Research into areas where Covid prevalence was particularly high has highlighted how important ‘choice’ over an individual’s work situation is for both public health and individual health outcomes, one of the government’s top health experts has said.
Professor Andrew Curran, chief scientific adviser and director of research at the Health and Safety Executive (HSE), suggested that research by the Scientific Advisory Group for Emergencies (Sage) into “areas of enduring prevalence” – places where the Covid-19 infection rate was high for significant periods between March 2020 and April 2021 – highlighted how some people may have had no choice but to continue working in situations that put their health at risk.
For example, the local authorities that experienced prolonged Covid epidemics in the early stages of the pandemic – including Peterborough, Bradford, Kirklees, Rochdale and Leicester – were those where people often needed to car-share or received only statutory sick pay.
These were also areas where blue-collar work and insecure contracts, such as zero-hours arrangements, were commonplace. Many lived in multi-generational households and vaccine-hesitancy was more likely.
Prof Curran told delegates at the Health and Wellbeing at Work Show earlier this month in Birmingham that many of these factors had a significant influence on a person’s ability to self-isolate if they tested positive for Covid-19. Some people may have felt they had no choice but to continue working.
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“One of the things that really came home to me was that we in the past concluded that everybody has the same choices to make in certain situations. I think the pandemic has shown that not the case,” he said.
“I was able to choose to work from home and isolate from my family, but a lot of people don’t have that choice. A lot of people could not choose to isolate if they tested positive, a lot of people could not choose to travel to work in their own car, a lot of people could not choose to take up the offer of a vaccine because they did not feel it was right for them.
“Does everybody have the same choice to, for example, stop being exposed to crystalline silica? If they’re on a particular contract type or providing for a multi-generational household, they might stop being able to provide for their family if they didn’t work.”
The employment rate was significantly lower in the “areas of enduring prevalence” than the comparison areas researchers looked at. There were higher proportions of people in manufacturing, wholesale, retail, education and health and social care work, and higher proportions of people belonging to less skilled occupation groups.
Prof Curran said that local health leaders in some areas were concerned that there was no public transport to industrial estates, so car sharing was a big issue despite social distancing being advised.
“We know that organisations tried to do something about it, for example paying for taxis, but we also know that some people, because of their financial situation, would still car share and share the taxi money between them,” he said.
Covid outbreaks were also common among night shift workers, with Prof Curran suggesting that “perhaps the controls were not being enforced as well during the night shift, which is something we’ve seen previously through the work we’ve done on occupational health generally”.
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He said that through the government-commissioned ‘Protect’ programme, which involves a series of studies into the Covid-19 pandemic, it wants to deliver “a legacy impact for future pandemics so that we don’t start with a blank piece of paper”.
He indicated that the management of any future pandemics will require local health leaders to play a stronger role in co-creating solutions with national heath leaders, and disseminating information at local level. Public health experts will also need to use local data and knowledge to “make a difference quickly”.
