On the World Day for Safety and Health at Work, Dr Yvette Martyn reflects on what can be learnt following the deaths of healthcare workers from Covid-19 and how their health and wellbeing can be supported going forward.
Today (28 April) 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. It is also the World Day for Safety and Health at Work, an initiative from the International Labour Organization (ILO) that is supported by the United Nations, and the International Commemoration Day for Dead and Injured Workers.
At the time of publication more than 100 healthcare workers in UK had died from Covid-19. I am sure I am not alone in feeling my heart sink each time a new name and picture is released of someone who has died. As I left medical school and entered the stressful world of on-call 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.
Earlier this month 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 would fly 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 roles. 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 in the course of their work.
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.
PPE availability
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 PPE among many other areas and have a lot to add to these vital discussions.
Mental health
While the focus has been on PPE, ensuring the safety of healthcare staff involves more than visors, masks, aprons and gloves”
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As we consider the health and safety of healthcare workers, we must also investigate how 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 members are witnessing deaths on a scale that they have never experienced before, decisions are being made that put 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 professionals can provide advice in relation to the support required on an individual basis through management referrals.
As we stand silent at 11am today, 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 world focuses its attention elsewhere.
