Emotional and Social Reintegration in the Age of COVID-19
July 22, 2020 | Webinar
Dr. Marcos Iglesias, Vice President and Chief Medical Director at Travelers, joined the Wednesdays with Woodward series to explore what employers can do to care for their employees’ mental health during this unprecedented time of stress and anxiety.
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Slide, Wednesdays with Woodward (registered trademark) A Webinar Series. Emotional & Social Reintegration in the Age of COVID-19. July 22, 2020. A woman appears in a video call at the top right corner of the slideshow.
Hello, good afternoon. Welcome to today's webinar--Emotional and Social Reintegration in the Age of COVID-19.
Slide, Disclaimer. This program or presentation is only a tool to assist you in managing your responsibility to maintain safe premises, practices, operations and equipment, and is not for the benefit of any other party. The program or presentation does not cover all potentially hazardous conditions or unsafe acts that may exist and does not constitute legal advice. For decision regarding use of the practices suggested by this program or presentation, follow the advice of your own legal counsel. Travelers disclaims all forms of warranties whatsoever, without limitation, implementation of any practices suggested by this program or presentation is at your sole discretion, and Travelers or its affiliates shall not be liable to any party for any damages whatsoever arising out of, or in connection with, the information provided or its use. This material does not amend, or otherwise affect, the provisions or coverages of any insurance policy or bond issued by Travelers, nor is it a representation that coverage does or does not exist for any particular claim or loss under any such policy or bond. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy or bond provisions, and any applicable law. Please note that this session is being recorded by Travelers. The recorded session may be used, copied, adapted, distributed, publicly displayed and or performed as Travelers deems appropriate.
Before we begin, I want to draw your attention to the disclaimer. Please take a moment to read it. You can also review this when recording of the session is posted on our Travelers Institute website.
Slide, Wednesdays with Woodward, A Webinar Series. Visit us at WWW dot travelers institute dot org. Logos of Travelers, Travelers Institute, Syracuse University Institute for Veterans and Military Families, Small Business & Entrepreneurship Council, and ACCION
My name is Joan Woodward, and I will be your host for today's session. For those of you who may not be familiar with the Travelers Institute, we are the public policy, educational, and informational arm of Travelers Insurance. For 11 years, we've hosted educational forums across the United States and Canada just like this. Well, actually not just like this, we do them in person usually, but we're trying this out for now.
And we do that on issues that affect our customers, communities, agents, and broker partners, which are really important for us, and for our 30,000 employees. Issues like small business advocacy, disaster preparedness, and distracting driving to name a few. This is the third webinar in our Wednesdays with Woodward series. Where I have the pleasure of speaking with thought leaders about pressing topics that impact us-- both on our personal and our professional lives.
We'll host these free educational webinars every other Wednesday through Thanksgiving. So please do mark your calendars. Visit the travelersinstitute.org, to see a recording of our first two webinars--A Path to Reopening Your Business, and Cyber Threats When Reopening Your Business--both very, very informational, practical advice to for you.
I want to say a special thank you today to our partner organizations, who help make this program possible. First the Small Business Entrepreneurship Council working every day in Washington to help small businesses get better advocacy on Capitol Hill. Accion, a very large lender for micro-businesses. And the Institute for Veterans and Military Families.
Today we have a terrific expert joining me--Dr. Marcos Iglesias. Dr. Iglesias is Vice President and Chief Medical Director here at Travelers--where he leads the workers compensation, medical innovation, and strategy teams. In this role he focuses on developing comprehensive, disability management solutions that focus on early identification of those risk factors and early interventions to return workers--to return workers to pre-injury function.
He also recently published a very useful white paper on the topic of emotional and social reintegration, which is available at the travelersinstitute.org website. And before I'm going to turn it over to Dr. I, as we call him. I want to let you can ask questions throughout this program.
So use the chat function on the very bottom of your Zoom camera--just scroll down, it'll pop up. And you can type a question to me, Joan Woodward, and make sure you address it to me so I can see it. The other way you can do it, towards the end of our program, you can raise your hand and ask a live question.
So you can go to the participant module. And then once you hit participants, you'll see something called Raise your hand. If you raise your hand, I'll call on you. And you can turn your video on, and you can ask your question live.
So let me turn the program over to Dr. I, and we really appreciate everyone joining today. We had an overwhelming response to our webinar.
Slide, Emotional and social reintegration in the age of COVID-19. Marcos A. Iglesias, M.D. June 2020. These materials are confidential and proprietary. Reproduction, copying, disclosure, dissemination, or distribution is strictly prohibited. Copyright 2020, The Travelers Indemnity Company. All rights reserved. Dr. Iglesias appears on the video call
Thanks so much Joan, it's really a pleasure to be here with you on Wednesdays with Woodward, and also with all of you who have joined us today.
