Worksafe’s hotel quarantine breach penalties are a warning for other employers to keep workers safe from COVID

Posted on October 16, 2021 by particularkev

Alex Collie, Monash UniversityVictoria’s occupational health and safety regulator, Worksafe, has charged the state’s health department with 58 breaches for failing to provide hotel quarantine staff with a safe workplace.

The breaches occurred between March and July 2020, and at up to A$1.64 million per breach, could amount to fines of $95 million.

This should serve as a warning to all employers to start assessing their workers’ safety against COVID and how they can mitigate these risks, ahead of the nation reopening.

Remind me, what is Worksafe?

States and territories have responsibility for enforcing laws designed to keep people safe at work: occupational health and safety (OHS) laws.

Worksafe Victoria is responsible for and regulates OHS in Victoria. It’s responsible for making sure employers and workers comply with OHS laws; and it provides information, advice and support.

Victoria’s parliament has given Worksafe the power to prosecute employers if they breach OHS laws. In 2018-19, it commenced 157 prosecutions which resulted in nearly A$7 million in fines.

Unlike some other state OHS regulators, Worksafe also manages the Victorian workers’ compensation system.

Why did Worksafe charge the health department?

Worksafe charged Victoria’s Department of Health with 58 breaches of sections 21 and 23 of the Victorian Occupational Health and Safety Act.

The Act requires employers to maintain a working environment that is “safe and without risks to health” of employees. These obligations extend to independent contractors or people employed by those contractors.

Worksafe is alleging that in operating the Victorian COVID-19 quarantine hotels between March and July 2020, the Department of Health failed to maintain a working environment that was safe and limited risks to health, both to its own employees and to other people working in the hotels.

Essentially Worksafe is stating that through a series of failures, the department placed government employees and other workers at risk of serious illness or death through contracting COVID-19 at work.

Worksafe alleges the Victorian health department failed to:

appoint people with expertise in infection control to work at the quarantine hotels
provide sufficient infection prevention and control training to security guards working in the hotels, as evidence shows training can improve employees’ safety practices
provide instructions, at least initially, on how to use personal protective equipment, and later did not update instructions on mask wearing in some of the quarantine hotels.

Worksafe undertook a 15-month long investigation, beginning in about July 2020. It’s possible the trigger for this investigation was a referral from the Coate inquiry into hotel quarantine, but that has not been stated.

Is it unusual for a government regulator to fine a government department?

It’s not that unusual. Government departments are subject to the same OHS laws as other employers in the state, and so Worksafe’s powers extend to them as well.

In the past few years, Worksafe has successfully prosecuted the Department of Justice, Parks Victoria and the Department of Health, resulting in fines and convictions.

In 2018, for example, Worksafe prosecuted Corrections Victoria (part of the Department of Justice) after a riot at the Metropolitan Remand Centre in 2015 that put the health and safety of staff at risk.

The riot occurred after the introduction of a smoking ban in prisons. Worksafe considered prisoner unrest was predictable and its impact on staff could have been reduced by having additional security in place in the days leading up to the smoking ban.

In that case the Department of Justice pleaded guilty and was convicted and fined A$300,000 plus legal costs.

What does this mean for other employers?

This case highlights that employers have obligations to provide safe working environments for their staff, and other people in their workplaces. This extends to reducing risks of COVID-19 infection.

These obligations don’t just apply to government departments. They apply to every employer in the state.

Employers should ensure they have appropriate systems and policies in place to reduce COVID-19 infection risk to their staff. This includes, where appropriate, physical distancing, working from home, wearing personal protective equipment (PPE), good hygiene practices, workplace ventilation, and so on.

Employers should consider the risks unique to their environment and address them appropriately, in advance of the nation reopening when we reach high levels of COVID vaccination coverage.

Some employers in high-risk settings – such as health care, retail and hospitality – will need to do more to protect their workers than others.

What happens next for the Vic health department?

