I’m an occupational health doctor. I run a small consultancy and my clients consist of local SMEs and some larger corporates. We do a whole range of workplace related medicals, including fitness to work decisions. I have very serious concerns about how the COVID-19 response is impacting on business.
Background to the Problem
COVID-19 is now being treated as a workplace health hazard, similar to asbestos or pathogens in a biological laboratory. This could have disastrous consequences for the economy which relies on people being able to attend work.
The initial response of business to Covid-19 was reasonable. It posed an equal risk in any setting, and it was only natural that employers would need to accommodate the same sorts of measures to slow its spread as were required in all other aspects of life and in any other setting (i.e. frequent hand washing, minimising close contact with others, etc). Early on, employers responded quickly to enable their employees to adhere to the generic public health guidance when they were in the workplace.
However, there is now an increasing tendency for COVID-19 to be regarded as a workplace hazard. This is not entirely unjustified in certain occupational groups, where early data suggest there might be some increased risk, but it is striking that front line NHS staff do not appear to be such a group. My concern is that regarding COVID-19 as a workplace hazard on a par with asbestos or radiation is not helpful.
This obsession with COVID-19 as a workplace hazard has arisen for several reasons.
With the lockdown, the workplace suddenly became the most likely site of transmission of the infection for many people, but this is an artificial situation created by an extraordinary and necessarily brief adjustment to ordinary life – it is being reversed as we speak.
It may also have stemmed from the idea that NHS staff were at far greater risk of contracting COVID-19 because of their work role on the “front line”. I understand that we now know this to be unlikely. Workers are just as likely to acquire it at home, in the shops or on public transport.
Significant discussion in the media about PPE (personal protective equipment) adds to the perception that COVID-19 is a workplace hazard. As the term indicates, the aim is to protect the wearer from some external hazard in their work environment. How could we have such fevered debate about inadequate provision of PPE without there being a serious workplace hazard?
But, accepting a few occupational groups who may be at a marginally increased risk, COVID-19 is likely to pose the same risk to individuals regardless of work. There are other types of hazard which affect workers and non-workers equally, for example natural background radiation and seasonal flu. Neither of these are specific to the workplace (with a few exceptions such as aviation or specialised labs). Never once have I come across influenza virus being regarded as a workplace hazard, even though it is quite possible one could contract it whilst at work. Some companies offer flu vaccine to staff, but not because of a duty of care to protect their staff from contracting flu whilst in work; rather it is offered in the belief that it helps reduce sickness absence in the flu season.
During a national co-ordinated response to COVID-19, it is inevitable that workplaces will need to play their role in slowing transmission of the virus throughout the population, and this might make COVID-19 look like a hazard unique to the workplace, but it is not.
An exaggerated perception of the risk that COVID-19 poses in workplaces will cause major problems for UK businesses and operations of all kinds.
COVID-19 (or our response to it) has transformed every workplace in the land into a high risk work environment. There are many types of high risk work environment – nuclear industry, asbestos removal, biohazard labs. We know where these are and generally the UK has excellent systems for protecting employees, but in all of these settings there is a significant support infrastructure in the background. You need health and safety officers, hygienists, specialist cleaning staff and doctors and nurses to assess individual fitness. Environments are risk assessed, adjusted and improved, cleaned and monitored. It’s a big effort.
The current perception of the risk posed by COVID-19 means that the entire UK’s place of work has become high risk, and borderline lethal. In fact, a laboratory processing dangerous pathogens would be a far preferable place to work. At least in the laboratory you know exactly where the pathogens are. You can isolate and contain them. You can easily identify staff most at risk (the one’s handling things in the extraction cabinet). This means the risk of contamination is extremely low, and your workers can be reassured that the threat is contained. Not so with the post COVID-19 workplace (which is now every workplace in the land) – here you have no hope of knowing where the pathogen is. You cannot contain it. You must put in place universal distancing and cleaning measures throughout every part of your operation. You must issue PPE, with all of the regulations surrounding the provision of PPE. You must screen every employee with an underlying medical condition to determine if they are safe to even enter the workplace.
The sense of risk to businesses is heightened by the knowledge that COVID-19 infection could even be RIDDOR reportable (formally reported to HSE as a disease caused by a biological agent present in the work environment).
Many news articles are perpetuating the view of COVID-19 as specifically a workplace hazard, and a particularly lethal one, such as this one in the Guardian.
Every single employee, returning to almost any workplace in the country, now needs to be risk assessed to characterise the risk to their safety. For many, this will be a quick process. But for many others with common, chronic health conditions (who will number several millions nationally), it will require significant resource to undertake assessments. As there is little guidance available and given the fear of a backlash from the media, unions, lawyers or the authorities, many employers will feel forced into excluding workers, even where there is little evidence that this is necessary. Employees may feel forced back in fear of their lives, whilst others will not be allowed back despite being desperate for a return to normality.
I am greatly concerned that the “new normal” will create an environment in which businesses will struggle to survive.
I can accept that workplaces need to make changes, and they must be encouraged to do this through reasonable means. I can accept that transmission will occur in workplaces and this should not be ignored. There needs to be accommodation for those shielding to remain at home. But employers cannot be made responsible for the misery of COVID-19, or blamed for its transmission in society. Businesses should be encouraged to play their role (and in my experience, they are – to an extreme degree), but they should not have to try and get the nation back to work whilst fearing sanctions because of a hazard that is universally present.
This week I’ve been wading through pages of medical guidance on how we can medically risk assess every medical condition. Alongside all of the other impacts, such as social distancing reducing office occupancy to less than 30% of normal, high sickness for months as self isolation policies continue, dealing with the palpable fear among staff, and coping with serious wider economic challenges, I struggle to see how this situation can be remotely sustainable for businesses.
I accept that for some workers, COVID-19 might make the workplace a hostile environment, and this needs prioritising and addressing. But I also fear that business itself is at risk of finding itself in a hostile environment, and one that many businesses will not survive.