Slide, a bullet point list
I hope we have a very good time talking about this topic. Because, again, this is no surprise to anybody here and this is why you're here, that we're in the middle of some extraordinary times.
And it's not just because of the novelty of this virus that we only came into knowledge about a few months ago, but also because of the depth, the breadth of the problem itself and the confluence of issues that have come into this time. With the pandemic itself, the economic downturn, there is social isolation. Relentless media attention like we've never seen, and now social unrest as well.
So it's clear that there really is no parallel to this situation we're living in. And because of that, I think we need conversations like this one. Conversations that are open, that are agile, that are flexible, because we're going to need to move forward by creating new solutions, crafting new ways out of this situation that we're in.
And what I'd like to do today is really focus on the impact of COVID and our current situation, because it's more than COVID on our well-being. And by this I mean--our physical, our emotional, and our social health. And what I'd like to especially do is to highlight an approach that we can take to returning to the workplace in the coming weeks and months that aims to avoid distress, by really focusing on emotional and social health.
Slide, Health: A biopsychosocial approach, a Venn diagram
So when I talk about health, I usually take a holistic approach of the individual. For me and for many of us, health is really a biopsychosocial concept. It encompasses sure our biological or medical health, but it's much more than that. It also encompasses our mental well-being and it encompasses to our social health. So with that, I'd like to approach how COVID in our current situation, has affected each one of these areas.
Slide, Biological emphasis, a list
First of all, there's the biological. And I would say that this is where we have spent the most time on and rightfully so understandably so. The emphasis has been on things like prevention. Prevention of this disease through environmental controls--whether we're talking about masks, social distancing, hygiene precautions. All of these are physical, all of these affect our biological health, and this is terribly important.
We're also in a desperate search for new treatments for a vaccine. And again, I underscore that this is right and important at this stage.
Slide, Biological: Medical Consequences, a list
But there are also direct and indirect effects of the COVID virus itself.
Obviously, the direct effects are obvious to those of us or those who have had the disease and have recovered or are recovering from it. But beyond that there are a lot of indirect effects. And over the long run, these may end up being more significant--affecting a larger proportion of the population and also lasting for much longer. And so what are some of these things.
Well, as you all know, we are avoiding medical care as a population. Some of it is due to shelter in place policies. Some of it is due to our apprehension, to going to our doctor or to our medical provider. And also, the cancellations that we've seen by medical providers. Cancellations of office visits, of routine care, of operations--especially elective operations.
But it's not just elective conditions, that are not receiving care. There was a very telling study that was published last month in the Journal of the American Medical Association, that summarized what the Veterans Administration system has been seeing. And the VA reports that inpatient admissions for serious diseases, has dropped--in some cases, 40 and other cases up to 57%. And these are conditions like appendicitis, stroke, heart failure, heart attacks.
These are not elective conditions and yet a lot of individuals out there are not seeking medical care for these conditions. So that is certainly an indirect effect of COVID. Finally, and maybe we'll talk a little bit about this later. The unemployment that has been caused by the response to the pandemic, may have marked health consequences that we will be dealing with for a number of years.
Slide, Psychological: Emotional consideration, a bullet point list
So that's the biological.
What about the psychological, the emotional? This is also going to be played out over the next weeks, months, and years on a very large scale. And I think it's important to underscore whenever we're talking about COVID or our situation, that most individuals in our population aren't going to be OK. Some may even become more resilient as a result of going through this situation. But the mental effects of the situation, could affect many people for many months or years.
There are three areas of psychological impact, that I think we need to look at. One is stress. And we're all living through the stress of the condition we're in. But the second one is mental illness. Things like depression, PTSD, substance abuse.
And then the last one is, will we see an increase in suicide rates? And if we look at our experience with certainly other economic downturns, but even other large-scale catastrophes, the answer is probably yes. We haven't gathered enough data to see that yet, but there has been a confluence of issues over the last few weeks and months, that point to a big danger in this area.
And, of course, there's the downturn of the economy as we talked about. Stress itself, increased substance use, the isolation that many of us are reporting, and avoided mental and physical care. I think don't bode well for suicide rates in the coming months.
Slide, Stress: Effects, a list
Stress itself has emotional, cognitive, and physical effects. On the emotional side, stress can lead to insomnia. It can lead to depression, to anxiety. It can lead to mental health conditions.
