Telework Before Illness Onset Among Symptomatic Adults Aged ≥18 Years With and Without COVID-19 in 11 Outpatient Health Care Facilities — United States, July 2020

Fisher, Kiva A.; Olson, Samantha M.; Tenforde, Mark W.; Feldstein, Leora R.; Lindsell, Christopher J.; Shapiro, Nathan I.; Files, D. Clark; Gibbs, Kevin W.; Erickson, Heidi L.; Prekker, Matthew E.; Steingrub, Jay S.; Exline, Matthew C.; Henning, Daniel J.; Wilson, Jennifer G.; Brown, Samuel M.; Peltan, Ithan D.; Rice, Todd W.; Hager, David N.; Ginde, Adit A.; Talbot, H. Keipp; Casey, Jonathan D.; Grijalva, Carlos G.; Flannery, Brendan; Patel, Manish M.; Self, Wesley H.; Hart, Kimberly W.; McClellan, Robert; Tan, Hsi-nien; Baughman, Adrienne; Hennesy, Nora A.; Grear, Brittany; Wu, Michael; Mlynarczyk, Kristin; Marzano, Luc; Plata, Zuwena; Caplan, Alexis; Ogokeh, E.; Smith, Emily R.; Kim, Sara S.; Griggs, Eric P.; Richards, Bridget; Robinson, Sonya; Kim, Kaylee; Kassem, Ahmed M.; Sciarratta, Courtney N.; Marcet, Paula L.

Since March 2020, large-scale efforts to reduce transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19), have continued. Mitigation measures to reduce workplace exposures have included work site policies to support flexible work site options, including telework, whereby employees work remotely without commuting to a central place of work.* Opportunities to telework have varied across industries among U.S. jobs where telework options are feasible (1). However, little is known about the impact of telework on risk for SARS-CoV-2 infection. A case-control investigation was conducted to compare telework between eligible symptomatic persons who received positive SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test results (case-patients, 153) and symptomatic persons with negative test results (control-participants, 161). Eligible participants were identified in outpatient health care facilities during July 2020. Among employed participants who reported on their telework status during the 2 weeks preceding illness onset (248), the percentage who were able to telework on a full- or part-time basis was lower among case-patients (35%; 42 of 120) than among control-participants (53%; 68 of 128) (p<0.01). Case-patients were more likely than were control-participants to have reported going exclusively to an office or school setting (adjusted odds ratio [aOR] = 1.8; 95% confidence interval [CI] = 1.2-2.7) in the 2 weeks before illness onset. The association was also observed when further restricting to the 175 participants who reported working in a profession outside the critical infrastructure†(aOR = 2.1; 95% CI = 1.3-3.6). Providing the option to work from home or telework when possible, is an important consideration for reducing the risk for SARS-CoV-2 infection. In industries where telework options are not available, worker safety measures should continue to be scaled up to reduce possible worksite exposures.