Cost Implications from an Employer Perspective of a Workplace Intervention for Carer-Employees during the COVID-19 Pandemic.

In developed countries, population aging due to advances in living standards and healthcare infrastructure means that the care associated with chronic and degenerative diseases is becoming more prevalent across all facets of society-including the labour market. Informal caregiving, that is, care provision performed by friends and family, is expected to increase in the near future in Canada, with implications for workplaces. Absenteeism, presenteeism, work satisfaction and retention are known to be worse in employees who juggle the dual role of caregiving and paid employment, representing losses to workplaces' bottom line. Recent discourse on addressing the needs of carer-employees (CEs) in the workplace have been centred around carer-friendly workplace policies. This paper aims to assess the potential cost implication of a carer-friendly workplace intervention implemented within a large-sized Canadian workplace. The goal of the intervention was to induce carer-friendly workplace culture change. A workplace-wide survey was circulated twice, prior to and after the intervention, capturing demographic variables, as well as absenteeism, presenteeism, turnover and impact on coworkers. Utilizing the pre-intervention timepoint as a baseline, we employed a cost implication analysis to quantify the immediate impact of the intervention from the employer's perspective. We found that the intervention overall was not cost-saving, although there were some mixed effects regarding some costs, such as absenteeism. Non-tangible benefits, such as changes to employee morale, satisfaction with supervisor, job satisfaction and work culture, were not monetarily quantified within this analysis; hence, we consider it to be a conservative analysis.

Decision-making in Surgery or Active Surveillance for Low Risk Papillary Thyroid Cancer During the COVID-19 Pandemic.

We describe our experience conducting a prospective observational cohort study on the management of small, low risk papillary thyroid cancer during the COVID-19 pandemic. Our study participants are given the choice of active surveillance (AS) or surgery, and those in the AS arm are followed at the study center, whereas surgical patients undergo usual care. During the pandemic we have transitioned from in-person research patient visits to largely virtual care of patients under AS. As of 30 October 2020, we had enrolled 181 patients enrolled in our study (including 25 during the pandemic), of which 92.3% (167/181) consented to telephone communication and 79.0% (143/181) consented to secure videoconferencing communication. Prior to the pandemic, 74.5% (117/157) of our patients chose AS over surgery, whereas during the pandemic, 96.0% (24/25) chose AS. Of the 133 study patients who were under AS within the timeframe from 12 March 2020, to 30 October 2020, the percentage of patients who missed appointments was 8.3% (11/133, for neck ultrasound and physician visits, respectively) and delayed appointments was 23.3% (31/133). This preliminary data suggests that prospective observational research on AS of thyroid cancer can safely continue during the pandemic.