On the cognitive side--many of us are facing this right? As we are fatigued, our concentration may not be what it should be or what it was. We have inattention, impaired memory as a result of stress. And this then can manifest itself in the workplace through things like increased interpersonal conflict, decreased productivity, increased absenteeism. Just a negative environment that stress can bring to the workplace.
And then finally on the physical level, stress can have serious medical effects. It can affect us not only by inducing fatigue and increasing our pain perception, that we have to deal with on a daily basis, but it can also increase diseases like heart disease, gastrointestinal disease, and many others.
Slide, Prevalence of symptoms of serious psychological stress, U.S. adults, a bar graph with one bar significantly higher than the other
I'd like to highlight the results of a survey that was published in JAMA also last month. And why this is important is because, it underscores the extent of COVID's impact on mental health. What the study showed was a survey that was given in 2018, and then again, in April of 2020.
And what it showed is that this year, in April, about 14% of US adults are reporting symptoms of serious psychological distress. This is compared to about 4% a couple of years ago in the pre-COVID era. So it's clear that COVID is having an effect on our psychological health.
It does not affect us all equally. Interestingly, it showed that there is a disproportionate effect on three groups. One is those who are younger, ages 18 to 29. Those who are earning less than $35,000 a year, and Hispanics. So this is something that we need to pay attention to and that we need to look out for even in our workforce.
The other part of this survey was--the question was, do you feel lonely always or most of the time? And 14% of us answered in the affirmative.
Slide, Social considerations
So we are seeing loneliness. This is part of the social consequence of COVID, and this can lead to both mental and physical health problems.
For example, in an elderly population, isolation has been found to be a factor in a number of diseases, including dementia, including functional decline, stroke, mortality from cancer. So it can certainly have direct medical effects that we need to be on the lookout for. And it's not just isolation that can be a problem, as we return to work, we're going to have to make a lot of short-term and long-term decisions about a lot of things.
Things like open offices, shared spaces, working from home, gatherings. What is the future of in-person meetings? How are you going to train in this new world? Are we going to travel for work? What about conferences? What about meetings like this one we're having?
And one of the nice things to come out of COVID has been the response that we've had as corporations, as individuals in using technology like what we're using today. And this may be the new normal, we'll have to see over the next few weeks.
Slide, Possible stressors as employees return to the workplace, a bullet point list
There are going to be a lot of other stressors as we return to work. And these are just some that we need to think about.
But there are also things like daycare, school status, spousal issues. When one returns to the workplace and the other one doesn't. Things like, how do we screen for COVID. So all of these things naturally, are going to induce stress, because of uncertainty. And that is not good.
Slide, Prevent, Identify, Intervene
Now because of all of this, I think it's incumbent upon us to develop strategies. We don't have a proven strategy because we've never been in this situation. So our strategies will need to be nimble, they'll need to be able to flex and adapt. But I think that having a strategy that looks at prevention, identification, and intervention, will be important as we look at our workforce and have them return to the workplace.
Slide, Prevention, a list
In terms of prevention, I think it's important to eliminate or reduce stress. I think that needs to be the cornerstone of the strategy. And I think that a way to do that is to have it hinge on providing a safe workplace. Whether it's through engineering controls, screening, administrative policies, we need to ensure that the workplace is safe. We need to ensure stability. And we need to communicate clearly, honestly, and frequently.
We've explored a lot of different mechanisms of communication and that's good. But we're going to need to keep exploring. How do we communicate to our workforce, that we are trying to keep them safe, that we're trying to provide a stable environment, and that we're on top of it.
Supervisors and managers play a crucial role in this communication process, and in caring for employees. And so I think that what we need to do is ensure that our managers, our supervisors have the tools and that they have been trained to be able to communicate effectively. Things like active listening, things like empathic communication--have always been important, but I think are even more crucial in this new age that we're entering.
The other thing that I think our managers and supervisors need to be good at, is to identify employees who may need some extra help. Most of us as we return to the workplace will be fine, but there will be some of us who need that extra help. Perhaps because we're going through issues at home, because of financial difficulties, emotional issues, social issues. So I think it's incumbent upon us to develop a strategy.
Slide, Are you okay?
A very simple tool that we ought to be using with our employees and with each other is simply asking, are you OK? By asking, are you OK, we may be opening the door to better communication, more open communication. But it also gives us the opportunity to identify those individuals that do need a little bit more help, that do need an intervention that we can point them to. And so I think that this is something that we can start doing today and that we should be doing on a regular basis.
I like to hear, when people ask me if I'm OK. Most of the time I am, but sometimes I may need some extra help, and it's good to know that others are there for me.
Slide, Interventions, a bullet point list
Once we identify those individuals that may need some extra help, then we need to have interventions for them.
