Writing for the Harvard Business Review, Jeff Levin-Scherz, Patricia Toro, Siupo Becker, and Meg Alexander of WTW detail six considerations for employers to create effective policies that help protect workers from monkeypox.

Monkeypox: The best-case (and worst-case) scenarios

1. Risk of transmission is low in a majority of workplaces

Monkeypox's primary method of transmission is through direct skin-to-skin contact with individuals who have skin sores. While the majority of reported infections are currently among men who have sex with men (MSM), skin contact or exposure to coughing or sneezing from an individual with the monkeypox rash can also lead to transmission. In addition, exposure to clothing or linen that has touched skin lesions can also lead to infection.

"Employers can take concrete steps to lower the risk of workplace monkeypox transmission," the authors write. "They can promote contact-free greetings and continue to encourage hand-washing and provide hand sanitizer."

2. Employers should create a monkeypox-response policy

According to the authors, managers should be able to access protocols to help protect employees with minimal workplace disruptions. "A monkeypox-response policy can help address employee safety, as well as business continuity and privacy needs," they add.

If an employee is exposed to the virus, they can still come to work safely. However, they should monitor for 21 days post-exposure for any symptoms, including a fever over 100.4 degrees Fahrenheit, chills, swollen lymph nodes, muscle aches, and skin lesions.

If an employee develops any of these symptoms after exposure, the authors note that they should seek medical attention before returning to the workplace.

"People diagnosed with monkeypox should seek medical care and must isolate at home until cleared by public health authorities," the authors write. "They can work remotely if their work does not require their physical presence at the worksite, but some patients will have severe pain or other symptoms that will make them unable to work during isolation."

Employers should disinfect spaces that were recently occupied by an employee with monkeypox, paying special attention to door handles, toilet flush handles and seats, faucets, light switches, and floors, the authors write.

3. Rely on state and local health authorities for prevention and treatment efforts

Providers and laboratories are responsible for reporting monkeypox cases to state public health departments. "Public health authorities will attempt to identify and notify individuals who have been exposed so that they may be vaccinated, monitored for symptoms, and, if necessary, seek treatment," the authors explain. 

While employers are not required to report cases, local and state public health departments can be a helpful resource in the event of a workplace exposure.

4. Monkeypox may disrupt the workforce

Workers are encouraged to use paid time off (PTO), including sick leave, to stay home when they are ill—but the weekslong isolation for monkeypox will surpass many employees' available PTO days.

"Employers can help by offering supplemental sick leave to those who are isolating, although this requires employees to report their diagnoses, which poses privacy challenges," the authors write.

Employers may also want to make a plan that helps employees who are diagnosed while traveling for work safely isolate for up to four weeks.

5. Ensure proper communication and avoid stigmatization

"Employers are a trusted source of health information and can demonstrate their concern for employee well-being by delivering accurate communication about monkeypox," the authors write.

In the event of a workplace exposure, employers should communicate promptly, while ensuring full confidentiality of any infected or exposed employees.

"Fact-based, nonjudgmental communication that is inclusive and doesn't stigmatize will help make people feel comfortable reporting monkeypox and will avoid creating a sense of false security among those who are not gay or bisexual men," the authors write. "Recommendations should be concise and practical."

6. Monkeypox guidance will adapt with additional information

In the coming months, "[o]ur understanding of transmission and the best measures to curtail spread and treat disease is likely to change," the authors note. "Vaccine access will improve, and more antiviral agents will become available. The virus could also develop mutations that alter its severity or transmissibility."

To ensure that workplace policies follow the most accurate information, employers should anticipate changing guidelines as better data becomes available. They should monitor updates from reputable sources, including CDC and the World Health Organization.

"Given that monkeypox is less contagious and less deadly than Covid-19, it will not cause the level of economic dislocation seen in the Covid-19 pandemic," the authors write. "Nevertheless, it has the potential to disrupt workplaces, and employers should be prepared to take actions to reduce its spread and ease the concerns of employees who are diagnosed or exposed." (Levin-Scherz et al., Harvard Business Review, 8/18)