The case has been filed in the Magistrates court, with an initial hearing date set for October 22. It will progress through the court system from there. Most prosecutions are heard in the Magistrates Court although some proceed to the County Court.

If the Department of Health pleads guilty, the courts will determine if a fine should be paid and how much. The court may also determine if a conviction is recorded.

Alex Collie, Professor and ARC Future Fellow, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Keeping workers COVID-safe requires more than just following public health orders

Posted on October 14, 2021 by particularkev

Stephen Duckett, Grattan InstituteSo far in the pandemic, state public health advice has been front and centre of public messaging about protecting the community from the spread of COVID-19.

But merely following the public health orders won’t necessarily meet employers’ obligations to protect staff from COVID, especially as restrictions ease in the Eastern states.

Protecting employees from COVID is good for staff, of course, and also good for the organisation because it will reduce the potential for staff being off sick.

Vaccination alone won’t guarantee a COVID-safe workplace. Even double-vaccinated people can be infected. Vaccination reduces the chance of infection by between 60% (AstraZeneca) and 80% (Pfizer). And double-vaccinated people can also transmit the virus, although again at a much lower rate.

As part of the scientific advisory group OzSAGE, we’re issuing guidance to employers about creating COVID-safe working environments. We propose organisations follow a four-level hierarchy of COVID controls.

Employers need to consider four key areas.
OzSAGE

Level 1: vaccination and working from home

The most effective protections against COVID are vaccinating to reduce the risk of infection, and limiting interactions with infected people. These are the two standard public health measures seen in state public health orders.

Employers should encourage employees to get vaccinated by providing:

leave or paid time off to get vaccinated
reliable and up-to-date information on the effectiveness of vaccinations
the details of the locations nearby where vaccinations are available
on-site vaccination, if possible, for shift workers and those who can’t easily attend a GP or vaccine hub appointment
incentives, such as additional annual leave days for vaccinated workers.

In some circumstances – especially where the organisation is responsible for caring for people at a higher risk of infection – mandatory vaccination of employees might also be considered.

Staff should be encouraged to work from home if that’s possible, while risk of infection is still high. Working from home doesn’t eliminate the risk of COVID, but it eliminates the risk of contracting (and transmitting) COVID in the workplace.

Putting in place “hybrid” working arrangements reduces the number of people in the workplace at any one time, and therefore the risk of transmission.

Level 2: safe indoor air

State public health orders have essentially focused on density limits. These are important, but don’t guarantee good ventilation and clean air.

COVID spreads by aerosols. Respiratory aerosols from breathing and speaking accumulate in indoor spaces, resulting in increasing risk over time.

Poor ventilation (stagnant air) in public buildings, workplaces, schools, hospitals, and aged care homes contributes to viral spread.

Masked woman with a clipboard surveys a storeroom. — Poor ventilation is a risk for transmitting COVID.
Shutterstock

Good ventilation is a key part of reducing the risk of COVID transmission.

As the number of people inside a space increases, CO₂ will increase to varying degrees, depending on the effectiveness of ventilation and the volume of the space. Measuring carbon dioxide (CO₂) is therefore a useful surrogate indicator to assess the relative infection risk of COVID in an indoor space.

It’s recommended employers invest in CO₂ monitoring and use that as a trigger to reduce occupancy and/or increase the provision of outdoor air and HEPA (high-efficiency particulate air) filtering to ensure the risk of COVID-19 is appropriately mitigated.

Having automated alerts (in non-HEPA filtered areas) from CO₂ monitors will prompt action to improve ventilation or leave the workplace.

Level 3: administrative measures

Organisations should be ready to manage COVID outbreaks – especially in New South Wales and Victoria, where public health contact tracing is at capacity.

Organisations might also use regular rapid antigen testing (where practical and feasible, considering cost and logistics), to prevent or limit outbreaks when people are shedding the virus but are asymptomatic.

Man holds rapid COVID testing stick. — Rapid tests can help detect COVID in those with no symptoms.
Shutterstock

The risk of an organisation-wide shutdown can be minimised by creating work bubbles – teams coming to work on different days – and other measures to reduce physical interactions.