And obviously, the interventions are going to depend on the problem at hand. But the sources for those interventions, are the ones that we should always have handy. Things like our employee assistance program, but we may need to reach out to community resources, national resources. I think one of the things that in this time is very important, is to develop and build resilience in each one of us and in our employees.
And so resilience training perhaps available through your EAP or through other resources, is important because it will help us to bounce back. And perhaps bounce back even stronger, as a result of the situation we're in. We'll have a chance to talk a little bit more about this, and we'd like to do that with you.
Slide, Text, The health of the post-COVID workforce will face many challenges. The road map has yet to be drawn. There will surely be unexpected twists and turns, but the opportunity for employers to shape the well-being of workers as they return is a destination that we dare not miss
We're in a challenging situation, but I think this gives us an opportunity to shine as employers--to show our employees that we care about them, that we will protect them, and that they really are part of our everyday success. And we want them to be successful along with us. So thank you Joan, for giving me this opportunity. I look forward to this question and answer now.
Terrific well, thank you Dr. I, it's really, really a nice overview and it's a really serious topic of making sure employees coming back to work feel safe. And just the question of are you OK? That very simple question can really help someone during their day.
So all right, guys now it's up to all of you. We have quite a crowd on the phone, on the Zoom. So two ways to ask your questions. So on the chat feature, you can type it to me. So you have to do it directly to me, and I'll read your question.
Also you can open up your video and audio and you can ask the question. I'll call on you. So wait till I call on you before you ask your question. But do remember that this is being recorded. Just so you're comfortable knowing that it will live on the Travelers Institute website and your question will be there as well, which is fine.
So as long as you're fine with that. But first, you sparked a few questions for me Dr. I, and how is it that our mental health is really connected to our physical health. Is that a real thing? And how does that happen?
Yeah so that's one of the reasons. I'm such a big believer in the biopsychosocial model. Our biology, our physicality, influences our emotions. You see it all the time, when we're in pain, when we have an illness, we're more likely to be depressed. So there's definitely a link there between the physical and the emotional.
But it works backwards too. Our emotions sometimes can give us physical problems. In fact, we're trained as physicians to look out for depression when somebody comes in with unexplained pain, for example, or with fatigue. So it's a two-way street. The emotions can affect our body and our body can affect our emotions.
And we do that all in the context of a social environment, of a milieu, of our family, our community, our workplace. Those things have an effect on how we respond emotionally, but also physically. I remember a number of years ago, there was attention drawn to the fact that we could start treating things like high blood pressure. Something that's very objective, that can be measured. And we could start treating it not just with drugs, but we could treat it through what's called a relaxation response.
As we learn to relax, as we learn to reduce our stress, our heart rate goes down or even our blood pressure goes down. So to many of us that was one of the first insights, into the fact that there's a two way street here. Our body is affected by our thoughts and the other way around.
So my good friend Kate Armfeld, just asked a question here are saying, people often automatically say they're OK, when they're ask. Is there another way to ask that question, to get a more honest response from folks?
Yeah and it depends on who it is you're asking. I think, because for some of us who know our employees very well. I think it may be appropriate to say, hey, I don't see that, I notice that maybe you're more tired than usual or you're more reserved, is something really going on? I'd like to help.
So I think you can do that with some individuals. I don't think it's something that you can approach everybody with. Some of us are going to withdraw if you push too much. So I think there's a balance, and knowing your employees is a good start.
Great OK. And you mentioned the health consequences of being unemployed. So just being unemployed, can you elaborate on that for us we had a question on that?
Yeah we've done a lot of work over the last 20, 30 years on looking at the physical impacts of worklessness. We all know obviously that when we're disabled or somebody is not working, there are certainly-- there are certainly social consequences. Isolation one of them. There are economic and financial consequences. There even emotional consequences and we've paid a lot of attention to those in the past.
But researchers over the last 20 years, have been looking also at the medical consequences of being unemployed, underemployed, or workless. And what we've seen is that there is a two to three-fold increase in medical conditions, like heart disease, like respiratory infections. Even like lung cancer, in populations that are not working.
There is, as we talked about, mental health consequences. And in fact, mental health diseases like depression, anxiety, et cetera, also go up two or three-fold, in that population. But it goes even beyond that, mortality goes up. There's an excess mortality, when you compare a workless population to a working population, suicide rates go up. Things like substance abuse, alcohol abuse, other drug abuse that goes up.
So there was a study a number of years ago that put it in a very memorable way, and it compared being workless to having a 10 pack per day smoking habit. So we usually think, one or two pack a day is a bad habit, is going to cause a lot of health consequences. Well, being workless, not working, can be the equivalent of smoking 10 packs a day. Not good.
