Should workplace health and safety go back to “normal”?

Let me be emphatic:  a pandemic was inevitable.  Maybe not this COVID-19 virus pandemic but a pandemic involving a virus with close-contact transmission and serious health consequences was absolutely going to happen.  Every strategic planner knew it and, to their credit, many organizations planned for it.  Their plans might not have been perfect, but many plans addressed situations where employees would be unwell for extended periods of time (and worse).  Planned for or not, this pandemic is changing workplace health and safety.

The COVID-19 pandemic is revealing vulnerabilities in our workplaces.  These occupational health and safety vulnerabilities were there all along; many were known (or should have been known) but were latent —without consequence until the harsh, impersonal reality of this virus brought them to into stark focus.

We are at the early stages of businesses reopening and envisioning what the workplace will look like when the pandemic recedes.  Knowing what we know now, should workplaces simply plan to go back to the old “normal”, or is now the time to revamp workplace health and safety?

Why are our workplaces vulnerable?

Every workplace has hazards.  Some hazards present obvious risks to workers.  Employers have a duty to assess and manage those risks.  Many of the actions necessary to prevent transmission and protect workers from infectious-disease risks are well known.  Some protections are built into the design of workplaces and the structure of safe-work procedures—protections that are maintained through training and supervision.  Together, these fundamental barriers, safeguards, and defenses decrease the risk of harm arising from those ever-present and emergent hazards. 

The COVID-19 pandemic has revealed defects and deficiencies in the barriers, safeguards and defenses that would otherwise protect workers from harm. In retrospect, it is obvious that care workers moving between long-term care homes for the elderly carry the risk of transmission between facilities.  It is now painfully clear that workers in close contact with each other in meat processing plants or agricultural bunk houses could spread disease to each other.  We always knew we should not come to work sick, but we let our workplace culture view those who came to work despite the sniffles, mild cough or fever as heroic.  The hazards were there all along. 

In hospitals and on the front lines of emergency care, the urgency of ministering to others and dealing with staff shortages may have created gaps in those defenses and safeguards we failed to recognize until now.  The virulence of this virus has revealed how minor gaps in any of our safeguards can result in an infection with serious health consequences.  The supply of our Personal Protective Equipment (PPE) may have been assumed sufficient in the past; we know now that gaps here can be fatal to the very people we need to care for us and manage this pandemic.  Even minor defects in the quality of PPE can result in exposure that can decommission a valuable, scarce staff member or team for weeks in quarantine or, at worse, result in infection, illness and even death.

Failure to fit-test respirators, to train the proper use of PPE, ensure initial quality, safely maintain stockpiles, and ensure the availability in sufficient quantities of quality product always exposed workers to greater risk.  COVID-19 laid bare those vulnerabilities.   It is one thing to have safe work procedures, require PPE or mandate hand-washing with hot water and soap but quite another to supervise or assure adherence to those safe work procedures.  We knew these shortcomings were there but their consequences seemed minor; the apparent time/effort cost of compliance lost out to the more immediate benefits (and often rewards) of time and production.  This pandemic has changed all that.

To be clear, it is rarely one defective product, one error in practice or one oversight in supervision or training that results in harm.  Jobs are typically designed with multiple barriers, safeguards and defenses that prevent harm.  To use the late James Reason’s "Swiss cheese” analogy, it is the alignment of holes or defects in the barriers, safeguards and defenses that allows a straight-line trajectory between the hazard and the worker that results in harm. The COVID-19 pandemic has illustrated just how porous our layered protections really are. Reducing the size and number of those “holes”, particularly those revealed by this pandemic, is necessary if we are to progress toward any new sense of normal.

Will the defects in our barriers, safeguards, and defenses really matter when we get back to “normal”?

The world has changed and there is no going back.  We know this virus is going to be here for a while.  Massive lockdowns have had their effect.  The mantra of “flattening the curve” has been achieved in many (but far from all) places.  So far, only a few jurisdictions have seen their health systems overwhelmed as we saw in New York, Italy and Spain.  Lockdowns have bought us time. Next comes the hard part.

