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.