That is not good, that is scary. So what about people who have got a couple of questions on this. I'm grouping the questions together they are coming in nicely now on different topics. But one of the topics is, what are the challenges facing employees going back to work?
So the fear of getting infected and a lot of us don't have the luxury of saying, no to our employers we're not coming back today. If there's a date certain, that they want you back in the office. How do you deal with that?
Yeah, I think again, this is where the two-way street between the employer and the employee is so important. I think as employees sometimes we should feel free, to bring up our concerns. And as employers, I think we have a responsibility to listen to our employees. Why do they have the concerns? Is there something going on?
Maybe they're facing particular situation at home, that is different or difficult. Perhaps they are taking care of a sick family member. And their fear is not so much that they're going to get infected, but they might bring an infection back home.
So how do we talk to that employee about what we're doing, why we're doing what we're doing. And whenever possible, obviously, we ought to be following public health authorities, the CDC, our local health departments, for guidance on how to keep our employees safe. And then making sure that we communicate that to our employees. This is what we're doing.
This is why, but I'd like to know why you're concerned and maybe we can fix that too. And again, the particularities are going to be different from situation to situation. But it's important that we not only communicate one-way, but we hear back from the employee as to what the real issue might be.
OK, thank you for that. I have a terrific question now from Stephen Lamb, and I think we're all dealing with this and especially some of our adult children might be dealing with regard to colleges. And accepting that offer, to go to college. So Stephen Lamb, says, are the do's and don'ts, we should be aware of during this pandemic regarding life changes. How should we navigate our decision making about life changes and challenges now?
So should we think about it through a different lens than we normally would have? For example, someone who's getting ready to go off to college and deciding do I really want to do online classes? And parents kind of having that conversation with a child to say, you might want to wait a year, take a gap year. How should you evaluate your decision making in this pandemic world?
Yeah, great question. And I don't know that there's a clear answer, but whenever we're in situations that are not normal and this definitely is one of those. I think we need to think long and hard about the types of decisions that we would have made otherwise, in a very routine fashion.
So I think this is where taking a step back, taking stock of who you are. What your options today are, what they might be in the future, is so important. And I think that part of the wisdom in making those decisions, is certainly in reaching out to others. Don't make decisions on your own, give yourself the luxury of time, because you may not need to make a decision today.
You may take several days or several weeks in making a decision, enlist support. Go to those people that you trust, hear from them. And know that even decisions like college and decisions like new jobs, are not irreversible. So give yourself the luxury of being able to be wrong. But at the same time of being able to take some chances that maybe you wouldn't have taken before.
Great OK, I think that's smart advice. And young folks don't know that things don't last forever, you can change your mind, you can pivot. And life is very long, right?
And this may be a great opportunity, right? You may not have taken that risk before, but in the middle of this circumstance, where all of us are facing uncertainty, it's OK, to take a gamble, to take a risk, you don't have a lot to lose.
OK, another great question coming in now from Stuart Ferguson, saying, what norms do you see developing-- new norms in our new normal situation with clients or policyholders, with contact for sales, risk management meetings. Just the normal agent broker going into a client, doing a risk management assessment. And how is that going to change going forward do you think?
Well, I think again, the primary caution--the primary thing that needs to be foremost in our mind is, how are we going to keep ourselves and those who we interact with safe. So are we following the guidance of the CDC, of our health department? Do we have strong protocols around infection prevention--around transmission prevention?
Do we use perhaps a questionnaire? Do we ensure that there is social distancing? The things that we've been hearing about right from the beginning, are still the things that are going to get that are going to help us through this.
Are we social distancing? Are we washing our hands? Are we having contact precautions? I think those things are going to be with us for a very long time. And I think, a lot of us have thought or I've heard a lot, especially towards the beginning. This is just going to be a matter of a few months.
Unfortunately, I think we're going to be in this situation for the foreseeable future. So we're going to need the change, we're going to need to use technology better. And technology--whether it's meeting technology, or apps that help us with wellness evaluations. Should we meet someone today?
Or perhaps not if I have a fever, perhaps not if I've had a cough, a new cough. Perhaps not if I've come into contact with others. So how do I meet with a broker? How do I meet with a client, otherwise? Well, let's use technology app, because that may keep us safe.
And in terms of wearing masks. So we can ask going to put a mask on to protect--I can ask you today to put a mask on, that's OK, that's a socially acceptable norm, right?
I think you should. And again, remember masks are also a two-way street. I wear a mask, to protect myself and to protect you. And so it's the professional thing to do. It's the courteous thing to do. It's the right thing to do, for me to wear a mask, in order to protect my client, my coworkers, and the average person I meet out on the street.
