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Work and the Coronavirus

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Helping people understand how COVID-19 affects work and employment by sharing insights and help from ILR's workplace experts.

Cancer, COVID-19 and Return to Work

A man seated at a table in a room with windows, working on a laptop.

Shaun Roberts

COVID-19 continues to wreak havoc on the global economy, disproportionately harming communities of color and essential workers. The United States currently has 4.59 million confirmed cases, but states are pushing to reopen in an attempt to salvage the economy and restore normalcy.

However, reopening too soon can exponentially amplify the catastrophe; this is especially true for cancer patients. Cancer and its treatments are a large underlying condition and risk factor for millions of Americans; The National Cancer Institute estimated that 15,760,939 people in the U.S. were living with cancer in 2017 and approximately 1.8 million new people would be diagnosed with cancer in 2020. When considering policies for reopening, employers must factor in their immunocompromised employees and their employees living with immunocompromised individuals.

Cancer treatments inherently result in the individual becoming immunocompromised, and to experience the treatments during a global pandemic while having high levels of contact with hospitals exponentially raises one’s risk for COVID-19. Two studies have been published showing that cancer patients with COVID-19 have one of the highest mortality rates. A United Kingdom study found that there will be an increase in preventable deaths due to diagnostic delays. The Covid-19 Cohort Monitoring Team is developing a system of care for cancer patients with COVID-19 that limits their contact with the hospital and is developed off an existing system to monitor the side effects of chemotherapy; the program is demonstrating encouraging results, but is strongly dependent on social distancing.

The limited research on cancer patients and COVID-19 illustrates a significant need for specific accommodations for patients that encourage social distancing. However, the U.S. Centers for Disease Control and Prevention has revised its list of medical conditions that cause increased risk to include cancer on July 17th, 2020. Until then, cancer patients and patients recently in remission were not considered high-risk individuals.

This has serious implications for the workplace. Without the CDC classification, it is more difficult for workers to petition their workplaces to work remotely as their states reopen. For example, the United Federation of Teachers uses the CDC list as the guidelines for its employees to apply for medical accommodations. In addition, it clarifies that the accommodations only apply for the workers' own disability, and if it is someone in their household who is at high risk they are not eligible for accommodations and should consider alternatives such as leaves. Situations like this could force people to choose between their jobs and their partners' health, and are abhorrent during a global pandemic. Programs like the Covid-19 Cohort Monitoring Team are reliant on safe households.

In my research, acknowledging this is an unprecedented situation and there is not a lot of research- it is ambiguous what a newly in remission cancer patient's immunocompromised status is. It can take up to 28 days to regain immune system strength after one’s last treatment. This month could be deadly to a survivor during the pandemic. Workplace policies should be flexible and accommodating, as long as the individuals and their doctors deem it necessary to work remotely.

The intersection between COVID-19, cancer patients and the workplace is important. Whether the patient is recently in remission and regaining their immune system or still receiving treatments, it is of the utmost importance that their households remain uncompromised. This requires compassionate policies that allow for the entire household to work remotely. The United Federation of Teachers is not the only organization that only provides accommodations for an individual's risk and not their entire households. This needs to change if we want to protect one of America’s most vulnerable populations.

I urge employees to be compassionate with requests to continue working remotely and with the continued leave of both cancer patients and members of their households. Going forward, I believe employers should expand their accommodations policies to include people living with immunocompromised individuals.

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