**4.2 Safe return to work with MIDO-COVID**

With ongoing transmission of SARS-CoV-2 during the phased reopening of nonessential activities in Mexico, a series of measures were implemented in CG's workplaces to ensure the safe return of employees. These measures are described in Annex 1.

There is ample scientific evidence demonstrating that the presence of comorbidities increase the risk of severity and complications of COVID-19, particularly cardiovascular disease, diabetes, hypertension, chronic lung or renal disease, and obesity [17]. In light of this evidence and building on previous experience [110–112], the CSF designed and developed the MIDO-COVID Digital Platform, aimed at assessing NCDs and COVID-19 serological status among employees resuming operations in the workplace.

Like MONITOR, MIDO-COVID is implemented following a stepwise process, performed by a MIDO expert<sup>2</sup> :

	- a.NCDs profile with interpretation and recommendations.
	- b.Serology test results with interpretation and recommendations.

The MIDO-COVID Digital Platform automatically delivers certified serologic test results. Importantly, this assessment confirms the presence of NCDs and

<sup>2</sup> In each workplace, employees are chosen to be trained as MIDO-COVID experts. These employees complete an online course in which they learn to measure weight, height, blood pressure, and capillary blood glucose; and how to record these measurements in the digital platform, perform serological tests, and provide brief counseling when informing employees of their test results.

*The MONITOR Ecosystem: A Digital Health Intervention for the Early Detection, Control… DOI: http://dx.doi.org/10.5772/intechopen.95260*


**Table 2.**

*Main results of the MONITOR digital health ecosystem (13 march to 31 October, 2020).*

validates the self-reports provided by employees using the mobile phone app. Finally, in the case of active COVID-19 infection, the employee is quarantined and the contact tracing protocol is begun, as described above.

In sum, joint coordination of the HR department at each company with the epidemiology team at the CSF has enabled effective deployment of the Carso COVID Protocol through the use of MONITOR. **Table 2** shows the main results of the MDHE as of October 31, 2020.

## **5. Permanent strategies following the current public health emergency**

Given that the COVID-19 pandemic has changed the way that companies function, the CG intends to retain certain strategies to protect employees' health. The COVID-19 pandemic has provided an excellent opportunity to improve the workplace environment in terms of health and safety at every worksite. The CG is fully committed to providing every employee with all the preventive tools, measures, and strategies needed to maintain a physically and mentally healthy community. In this sense, the CSF encourages joining MONITOR together with MIDO, with the recognition that poor control of NCDs increases the risk for COVID-19 complications [113]. MIDO screening can facilitate early detection of type 2 diabetes, hypertension, and dyslipidemia, focusing specifically on predisease stages and early treatment. MIDO offers a systematic risk assessment of screened individuals, identifying those with a healthy, at-risk (pre-disease), or disease status [112].

Inter-connecting MONITOR and MIDO-COVID in a digital ecosystem allows HR personnel to identify COVID-19 positive employees or those with high-risk of complications. Daily information can be used to better monitor, diagnose, track and control employees' infection risk and overall health. Moreover, data are stored in a secure cloud, where it can be retrieved to generate predictive models for each

company and type of workplace, as a strategy to better understand and control risk factors in each sector.

Flexible schedules, in which employees alternate teleworking and working at a CG location when necessary, are very important. If an employee feels unwell, they must notify their direct manager and should not present to their work location. In worksite dining rooms, menus should be based on nutritional recommendations following the EAT-LANCET Commission on healthy diets and sustainable food production. Every meal is to be prepared according to the planetary health plate, characterized by at least 50% vegetables (fruits and vegetables) and the remainder comprising whole grains, plant-source protein, animal-source protein, dairy foods, and unsaturated plant oils [114].

Workplaces are implementing programs to promote wellbeing and healthy lifestyles among employees and their household members. In this way, the CG seeks to empower its employees through health promotion initiatives conducted by trained multidisciplinary health professionals in topics including nutrition, NCDs prevention, physical activity, vaccination, mental health awareness, and wellbeing.

As part of its response to COVID-19 as well as other novel pathogens, the CG plans to create emergency response teams and permanent communication via DH among HR departments across all CG businesses. Frequent intervention assessments will be carried out to gauge adherence to protocols and determine where improvements are needed.

## **6. Conclusions**

This chapter describes the CG COVID-19 mitigation strategy within a corporate group in Mexico. Priorities for the CG during this outbreak have been to protect employees' health and wellbeing by implementing protocols and strategies based on scientific evidence. Consequently, occupational safety and health have taken on greater relevance in all kinds of workplaces.

First, our experience shows that Digital Health can be used to quickly identify people with any infection risk, during early stages. CG employees are empowered through advice and counseling using IT tools such as a mobile phone app or website. The MONITOR strategy has proven to be an effective intervention. The use of DH has been instrumental in outbreak control and maintaining workplace activities. Second, we have learned that the use of a Digital Health ecosystem is effective in detecting and controlling COVID-19 outbreaks in work settings.

This experience can be useful for other organizations in the process of implementing and operating digital health based strategies to cope with outbreaks of viral disease.

### **Acknowledgements**

We wish to acknowledge the work of the different HR departments of CG in the implementation and follow-up of the Carso COVID Protocol. The strategy and results included in this chapter were only possible because of their dedication, and their hard work.

On the other hand, we acknowledge the help provided by Alejandra Cantoral, ScD., Larissa Betanzos, ScM, and Adriana Granich, MD, for the data compilation of digital health solutions around the world. We also acknowledge Analisa Avila, of Edanz Evidence Generation, for editorial support.

*The MONITOR Ecosystem: A Digital Health Intervention for the Early Detection, Control… DOI: http://dx.doi.org/10.5772/intechopen.95260*