OK, so how do we--this is from Alicia Sandbridge, how do we build resilience and tools from managers, that are helping their employees with these stressor situations, when they're experiencing those same concerns themselves. So we're asking our managers, to help employees get through this, yet they too are experiencing the same things.
Yeah, and that's a drawback, but also an advantage, in that we're all in this together. So as we ourselves learn, we can communicate that to our employees and to others. This isn't just about employees, we can communicate it to our friends, to our family. So whenever you're taking care of others, there's the maxim you always have to take care of yourself first. You're not going to be a lot of good to others, if you're not in a good state.
So we need to take stock ourselves. Do I need some resilience training? How am I managing anxiety? How am I managing stress? Am I depressed?
How am I sleeping? And do I need to take care of that myself? As I learn that, can I then communicate that to others. So there's no--we need to avoid a feeling of pride. I need to be able to come to others and say, hey, I need help, and I'm going to help you along--I'm going to be with you alongside you, as I'm getting help myself.
So I think that's OK, and I think companies that are providing resilience training--whether it's obviously it's virtual, but it's live or through recorded sessions, or even making apps available to their employees. Are giving them those tools to build resilience, to deal with these situations as individuals, but also as a community.
OK, another question here. And this is a really important one, and a good one. I'm going to say, it's from anonymous, because I don't want to name the person. But this could be a lot of people's mind. How does one suffering with depression, deal with a social stigma, and barriers at work and home, that may prevent someone from seeking the help they need. This is a tough one.
Yeah it is. And I think--well, I'll address that in a minute. I think this is an important one for all of us to hear, because we may be stigmatizing others, and we need to make sure that we don't. We need to understand, that there are a lot of people hurting out there.
And we need to be more open than we've ever been before, because again, I think the situation is graver than it's ever been. So I think that question, is not an easy one to answer. But I'd like to point us to the fact that we should not be part of the problem, we need to be part of the solution.
I think for the individual who is depressed, it's very hard to get out of that on your own. And you need to seek out, those who will help you. Certainly, those around you, those who care for you, your family, your friends. But you will also need in many cases, in most cases, the professional help.
Fortunately, professional help today is more and more available. Not only through things like EAP, but even through apps. But also, through telehealth, and that is something that we need to avail ourselves of.
So you may not be able to go see a mental health professional in person and depending on where you are and your situation. But there's more and more of that available virtually, through things like telehealth. And I think that we need to make ourselves-- we need to reach out and get that help, because you're not going to do it on your own. You need the help of those around you and of professionals.
OK, here's a good one it's a really good one. What do you suggest are some of the best distressing techniques? What can we do today, when we get off of this Zoom call to distress ourselves, and our families, and our employees? What do you suggest?
Well, one of the foundations of medicine is always get rid of things that caused the problem. And I have to tell you this is something that I've been doing, and I need to do more of. And that is, eliminate stress by reducing the amount of news that you watch, listen to, or read.
And I mean that very seriously. I think that I mentioned earlier, the speed and volume of the news coming at us has been overwhelming to many of us, and that has caused stress and the fact that we get different views and we never have the right answer, because there aren't easy answers today. We need to distress, and part of that is going to be unplugging from media. Dosing our news intake, very consciously.
So that is one--that's one thing that we can do. But I think we need to do other things. We need to take care of ourselves. Our self, our emotional self, our physical self, we need to be active.
A lot of us have stopped. Maybe doing some of the activities we were doing before, whether it was running, or walking, or hiking. We need to find things that are pleasurable, that are good for us. We need to take care of our sleep.
So if you're having problem with sleep and many of us are, we need to look at programs that help us with that. Things simply called sleep hygiene. How do I sleep better? Do I need more intensive solutions to my sleep problem, like cognitive behavioral therapy?
But then other things that I can do, are find things that are pleasurable. Do I like to read? Do I like the Journal? Do I take up a new hobby? Maybe painting. Maybe whatever is pleasurable to you.
And then there are many, many techniques that we can learn. Things like deep breathing exercises, things like visualization techniques, mindfulness, meditation, prayer. All of these things are important. What's more important is, find the one or two that help you and that you're willing and able to do, and that you do regularly. And I think, that will help with stress and stop watching the news.
Now turn off that cable TV. I've said that a number of times in my speeches, I couldn't agree with you more. So this is maybe a sensitive one, but I'm going to read it and I'd love your thoughts on it. How do you address cultural synchronicities?
As a component of reintegration. So we all come from different cultures, different backgrounds and we all accept stress and have resiliency and different levels. So what about cultural idiosyncrasies?
