Much as it is causing intense day-to-day challenges, Covid-19 is also offering OH practitioners – nurses and physicians – a unique and rare opportunity to review and extend their leadership role. Dr Chow Sze Loon outlines five ways in which OH can make itself indispensable during this ongoing pandemic.
Even before the World Health Organization (WHO) announced Covid-19 as a global pandemic on 11 March 2020, workplaces were carrying out various strategies to detect and prevent what was then still a novel viral infection from infecting their workforce.
About the author
Dr Chow Sze Loon is a practising public health medicine specialist and occupational health doctor under the Public Health Division of the State Health Department of Penang, Ministry of Health, Malaysia
As hard-pressed occupational health practitioners have become only too aware this year, the new role the profession has had to take on in navigating the pandemic, in advising and guiding employers and employees alike, is unprecedented. As Occupational Health & Wellbeing has also highlighted in recent editions, it is also potentially a golden opportunity for OH to showcase its value to the wider workplace of various industries.
Occupational health practitioners – nurses and physicians – must seize the opportunity the pandemic represents to advise employers on the growing demand for preventive and control measures that can reduce absence and/or stop or slow the transmission of Covid-19 within the workplace.
Within this, practitioners also have an opportunity to review and extend their current practice and role during this pandemic. Five common key areas are explored in this article which offer all practitioners an insight for reflection and, in turn, enhancing our roles and value we present to the workplace health table.
1) Become your organisation’s “resource person”.
Covid-19 is not in itself an occupational disease, except for those who are working as on the front line within healthcare facilities.
However, that does not remove the risk of exposure among employees, especially where cases have been reported sporadically and community transmission has been established.
Thus, it is timely for practitioners to be reviewing and updating the current workplace occupational safety and health policy within their organisation (or client organisations) so that it is relevant to the demands and restrictions of the pandemic.
This is likely to be led by local and national government directives (for example, in the UK, Public Health England), guidance from the WHO, and industry-specific tool kits.
Practitioners will need to address and promote issues such as workplace cleanliness and hygiene, hand hygiene, respiratory hygiene and etiquette as well as establishing physical screening processes around premises.
Occupational health practitioners can make themselves the vital “resource person” within their organisation. This could include, for example, ‘translating’ official, industry or government directives or guidance for busy managers and employers so they are clear on the specific practical steps they need to be implementing.
Or, to cite another example, it could be advising on the recommended choice of hand sanitiser, the frequency of cleaning and disinfection within the workplace, the specific mechanisms required to screen employees and visitors before entering the premises and so on.
2) Take the lead on risk assessment, screening and testing.
Not every employee needs to be screened for Covid-19. Risk assessment is therefore an important task to undertake by all organisations.
Regardless of mass Covid-19 screening or targeted testing, the ultimate aim remains the same: to detect the case early for isolation with treatment and the timely search for all close contacts to prevent subsequent transmission.
WHO advocates a targeted approach to seeking, testing and isolating cases, so limiting the expansion of the disease. Such an approach, in turn, requires the OH practitioners to stratify the risk of an employee getting the infection following a known exposure.
The exposure could be of geographical (cluster reported in certain localities) or close contact to a confirmed positive case (usually those sharing the same household and/or work space).
Transmission risk depends on factors such as contact pattern, infectiousness of the host and the duration of exposure. Most transmission occurs through close range contact (at least 15 minutes face to face and within two metres), as highlighted by the European Centre for Disease Prevention and Control.
3) Manage the misinformation “infodemic”.
WHO director-general Tedros Adhanom Ghebreyesus is right when he says: “This is a time for facts, not fear. This is a time for rationality, not rumours. This is a time for solidarity, not stigma.”
In the midst of pandemic, nations are also battling against what has been called an “infodemic” of fake news, misinformation, and conspiracy theories are frequently flooding the social media.
This phenomena is worrying, not least because it can undermine trust in health institutions and public health measures.
In the workplace setting, the occupational health practitioner should recognise this ongoing threat and work to position themselves as the person within their organisation where people can go to for authoritative, practical, calm evidence-based advice and guidance.
For example, employees must be reminded constantly that transmission is through respiratory droplets and not airborne.
Symptomatic and pre-symptomatic transmission (one to two days before symptom onset) is likely to play a greater role in the viral transmission as compared to asymptomatic individuals. Hence, this explains the rationale of physical distancing, respiratory etiquette, hand hygiene and mask wearing in crowded places.
4) Provide leadership on return to work after diagnosis/surveillance
Return to work after isolation and treatment is possible when a Covid-19 RT-PCR test is negative and symptoms are improving.
Upon returning to work, the employee must be advised to continue practising the new normal of preventive measures, which includes wearing a mask, using hand sanitiser and maintaining physical distancing.
The OH practitioner, again, is likely to take a leading role along with an opportunity to make yourself, your organisation’s go-to resource and point of expertise during this process.
For example, you may be called on to advise your organisation on the need to screen other employees if there is workplace exposure prior to the diagnosis. Early detection and isolation are both crucial in preventing transmission in workplace.
5) Be centre-stage in helping managers and employees cope with stress and mental ill health
Finally, it is becoming increasingly clear that, running alongside the day-to-day management and mitigation of Covid-19 itself, there are going to be massive, and potentially long-term, challenges around employee mental health and wellbeing.
Employees with existing medical conditions may be at particular risk of developing stress during pandemic, given all the uncertainty. But, from lockdown through to working from home or in a front line capacity, anxiety and stress is something many people will be experiencing. As such, OH services can be central in terms of day-to-day management and support.
OH practitioners, for example, can play a pivotal role in helping employees to recognise the signs and symptoms of stress, and direct them to helpful resources for mental health and peer support.
It is important to identify the early signs of mental distress and provide relevant mental health support. This can include signposting and referring on to counselling or an Employee Assistance Programme (EAP), Psychological First Aid (PFA) or even more specialist support to mitigate the effect of stress.
“Coronavirus is an opportunity, but also a risk, for occupational health”, Occupational Health & Wellbeing, July 2020, https://www.personneltoday.com/?p=254561; “Occupational health faces five ‘scale-up challenges’ to meet demand post pandemic”, Occupational Health & Wellbeing, September 2020, https://www.personneltoday.com/?p=258017