Staggering work hours to reduce congregating at lift spaces is another useful, low-cost strategy.

Level 4: masks

COVID-19 is an airborne disease, so the use of masks is integral to reduce transmission and to offer some protection if there is any breakdown of other controls.

Masks are also essential because 30–70% of transmission may be asymptomatic: from infected people who look and feel well and may not be aware they are infected.

Basic cloth masks and surgical masks reduce the transmission of COVID. The effectiveness of masks increases when they fit snugly on the wearer’s face.

Workers should be provided with appropriate fitted masks and should be trained in how and when to use them. At a minimum, where workplaces are in areas with community transmission of COVID, masks should be worn whenever workers are indoors.

Rates of COVID are still high in NSW, Victoria, and the ACT. Employers, especially in those jurisdictions, should review their work health and safety plans to ensure their workers and customers are properly protected.

This article was co-authored by occupational and environmental physician Karina Powers, engineer and scientist Kate Cole, Flinders University Professor Richard Nunes-Vaz, and other members of the OzSAGE advice for business working group.

Stephen Duckett, Director, Health and Aged Care Program, Grattan Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Health workers are among the COVID vaccine hesitant. Here’s how we can support them safely

Posted on October 14, 2021 by particularkev

Holly Seale, UNSW; Margie Danchin, Murdoch Children’s Research Institute, and Ruby Biezen, The University of MelbourneGiven the caring nature of their profession, the general public might assume there isn’t any vaccine hesitancy among health workers. It can surprise (and anger) the community when health workers protest the introduction of COVID vaccine mandates.

In France, around 3,000 health workers have been suspended because they were not vaccinated. In Greece, health workers have protested against mandatory vaccination plans. Similar scenes have played out in Canada and New York State.

In Australia, health workers have reportedly joined protests in Melbourne and Perth. A small number of unvaccinated staff members are challenging vaccination mandates in the NSW Supreme Court. Beyond the hospital sector, there are reports of staff members leaving the aged care sector following the introduction of mandates.

Hesitancy among health workers broadly reflects concerns in the wider community. But the risks of being unvaccinated in health settings mean we should acknowledge these concerns and support informed decision-making.

A range of concerns

Over 90% of health workers in NSW and Victoria have received a COVID vaccine. But there remains a small percentage of people who work at hospitals and other clinical settings who are vaccine hesitant or want to choose the vaccine they receive.
NSW health figures suggest that currently about 7% (or 7,350 staff members) remain unvaccinated.

Internationally, prevalence of COVID vaccination hesitancy in health workers ranges from 4.3 to 72% (average 23%).

In the US, one in four hospital workers in direct contact with patients had not received a single dose of a COVID vaccine by the end of May.

A study conducted in the first few months of this year found while most health workers intended to accept a COVID vaccine, 22% were unsure or did not intend to vaccinate. These findings tallied with a study in Italy that found 33% of health workers were unsure or did not intend to vaccinate.

The top three reasons for health workers to be hesitant echo the same concerns expressed by some in the wider community: vaccine safety, efficacy and side effects.

Earlier surveys overseas showed less than a third of health workers felt they had enough information around COVID vaccines. And, just like the wider community, health workers are vulnerable to misinformation and sometimes have insufficient understanding about how vaccines are developed.

A group who identified themselves as health workers staged a peaceful protest in Melbourne.

The risks

While hospital patients are more likely to be the source of hospital COVID outbreaks, unvaccinated health and aged care workers still pose a risk to patient and resident safety. Transmission of COVID to or between unvaccinated health workers poses a risk to the wider community including their families and friends.

Beyond the risk of transmission, there is also the impact vaccine-hesitant health workers have on wider vaccine confidence. Health workers are seen as credible sources of information and are trusted by the community.

