Grand Rounds Blog

Preventive health screenings and having access to the flu shot can reduce the serious health impacts of COVID-19.


Unfortunately, preventive health screenings across the nation have plummeted by nearly 70% since the pandemic started, depending on the type of test. Preventive health screenings are tests that are conducted when a person is feeling well, to enable early detection and treatment of some serious conditions that may initially have no symptoms, such as cancer, high blood pressure, high cholesterol, etc. If these illnesses go undetected, this may lead to negative health outcomes in five to 20 years, like strokes, heart attacks or kidney failure. But these conditions can also have a very short-term impact—they can increase the likelihood of hospitalization and death due to COVID-19 in the upcoming year.

As we’ve learned with this pandemic, regardless of age, a person’s underlying health matters: people with pre-existing underlying conditions have worse outcomes if they get infected with COVID-19. So if someone has a pre-existing condition, like diabetes, obesity or high blood pressure, getting those under control is an important preventive measure. For example, studies have shown that poorly-controlled blood sugars in diabetics increases the severity and mortality if they have COVID-19. Other studies have suggested that COVID patients with high blood pressure, who were already taking certain blood pressure medications, had better outcomes. All of this suggests that knowing in advance about a certain condition and getting appropriate treatment will reduce a person’s risk of severe illness (including hospitalization, intensive care and death), in the event of a coronavirus infection.

The problem is, many people with high blood pressure, diabetes or cancer don’t know they have the condition. For example, according to the CDC’s 2020 report on diabetes, nearly one in five adults living with diabetes in the U.S. didn’t know they had the condition. In addition, of the estimated 88 million American adults with pre-diabetes (abnormally high blood sugars bordering on the diabetic range), nearly 85% were unaware of their condition. As for hypertension, CDC estimates that 45% of adults in the U.S. have high blood pressure and about 20% of them don’t know it.

So these people may have no idea that they are at higher risk for severe COVID illness. This could impact how seriously they take coronavirus prevention measures like mask wearing and distancing, as well as decrease their ability to bring their underlying conditions under control. And for employers, this lack of awareness could severely impact healthcare costs. With such large proportions of the American workforce potentially unaware of their elevated risks, the numbers of employees experiencing COVID-related hospitalization, ICU stays or post-COVID disability may place enormous strain on companies of all sizes.

With COVID in the picture, preventive health is no longer just about long-term ROI – it may actually impact a business’s healthcare spend in the upcoming year.

This impact may be even greater as we head into winter, which, in colder states, will drive people indoors and may increase the likelihood of coronavirus transmission. Winter is also the season when other respiratory viruses, like influenza, are circulating, which increases the possibility of co-infection and potentially even more serious outcomes. One study of over 1,000 patients at Stanford suggested that about 20% of patients with COVID were co-infected with another respiratory virus. So it may be possible to be infected with both coronavirus and influenza, which could cause greater morbidity for those with undiagnosed underlying conditions. Therefore helping employees access the flu vaccine, along with appropriate preventive health screenings, takes on greater urgency in the upcoming weeks.

The bottom line is this: it is crucial for employers to promote preventive health now.  

Because if employees know they have a condition, they can do something about it—whether it be diet, exercise, medications, flu vaccination or more stringent mask-wearing. And improving their health today will not only enhance their productivity and outcomes in the long term—it can reduce their risk of COVID-related hospitalization and death right now. 

Many employers have asked us “how?” The pandemic has certainly made it challenging to access in-person care, or has made people afraid to seek preventive care. And traditional telemedicine typically only provides “tele-urgent” care, but not wellness checks or preventive screenings. Employers should consider investing in virtual care options that have a more primary care rather than urgent care approach, in that they offer screening and long term follow-up. In addition, consider partnering with organizations that offer mail-in or home-based screening tests or vaccinations. Create communications for employees about the importance of getting age-appropriate preventive screenings and flu vaccines, whether through their existing doctor or through a virtual/home-based option. Directly communicating the importance of preventive health in reducing COVID severity, and offering creative remote solutions, can spur employee action. For example, to an employee in their 30’s, the idea of detecting and controlling high blood pressure now, in order to prevent a heart attack in their 50’s may seem less urgent than identifying and controlling their high blood pressure now, to prevent hospitalization or death from COVID.

For most businesses, thinking through these issues and communicating them successfully to employees can be the key to navigating this pandemic. At Grand Rounds, we have virtual Chief Medical Officers ready to help you think through these types of issues as our nation returns to work.

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