Economic activity will resume.  Consumers may be wary of returning to the market place and workers may also have concerns for their health and welfare as much as their livelihood as they return to the workplace.  In this next phase of our pandemic experience, any gap or defect in our barriers, safeguards, and defenses can result in local shut downs and community spread.  The cost of a local outbreak may be an immediate lockdown of a community and no guarantee of a rapid return to production or service for the enterprise.

There may be a vaccine at some point… maybe. There may be a treatment for the worst cases….maybe.  Neither looks imminent and the long-term prospects for immunity are unknown for those who have had the disease. 

Testing, containment, and contact tracing is the new mantra for controlling this pandemic but that does not mean any workplace can return to its pre-pandemic state. 

How do we get to the new normal?

Every workplace will have to navigate the new reality, informed by the science of workplace safety and health and the imagination that comes with local knowledge.  There may be new resources to help but ultimately workers and employers are going to have to put their lives and the lives of those they serve on the line.  Shrinking if not eliminating the gaps and defects in our barriers and safeguards has to be the priority. 

The vision of workers and workplaces safe and secure from injury, illness and disease cannot be achieved without excellence in prevention.  Jobs, processes and equipment must be designed to minimize risk. Managers and supervisors must continually monitor and refine systems and incentives.  Training must be thorough and frequent. There is no point in telling staff to “work safely” while praising production achieved by cutting corners.  I’m was guilty as anyone in the past for pressing ahead to work with a runny nose or feeling a little ill—that just can’t happen in this new reality. 

Work is still good for your health and wellbeing.  Work can be therapeutic for physical and mental injury recovery.  That doesn’t change, particularly for most workplace injuries.  Illness (feeling ill) and disease (test-positive diagnosis even if feeling well) are in a different category in this new reality.  Workplace culture—the way we handle illness and actual asymptomatic test-positive or possible disease—has to change.   If workers aren’t empowered in their workplace and supported financially and emotionally to stay home, all of us may suffer the consequences. 

There will be consequences… and challenges

As we progress through this pandemic, there will be more people infected but more will recover, presumably with some immunity for some period of time.   Already, questions concerning the organization of work teams are beginning to arise.  Should workers who have recovered be grouped together? How much detailed contact recording should we do in anticipation of a positive case with an employee?  How do we determine who is a close contact?  What do we do when a person in the office or shop floor does test positive?  Who will sanitize a test-positive employee’s work station and what happens in the mean time?

Almost all businesses will have lower productivity, at least initially.  New staff will still have to be oriented and trained to the new reality; existing staff will have the added complication of unlearning  behaviors and replacing them with new ones (it’s hard to change a reflex like shaking hands when meeting a client).  Even the way we orient, educate and train will have to change.  Large conferences and classroom sessions may have been efficient but won’t work for some time to come; smaller groups and innovative delivery methods may be effective if somewhat slower alternatives.  

Controlling customers in retail, having fewer workers in call centres, providing wider spacing on production lines, mandating PPE (and allowing the time to put it on, test and safely remove), increasing site sanitation and hygiene—all these measures will be necessary for months, perhaps years to come.  This will alter production timing and costs but may make alternative designs and ways of doing things safer, more efficient and perhaps more profitable in the long run. 

Your workplace health and safety procedures are going to have to change, too.  Each change in procedures, process design and operations can generate potential issues for workplace health and safety.  Moving from open-office floor plans to more offices, staggering working and break hours, adding physical dividers to workspaces, changing ventilation, adding more wash stations, allowing more time for sanitation—these are not trivial changes to the workplace.  Each change has immediate and intended consequences but also unintended ones.  Evacuation plans change when open spaces suddenly have walls, for example.  Cleaners will need more time between those working hours to increase surface cleaning.  And those contingency plans you have in case of fire or flood or evacuation are all going to have to be revisited to take into account the changed environment and physical distancing requirements. 