There are videos on social media, YouTube and TikTok of individual health workers speaking about the COVID vaccines, often repeating misinformation regarding the safety or effectiveness of the vaccines or expressing uncertainty. The potential impact of these viral videos may be heightened compared to those featuring speakers who don’t work in health professions. University of Washington researcher Rachel Moran, who examines internet misinformation, says such health workers are

leveraging the credibility of medical professionals to create a false impression that there is considerable debate about COVID vaccines among doctors and nurses when, in reality, there is a consensus about their efficacy and safety.

Crowd of protesters — In New York, crowds rallied last week against city-wide COVID vaccine mandates for public school teachers and state-wide mandates for health-care workers.
EPA/JUSTIN LANE

How can we all stay safe?

Moving forward, we must acknowledge three things when it comes to health workers and vaccine hesitancy:

1. Don’t judge

While there is a moral imperative and duty of care for health workers to receive the COVID vaccine, we should ensure unvaccinated staff members have the opportunity to discuss vaccines in a non-judgemental way.

As with the general public, we need to find out who health workers trust and connect them with trusted resources to alleviate their fears. This might be done via hospital websites, discussions with their primary health-care providers or evidence-based information.

2. Work out what works

Unlike the community setting, there has been a gap in funding to develop and test resources and interventions focused on supporting health and aged care worker vaccine uptake.

Understanding the specific strategies that work to support vaccine uptake, without having to move directly to mandates, is important from not only a patient safety perspective but an occupational health and safety lens.

These findings are relevant for COVID and other occupational vaccine programs.

3. Ensure supply and access

Prior to introducing a mandate, there needs to be adequate supply and equitable access to vaccines. We need to ensure people have the opportunity to review vaccine safety and effectiveness data and to get the vaccine of their free will.

Careful planning, consultation and communication with key groups can improve acceptability of mandates.

In the coming weeks, more health workers are likely to resign or be dismissed for failing to comply with the COVID mandates. There will be those in social media who will call out the situation as the “right move”. But some health workers will become privately or publicly vocal on the issue and will cast doubt on the vaccine. It is important we prepare for these situations, especially in regional areas where there may be fewer voices and greater trust in long-serving health workers.

Holly Seale, Associate professor, UNSW; Margie Danchin, Paediatrician at the Royal Childrens Hospital and Associate Professor and Clinician Scientist, University of Melbourne and MCRI, Murdoch Children’s Research Institute, and Ruby Biezen, Research Fellow, The University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

‘Living with COVID’ looks very different for front-line health workers, who are already exhausted

Posted on September 6, 2021 by particularkev

Karen Willis, Victoria University and Natasha Smallwood, Monash UniversityWith the Delta variant raging across New South Wales and Victoria, health services are stretched and strained. Behind the scenes is a fearful, anxious and overburdened workforce.

In the next few months, the health workforce will care for many more patients with COVID-19, with case numbers in NSW expected to peak over the next two weeks.

The nation is focused on plans to reopen borders and increase freedoms as soon as there are sufficiently high rates of vaccination. But what does “living with” COVID-19 look like for health professionals?

What have health workers had to deal with so far?

In 2020, we surveyed front-line health-care workers across Australia.

We found the pandemic had taken a considerable toll on the mental health of health-care workers, with significant numbers having symptoms of mental illness.

Alarmingly, 70.9% of our sample of 7,846 reported emotional exhaustion and 40% had moderate to severe symptoms of post-traumatic stress disorder.

Throughout the pandemic, health-care workers have been disproportionately infected – often through exposure to the virus at work.

We asked health-care workers about the key pressures of working during the pandemic. These were:

constant workforce and occupational disruption, including being redeployed or working longer, unpaid hours. Those most affected were more likely to experience poorer mental health
worries about being able to provide best care to patients, excluding families from visiting patients, and the emotional toll of caring for patients and their families when people died alone due to visitor restrictions
being blamed by, and placing more stress on, co-workers when they were exposed to or infected with COVID-19 and therefore could not be at work
worrying about people who were missing out on health care for various medical conditions during the pandemic because they were reluctant to seek health care or due to services being scaled back

a surge in mental illness across the community due to social restrictions
worries about being safe at work; and bringing COVID-19 home from work, thus infecting their families.