Sure, and again, COVID because it's a worldwide problem. And we've been seeing it develop over a period of months in different places has been a laboratory to look at that. We see some. We see some cultures, that are much more rule oriented, and they behave very differently than cultures maybe a little bit more like ours that are more rule breaking. And so this is something that we experience even in this country.
Are there some of us who tend to be more rule breakers than rule makers, or rule followers. There's going to be a difference in how we respond to the infection itself, to the transmission, to the--
And how does that breakdown? So if you're--everyone in their mind, there's 350 some people and you're either a rule breaker, you're pushing the limits, or you're a compliant person. And so how does that--how does that break out for us?
Well, I mean we're seeing that aren't we Joan? And we're seeing it state by state, city by city, neighborhood by neighborhood. In some cases, people don't want to wear masks, that's a rule breaker.
There is going to be areas or other people, that are much more. Now we need to follow the rules, I'm going to be less accepting of deviation from the norms, from the social norms. And I'm going to wear a mask, and I think everybody should wear it.
So when you have those two very different ways of looking at the world, you're going to have conflict. And that's one example of a cultural, of a cultural issue going on right now, all over this country. How do we bridge that?
Well, part of cross-cultural communication, is listening to the other person. Having empathy first of all, I care about what you feel, I care about how you see things, so I'm going to listen to you. I'm also going to ask about your story, I'm curious about your side of the story.
And so this isn't just rule breakers and rule makers, I mean this is any culture. This is how we bridge those gaps. Is let's listen, let's ask in a respectful manner. And then underlying all of this is that respect.
I respect your opinion. I respect and give you the opportunity to speak candidly. And hopefully as we do that, we're going to come up with a mutual solution or solution that's mutually beneficial and acceptable.
So there's an art to that and I think we need to engage in that more and more, as opposed to just saying. I'm in this camp, you're in that camp, and we can't talk about this. We're just going to yell at each other.
Right. So do you see companies--actually we've got a couple of questions here about resources. Where to turn for resources? We all know the CDC website and others for the medical side, but what about resources available to employees. Do you see employers providing this mental health much more widely now or PTSD support in the workplace?
I do. There's been a lot of very good news coming out on that front. And I would ask you to go to the Mental Health America website, because what they've done is they've highlighted a lot of different employers large, medium sized, smaller employers. And what they're doing in response to the mental health needs of Americans today.
And so some of the things that we're seeing are increased mental health benefits. We're seeing how companies are dealing with communications. Communications at all levels in the company. How they're dealing with resilience programs. How they're beefing up their wellness programs, their employer assistance programs.
I've seen a lot in terms of resilience building, and I think that's great. I think companies have been successful when they have allowed their employee population to share their stories. So it's part of building that community support, keeping some of the social isolation away from the workplace.
So I'd really encourage all of you to go to Mental Health America, because they've done a really good job of highlighting a lot of companies that are doing very good things. You might get some ideas for your company. And I certainly applaud Mental Health America, and all of our companies that are really trying to do the best in this world that we've never been in before.
Right, I agree. So I'm going to ask the audience. If you have a question you want to turn on your video, now would be a really good time to go to the participant button at the middle of your screen and raise your hand.
If you raise your hand, we're going to recognize you and you can ask your question live. I have a number of questions coming in still. So I'm going to go to the next question. But if you're a brave enough soul to go ahead and raise your hand, we'll recognize you live.
So this comes from Charlie Borchenko. What do you--what does Dr. I, think about testing and a false sense of if your test says it's negative, couldn't you the next day go to a grocery store or contract COVID the very next day. Are you worried about people feeling overconfident that they've gotten a negative test?
Yeah, no question, and that's true of any test. But we can--so somebody can get infected not know it and not test positive for a number of days. Most symptoms start occurring at around day 5 after exposure. The test, the PCR test, which is the immediate test that looks for the virus itself, doesn't usually become positive for the first couple of days.
So at day 1, after exposure, a negative test is not very helpful. At day 2, it's a little bit less of a problem, but it still may not be positive. So we can't rely only on testing, we have to rely on exposure. We have to rely on symptom analysis.
So have I been exposed knowingly, exposed that I need to be more careful. Do I have symptoms today? Fever, chills, cough, headache, loss of taste loss, loss of smell, then I really might have it and I need to be careful of not exposing others.
OK, thank you for that. So another good question for my friend Matt Gunter, here. How can we build a sense of community with all of our employees, our disparate employees working from home?
How do you maintain that culture of an organization and a sense of community? Engagement is important right? Engaged employees are much better performers. And how do we get engagement back in our lives?