COVID-19 is potentially everywhere but your community, your plant, or your office may be COVID-19 free, at least for a time.  That doesn’t mean you can dispense with prevention or count on the absence continuing.  You have to prepare for when this pandemic comes to your operation. 

Workplace transmission of COVID-19 may well result in workers’ compensation claims or potential action from customers or other non-workers in the workplace.  Incident investigations are going to have to include contact tracing.  The interactions of field staff, customer contacts on-site, delivery personnel movements, and cleaning staff patterns must be part of every incident investigation.  Record keeping becomes less of an accounting tool and more of a health and safety imperative.

You are going to need very detailed plans on what to do when a member of your staff, a customer, supplier or visitor to your worksite tests positive.  The immediate cleaning and sanitation needs are obvious but who does what, how do you determine close contact are just the beginning.  How long will you have to close, will key staff members be forced to quarantine (and will you pay them while well but in quarantine), what happens to non-close contact workers who are displaced---just some of the questions that will need answers.  The general duty to protect workers is not diminished in a pandemic.

The bad news is that many businesses will not survive the transition to the new reality.  There will be disruptions and cost pressures, bankruptcies and closures, and operations that resist necessary changes (sometimes with no consequences in the short term, reinforcing actions that put workers in danger).  And even if normal economic theory applies and new enterprises fill the breaches created, the risks do not just disappear. 

And the good news?

There are positives to all this.  If nothing else, there is a heightened awareness of occupational hygiene and safety in the workplace.  We may not have been ready for a pandemic, but ready or not, workplaces are rapidly adapting and innovating now.

We may not have a vaccine or effective treatment yet, but we do have solutions to prevent the spread of this disease in workplaces and communities.  The solutions recommended by public health around the world are based on tried and true principles.  Most of the advice from the Spanish Flu pandemic a century ago applies today:  wash your hands, isolate the sick, keep physical distance, wear a mask, and avoid large gatherings like funerals. 

We may not have all the answers about this virus but we have the sciences of genetics, epidemiology, and statistics to accelerate our understanding.  We have science-based principles protect workers and others in the workplace.  The “Hierarchy of Controls” has been central to health and safety since the middle of the last century.    The physical distancing (eliminating the hazard), those now ubiquitous plexiglass barriers in retail (engineered controls), and markers directing flow in supermarket aisles (administrative controls), and even mandated masks on planes and buses (personal protective equipment) are principle-based and the best defense we have for now.

Perhaps changes in work procedures will result in fewer injuries and work-related illnesses overall as processes are reviewed and re-designed.  A shift in workplace culture towards prevention of COVID-19 may include a more general re-think of priorities and incentives in the workplace.   Already, workplaces are innovating based on what we know.  Processes, equipment, and physical plants are being re-imagined in light of the pandemic with greater safety and health for workers.

That’s not to say workers won’t get hurt in our redesigned workplaces.  Physical injuries and non-COVID-19 injuries are still a risk in every workplace.  Trips and falls still are still happening; cuts, contusions and fractures are still common; mental injuries and other work-related trauma are still very real injuries in our workplaces.    

Workers are still going to need treatment and rehabilitation for injuries.  Physiotherapists may need new protocols for working with their patients but the work they do is vital to increasing function and preventing disability.  Prosthetists are still going to have to work one-on-one with amputees.  Some professions may be able to work remotely with some clients some of the time.  The good news here is that there are ways to work safely and manage the risks revealed in this pandemic.

What happens if we get a broadly effective treatment, an effective vaccine, or reach “herd” or community immunity?  Many of the changes made because of this pandemic will persist.  And that may be for the best. 

We were not “lucky” with this pandemic –it is serious and deadly but could have been more so; this pandemic has revealed vulnerabilities that were always in our workplaces.  Hopefully, in making workplaces safer, healthier and more resilient for this pandemic, we will re-imagine workplace health and safety … and be far more ready for the next one. 

[  I-61504  Spanish Influenza poster:  Fight the Flu  1918-1919, British Columbia Archives]