Not surprisingly, we also found many health professionals were contemplating leaving the health workforce.

That was then – what has changed?

None of those issues have been resolved. Now health-care workers are facing even further pressures.

The sheer number of exposure sites, including exposure sites in or around health centres, are a major cause for concern. Exposure to the virus for health-care workers is enormously disruptive and leads to a cycle of COVID-19 testing and being furloughed for 14 days.

The flow-on effects of quarantining are huge. How do you manage, at short or no notice, caring for your children, the impact on your partner, and the rest of the over-stretched workforce having to step up to do your job?

One exposure site can knock out hundreds of workers from the health-care system.

We don’t have an unlimited supply of health-care workers. We also need to staff additional health workplaces, such as COVID-19 testing clinics and vaccine hubs.

This means there’s no slack in the system when we need to suddenly replace workers. Consequently, some health services may need to be reduced.

How can our health system cope?

Health-care workers in our survey also talked about how COVID-19 has emphasised the need to address existing “cracks in the system”.

As one respondent, a psychologist in her 40s, explained:

Things that were not going well, and had been neglected, have been made worse. Rundown buildings, casualised workforces working across multiple hospitals, stretched services covering multiple wards, a culture of “toughing it out” […]

The Australian Medical Association, too, is calling for a system overhaul, rather than a “top-up” funding approach, stating:

Even pre-COVID, emergency departments were full, ambulances ramped, and waiting times for elective surgery too long.

If we are to live with COVID-19, we need a health-care system that can cope with the “normal” pressures of providing health care for 25 million people, intermittent crises, plus respond to both the short and long-term needs of people with COVID-19.

Health-care workers’ mental health is an issue not only for themselves and their families, but for patient care and workforce retention as well: it’s an occupational issue.

Preparing the health-care system to respond to crises such as pandemics, must include supporting health-care workers and protecting them from burnout, overwork, and exhaustion. We risk losing our most valuable asset in the health-care system if we fail to urgently respond to these issues.

Karen Willis, Professor,Public Health, Victoria University, Victoria University and Natasha Smallwood, Assoc Professor, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Can Healthcare Workers Hang On in the COVID War?

Posted on August 14, 2021 by particularkev

At last, health, aged care and quarantine workers get the right masks to protect against airborne coronavirus

Posted on June 25, 2021 by particularkev

C Raina MacIntyre, UNSW; Benjamin Veness, CQUniversity Australia, and Michelle Ananda-Rajah, Monash UniversityAlmost a year ago, in July 2020, our calls for the government to urgently upgrade the guidelines to protect health workers from airborne SARS-CoV-2 fell on deaf ears.

The existing guidelines said health providers working around COVID-19 patients should wear a surgical mask. It restricted use of the more protective P2 or N95 masks, which stop airborne particles getting through, to very limited scenarios. These involved “aerosol-generating procedures”, such as inserting a breathing tube. This was expanded slightly in August 2020 but still left most health workers without access to P2/N95 masks.

More than 4,000 Australian health workers were infected by COVID-19 during the Victorian second wave. Health authorities denied the importance of airborne transmission and blamed clinical staff for “poor habits” and “apathy”. Health workers expressed despair and a sense of abandonment, cataloguing the opposition they faced to get adequate protection against COVID-19.

Last week, 15 months after the COVID-19 pandemic was declared, the Australian guidelines on personal protective equipment (PPE) for health workers, including masks, were finally revised.

What do the new guidelines say?

The new guidelines expand the range of situations in which P2/N95 masks should be available to staff – essentially anywhere where COVID-19-infected people are expected to be – and remove all references to “aerosol-generating procedures”.

This recognises that breathing, speaking, sneezing and coughing all generate aerosols which can accumulate in indoor spaces, posing a higher risk than “aerosol-generating procedures”.

