic, this is a must; if they are asymptomatic, this is strongly encouraged.

Q7: Are there any data points on types of masks that are most effective? Do masks actually stop molecules from transmitting, or just lessen the volume/velocity of transmission?

A7: Cloth masks absolutely prevent a cloud of infectious respiratory droplets from creating their usual cloud around the mask wearer. They protect others from the mask wearer.

  • This NPR report is a good one on that subject.

  • The data absolutely support mask-wearing. Observational studies during COVID-19:

* SARS-CoV-2 Infections and Serologic Responses from a Sample of U.S. Navy

Service Members — USS Theodore Roosevelt, April 2020


* Absence of Apparent Transmission of SARS-CoV-2 from Two Stylists After

Exposure at a Hair Salon with a Universal Face Covering Policy — Springfield,

Missouri, May 2020


Q8: How can we share some best practices from larger companies that are executing anti-virus efforts at a high/advanced level?

A8: You might want to create peer groups of similar businesses to share best practices.

Q9: With limited contact tracing resources and increasing cases, local health departments seem to be broadly instructing potentially exposed individuals to quarantine for 2 weeks. Having large numbers of employees out as a precaution has the potential to severely impact the ability for essential businesses to continue operations. At the same time, a workplace exposure would also have a similar impact. What should employers do to mitigate staffing shortages?

A9: Public health acknowledges the essential role of some workers, and therefore allows them to continue working even after being identified as a “contact” to a case of COVID-19.

  • If an essential employee was possibly exposed, that employee should work from home if possible for 14 days from the day of exposure.

  • If an essential employee must work on-site, applicable guidance from the department of health concerning exposed or infected employees must be adhered to, and safety measures must be implemented, including (but not limited to):

* Be masked at all times.

* Be separated from others by 6 feet or more to the degree possible.

* Be closely monitored for any symptoms or illness.

* Practice strict hand hygiene.

Q10: What’s the cumulative effect of adopting/promoting multiple anti-corona virus measures (e.g., masks, distancing, hand hygiene, etc.) concurrently? Do they work together to combat corona virus spread more than each practice does individually?


  • Distance is the most vital; then

  • Blocking the virus (plexiglass, walls, masks); then

  • Hygiene.

  • There is no single “magic bullet” against COVID-19; all of the above measures are extremely important.

Q11: In the overall fight against coronavirus, how much would it help if employers were to actively support/facilitate mass testing for their employee populations?

A11: Not a ton, unless it were part of a specific broader government health effort.

  • We recommend testing symptomatic people, and also exposed asymptomatic people, probably at day 5-8 following exposure, assuming they’re still asymptomatic.

  • But beyond the above, it’s best to avoid getting into the testing business unless its needed.

  • We also want to reiterate that if an employee tests positive, there is no requirement for a negative test before that employee can return to work. We encourage use of the CDC’s symptom-based strategy for ending isolation. Persons recovering from COVID-19 illness should be isolated for at least 10 days after illness onset, and for at least 3 days after illness recovery; more here: https://www.cdc.gov/coronavirus/2019-ncov/community/strategy-discontinue-isolation.html.

Q12: When the virus spreads to levels which indicate “community spread” or a “cluster” within a company environment, what are the implications and consequences?

A12: The direct implications could be illness or death for employees, customers, and/or their families or housemates.

  • We know that a healthy community is the best way to support a healthy economy. To the degree that we can all work together to decrease disease transmission, it will help our businesses thrive.

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COVID-19 12 Q&A by TN Doctors
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