Essential Worker Absenteeism

This project was incepted at NetCOVID seminar where I was a part of the original team. Essential worker absenteeism has been a pressing problem in the COVID-19 pandemic. Nearly 20% of US hospitals experienced staff shortages, exhausting replacement pools and at times requiring COVID-positive healthcare workers to remain at work.

Weekly unit absence percentage (bars) by hospital unit type and total HCW incidence (magenta line). Unit types are Gen, general; Int, intermediate; and ICU, intensive care. COVID-related absences are dark shades. Pre-COVID 2019 absences are black dashed lines. Units with less incidence— counterintuitively COVID (Cov) units—generally had more PPE use (N95 masks) between HCWs, fewer staff shortages, and minor excess absenteeism. Universal surgical mask (but not N95) use and patient (but not HCW) screening were hospital-wide policies. N95 masks and break-room distancing between HCWs were introduced in Gen1 and Gen2 units in the second and the third week, respectively, but were in use from week 0 in Cov units [1].

The aim of this project is to develop a data informed model examining different staffing strategies affect epidemic dynamics on a network in the context of rising worker absenteeism, with a case study of a COVID-19 Hospital in Central Florida using real data. While the case study is a hospital, results can be applicable to any essential organization that is facing worker absenteeism. Particularly, we looked at worker replacement with external workers against redistribution of work among remaining healthy workers. We found a time-varying tradeoff: Worker replacement minimizes peak prevalence in the early phase, while redistribution minimizes final outbreak size. Any “ideal” strategy requires balancing the need to maintain a baseline number of workers against the desire to decrease total number infected. We show that one adaptive strategy—switching from replacement to redistribution at epidemic peak—decreases disease burden by 9.7% and nearly doubles the final fraction of healthy workers compared to pure replacement.

[1] - Aguilar E., Roberts N.J., Uluturk, I., Kaminski P., Barlow, J.W., Zori, A.G., Hébert-Dufresne, L., Zusman, B.D. (2021). Adaptive staffing can mitigate essential worker disease and absenteeism in an emerging epidemic. Proceedings of the National Academy of Sciences, 118(34). Download