“Fit testing” is an annual procedure that should be done for all workers wearing a P2/N95 mask or higher grade respirator, to ensure air can’t leak around the edges.

But this was previously denied to many Australian health workers.

The new guidelines unequivocally state fit-tested P2/N95 masks are required for all staff managing patients with suspected or confirmed COVID-19. This means health workers can finally receive similar levels of respiratory protection to workers on mining and construction sites.

The new guidelines leave ambiguity around which workplaces are within the scope by stating that health care:

may include hospitals, non-inpatient settings, managed quarantine, residential care facilities, COVID-19 testing clinics, in-home care and other environments where clinical care is provided.

The guidelines also allow employers to decide what comprises a high risk and what doesn’t, allowing more wiggle room to deny workers a P2/N95 mask.

N95 and surgical masks on a table. — N95 masks (top) protect against airborne transmission, while surgical masks (bottom) don’t.
Shutterstock

The guidelines say when a suitable P2/N95 mask can’t be used, a re-usable respirator (powered air purifying respirators, or PAPRs) should be considered.

But the guideline’s claim that a PAPR may not provide any additional protection compared to a “well-sealed” disposable P2/N95 mask, is not accurate. In fact, re-usable respirators such as PAPRs afford a higher level of protection than disposable N95 masks.

The new guidelines should also apply to workers in hotel quarantine – both health care and non-clinical staff. This will help strengthen our biosecurity, as long as they’re interpreted in the most precautionary way.

That means not using the wiggle room that allows workplaces to deem a situation lower risk than it actually is or that their workplace is exempt. When working around a suspected or confirmed COVID-19 case, all workers must be provided with a fit-tested P2/N95 mask. Otherwise they are not protected from inhaling SARS-CoV-2 from the air.

In aged care and health care, where cases linked to quarantine breaches can be amplified and re-seeded to the community, the new guidelines go some way towards better protecting our essential first responders and their patients.

Guidelines miss the mark on ventilation

The guidelines fail to explicitly acknowledge COVID-19 spreads through air but nonetheless recommend the use of airborne precautions for staff.

Airborne particles are usually less than 100 microns in diameter and can accumulate indoors, which means they’re an inhalation risk.

The old guidelines focused on “large droplets”, which were thought to fall quickly to the ground and didn’t pose a risk in breathed air. This was based on debunked theories about airborne versus droplet transmission.

The new guidelines fail to comprehensively address ventilation, which is only mentioned in passing with a reference to separate guidelines for health-care facilities. This may not cover aged care or hotel quarantine.

We must ensure institutions such as hospitals, hotel quarantine facilities, residential care, schools, businesses and public transport have plans to mitigate the airborne risk of COVID-19 and other pandemic viruses through improved ventilation and air filtration.

Australia could follow Germany, which has invested €500 million (A$787 million) in improving ventilation in indoor spaces.

Meanwhile, Belgium is mandating the use of carbon dioxide monitors in public spaces such as restaurants and gyms so customers can assess whether the ventilation is adequate.

Cleaning shared air would add an additional layer of protection beyond vaccination and mask-wearing. Secondary benefits include decreased transmission of other respiratory viruses and improved productivity due to higher attention and concentration levels.

No updated advice on hand-washing

The United States Centers for Disease Control and Prevention (CDC) now acknowledges exposure to SARS-CoV-2 occurs through “very fine respiratory droplets and aerosol particles” and states the risk of transmission through touching surfaces is “low”.

Yet this is not acknowledged in the latest Australian health-care guidelines.

Australians have been repeatedly reminded to wash or sanitise their hands, wipe down surfaces and stand behind near-useless plexiglass barriers.

The promotion of hand hygiene and cleaning surfaces is not based on science, which shows it is the air we breathe that matters most.

Revised public messaging is needed for Australians to understand shared air is the most important risk for COVID-19.

