By Dr Yvette Martyn
On 28th April 2020 it is the World Day for Safety and Health at Work. The International Labour Organization (ILO) started the World Day initiative in 2003 in order to stress the prevention of accidents and diseases at work. 28th April is also International Workers' Memorial Day. This year at 11am we will stand silent to remember all the healthcare workers who have lost their lives to COVID-19 while working during the pandemic.
There have now been over 100 COVID-19 deaths in healthcare workers. I am sure I am not alone in feeling my heart sink each time a new name and picture is released. As I exited medical school and entered the stressful world of oncall rotas, crash calls and life or death situations, these were the staff members that supported me. Losing members of the healthcare worker family to an infection that they may have caught at work is devastating.
On 17th April 2020 the British Medical Association announced that as a mark of respect to the doctors and NHS workers who have lost their lives to the COVID-19 pandemic, the flag at BMA House is now flying at half-mast. A poignant symbol of the tragedy, which continues to unfold.
Healthcare workers fall into a number of groups: those working in clinical activities, laboratory workers and non-clinical ancillary staff, all may be exposed to COVID-19 when working in their role. These deaths are not statistics, while these people may have dedicated their lives to caring for others, they did not sign up to give up their life for the cause. There are now a number of families who have been robbed of their cherished loved ones, these are deaths that should have been prevented. As the pandemic continues the emphasis must be on preventing any further work related deaths.
The media has highlighted the shortcomings with personal protective equipment (PPE) and the controversy around the Public Health England guideline, Considerations for acute personal protective equipment (PPE) shortages which indicates that staff should reuse single use items and seek alternative kit. Downgrading guidelines secondary to PPE availability should not be happening. Instead every single avenue for manufacturing this equipment should be explored alongside providing advice on evidence based safe decontamination methods for the stock available.
While the focus has been on PPE, ensuring the safety of healthcare staff involves more than visors, masks, aprons and gloves. There needs to be careful consideration of the hierarchy of control at every possible stage where control measures can be implemented including the full utilisation of engineering and administrative controls. PPE should be considered the lowest form of control measure. Senior decision makers must listen to the views of occupational health professionals when undertaking their risk assessment. Occupational health specialists are trained in risk management, biological hazards, control measures and personal protective equipment amongst many other areas and have a lot to add to these vital discussions.
As we consider the health and safety of healthcare workers we must also investigate the assistance needed to support the mental health of workers in both the current response phase and the recovery phase of the pandemic, which we will enter in the future. Staff are witnessing deaths on a scale that they have never experienced before, decisions are being made which puts them at risk of moral injury and many workers are having to adapt to a constantly changing work environment. Occupational health can assist at the policy development stage. In addition occupational health professions can provide advice in relation to the support required on an individual basis through management referrals.
As we stand silent on 11am on the 28th April 2020 to remember those who have lost their lives while doing their jobs, we must ask ourselves what we can do moving forward, both to prevent further deaths and to support the health and wellbeing of healthcare workers once the pandemic concludes and the rest of the world focus their attention elsewhere.