And I think a lot of companies are doing a really good job of this. As I mentioned earlier, communication at all levels of the organization--from the CEO to your manager, are you hearing from them? Are you sending out regular communication?
Are you using all different types of media, email, blogs? Are you doing video like this--virtual meetings? I think it's great that a lot of companies are encouraging virtual social events.
Are you encouraging community involvement--even again, done virtually or done electronically? I think those are all ways that we can build that. And then have a forum where those stories are shared with each other, so that we can hear what somebody else did and may be able to replicate that.
Great, so saying no one raising their hand on my screen here, I am going to go ahead and close the program. We had a terrific conversation. And thank you so much Dr. I, for these really important suggestions for us to focus on our employees’ mental health, our own mental health, stress and anxiety.
Please do go to some of these resources that he did talk about--obviously, the National Suicide hotline, another 9-1-1. There's lots of resources out there for you.
So Dr. Marcos, do you want to have a closing word before I tell all the audience members about our next webinar coming up on August 5th and the topic we're going to talk about. Is there anything else, you feel you needed to add?
Slide, Wednesday, August 5, 2020, 1 to 2 P M E D T. Liability Issues for Businesses in the Time of COVID-19
No, thank you. Please avail yourself of resources. The more you have at your fingertips, the more you're going to be able to help others and help yourself. There are really good resources. I think the CDC website, has done a wonderful job of summarizing and linking to many of these that are available for you for free.
Great, so if you want any more information about this topic or others first of all, please go ahead and read on the Travelers Institute website, Dr. I's important paper, for other resources. If you want more information specifically about our Wednesdays with Woodward webinar series. It's also at travelersinstitute.org. So mark your calendars for our next one.
Again, we're doing these every two weeks. So August 5th, we'll have our next webinar, and the conversation is going to really focus back on the business about liability issues for businesses. And we're going to include terrific people like Yafit Cohn, a brilliant mind in our legal department at Travelers, as well as Harold, at the Harold Gen, at the US Chamber of Commerce Institute for Legal Reform. And they're going to be with us talking about all the liability issues that your businesses are going to face, as you reopen.
And also legislation moving through Capitol Hill, and talking about what could get passed and what couldn't get passed--in the next week or so, a couple of weeks or so, regarding liability issues for businesses. So again, we're going to talk about softer side issues like we did today and then the hard-core litigation issues.
We're going to talk about managing your career through these difficult times. We're going to talk about all sorts of other issues on Wednesday. So please do join us and please pass these invitations, to anyone in your organization that you feel would benefit. So thank you for your time today, and we appreciate you joining. Take care.
Dr. Iglesias highlighted three areas of focus for an individual’s health: biological, psychological and social.
- Biological health includes direct medical consequences, such as contracting COVID-19, and indirect consequences, like people delaying routine medical care for fear of contracting COVID-19 at a doctor’s office.
- Psychological health takes form in many ways, including emotional, cognitive and physical stress. Mental Health America has reported a 19% increase in screening for clinical anxiety since the beginning of the pandemic. Dr. Iglesias explained that new sources of stress, such as fear of infection, personal or family issues and financial stress, need to be considered as employees return to the workplace.
- Social health is an important factor as well, as people continue to social distance, gather less in groups and have less frequent interactions with co-workers. Some employees will continue to work remotely longer term and may need extra attention to keep them engaged virtually.
Dr. Iglesias laid out his three-pronged approach to avoiding distress in the workplace: prevention, identification of those at risk and intervention.
- Prevention: Offering a safe environment for employees by reassuring them that their safety and well-being come first. Keys to prevention involve providing stability by letting employees know what to expect as they return to the workplace; communication that is timely, factual, clear and supportive; flexible work arrangements, which can help reduce stress for those dealing with personal issues; and emotional openness built into employee interactions.
- Identification: A simple “Are you okay?” can open the door to better employee communications between co-workers and managers. Supervisor training should be focused on: active listening and empathic communication, identifying employees with depression and other issues, handling accommodation requests, and managing the stigma of COVID-19 and mental health issues.
- Intervention: Different follow-up actions are needed to handle physical and mental health in a post-COVID world. Access to telehealth can be an important health care strategy post-COVID, including audiovisual tools, patient portals, e-consults, apps, chatbots, etc. In addition, resilience training to focus on building connections, fostering wellness with nutrition, exercise and sleep, and stress management can help reduce depression and anxiety. Employers can achieve many of these action items through Employer Assistance Programs (EAPs) or by referrals to external organizations specializing in these areas.
Read Dr. Iglesias’s white paper on this topic here.
Vice President & Chief Medical Director, Travelers
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