Treatment with the antiviral combination nirmatrelvir–ritonavir (Paxlovid) was associated with fewer lost workdays and lower disability-related costs among US employees at high risk for severe COVID-19, according to a retrospective observational study in the Journal of Medical Economics.

Using insurance claims and workplace productivity data from large US employers, the researchers, led by scientists from Paxlovid maker Pfizer, compared productivity outcomes among high-risk employees diagnosed as having COVID who either received Paxlovid within five days of diagnosis or received no antiviral. 

Analyses of absences among treated and untreated workers and those on short-term disability (STD) and long-term disability (LTD) included 1,909, 20,065, and 20,318 employees, respectively. The study included data from December 2021 through December 2022, a period dominated by Omicron variants.

After 1:1 matching on age, sex, comorbidities, timing of infection, and baseline health care use, employees who received Paxlovid had 5% fewer workday absences, 17% fewer STD days, and 27% fewer LTD days per patient per month than untreated employees. 

Monthly absence-related costs per treated worker were $434 versus $468 in their untreated counterparts, and daily costs were $84 versus $108 in treated versus untreated STD workers and $4.39 versus $7.35 for treated and untreated LTD staff.

Health care costs 2 to 3 times higher for infected workers

COVID has remained a major driver of disability claims and lost productivity. The authors note that direct health care costs for those diagnosed as having COVID were two to three times higher than those of controls in the six months following infection.

They noted that the analysis was restricted to employees of large, self-insured firms and may not generalize to other workers or those with different insurance status. 

“Although findings indicate modest cost savings at the patient level, these savings could be substantial at the employer level, especially for employers with substantial populations of employees with specific comorbid conditions such as diabetes, overweight and obesity,” the researchers concluded.

Two genetically unrelated US outbreaks of Listeria monocytogenes infections linked to packaged salads from two different firms caused 30 illnesses, 27 hospitalizations, and four deaths over eight years, according to a new report by Centers for Disease Control and Prevention researchers and collaborators published in Emerging Infectious Diseases recently. 

Though the two outbreaks were genetically unrelated, they were investigated concurrently: Outbreak A was investigated three times with illnesses occurring over eight years, whereas illnesses in outbreak B occurred over five years. 

Outbreak A was detected via PulseNet in 2019, initially with five cases identified in five states. The investigation ended within that year, but was reopened when other states had similar detections via PulseNet in 2020 and 2021. 

Outbreak B began in 2021, when PulseNet identified a cluster of 10 clinical isolates related to water-sediment isolates collected in the Salinas Valley of California. That outbreak was tied to 10 cases in eight states (Illinois, Massachusetts, Michigan, New Jersey, New York, Ohio, Pennsylvania, and Virginia). 

Outbreaks show potential risk of packaged salads

“In the outbreaks described, packaged salad exposure was easily identified, but narrowing the source to a single firm was difficult because leafy green processors are often associated with multiple brands and can have similar packaging,” the authors wrote. 

Both outbreaks highlight the ongoing potential for L. monocytogenes infections as a result of consuming contaminated packaged salads

Routine surveillance and actions taken by the producers of the bagged salads saved lives, they noted. 

“Both outbreaks highlight the ongoing potential for L. monocytogenes infections as a result of consuming contaminated packaged salads, especially for high-risk consumers,” the authors added.