C Raina MacIntyre, Professor of Global Biosecurity, NHMRC Principal Research Fellow, Head, Biosecurity Program, Kirby Institute, UNSW; Benjamin Veness, Adjunct Professorial Fellow, CQUniversity Australia, and Michelle Ananda-Rajah, Consultant physician General Medicine & Infectious Diseases, Alfred Health, past MRFF TRIP Fellow, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Fired for storming the Capitol? Why most workers aren’t protected for what they do on their own time

Posted on January 12, 2021 by particularkev

The man on the right wearing the Trump hat was identified by his badge as an employee of Navistar Direct Marketing, which fired him.
AP Photo/Manuel Balce Ceneta

Elizabeth C. Tippett, University of Oregon

Can you be fired for joining a violent mob that storms the Capitol?

Of course you can.

Among the jarring images of white insurrectionists who broke into the U.S. Capitol on Jan. 6 was a man marching through the building holding a Trump flag with his work ID badge still draped around his neck.

It didn’t take long for internet sleuths to zoom in on the badge and alert his employer, Navistar Direct Marketing, a Maryland direct mail printing company.

The company promptly fired the man and contacted the FBI, issuing a statement that “any employee demonstrating dangerous conduct that endangers the health and safety of others will no longer have an employment opportunity.”

Even though the Capitol Police let all but 14 of the rioters walk away, the FBI and District of Columbia police have begun tracking them down. Other companies have also taken action against employees identified in the many photos from inside the Capitol. Even the CEO of a data analytics firm found himself without a job following his arrest.

Based on my experience as a law professor and lawyer specializing in employment law, I doubt that Navistar management is losing sleep over whether its decision was legally justified.

It’s not even a close case. Non-unionized workers in the United States – about 90% of all workers – are employed at-will. That means you can be terminated at any time, without notice, for any reason. It doesn’t even have to be a good reason. Unless the company has guaranteed your job in writing, or there is a specific law that protects your conduct – such as laws protecting union organizing or whistleblowing – your fate is up to them.

The law is more protective when it comes to unionized workers and government employees. These workers may have the right to be terminated only for cause, and they might get a hearing process prior to being disciplined. Government workers are also protected by the First Amendment, particularly when it comes to free speech in their capacity as citizens rather than speech related to the workplace.

That’s why the teachers and off-duty police officers spotted at the Capitol have only been suspended pending investigations, rather than fired outright. For these workers, their fate may depend on whether they were peacefully participating in the day’s earlier rally – an activity that would be considered protected speech – as opposed to engaging in violence or joining the capitol invasion, which would be unprotected illegal conduct.

Things get murky if these government workers were displaying white supremacist symbols, like a confederate flag, at the rally. Courts have recognized limits on the public speech of police officers to uphold public confidence, community relations and department morale.

A throng of Trump supporters stand in the U.S. Capitol Rotunda on Jan. 6 as one snaps a picture. — A supporter of President Donald Trump appears to take a selfie at the Capitol on Jan. 6.
Saul Loeb/AFP via Getty Images

But as the Brennan Center, a liberal-leaning law and public policy institute, observed in an August 2020 report, “few law enforcement agencies have policies that specifically prohibit affiliating with white supremacist groups.” The absence of such policies could make it harder for departments to later discipline off-duty police officers for their role.

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State lawmakers who participated are a different matter. Because they were elected by the people, they can’t be removed like ordinary employees. That might require a recall election or a state impeachment process.

But for most of the folks who snapped selfies in the Capitol – or ended up in someone else’s – if they don’t get a knock on the door from the FBI, they may soon be getting one from HR.

Elizabeth C. Tippett, Associate Professor, School of Law, University of Oregon

This article is republished from The Conversation under a Creative Commons license. Read the original article.

When health workers came up against COVID it laid bare gaps in their training

Posted on November 27, 2020 by particularkev

Jed Montayre, Western Sydney University and Yenna Salamonson, Western Sydney University

COVID-19 turned 2020 on its head for all healthcare workers, particularly those at the front line of the pandemic response.

Unexpectedly, the need to control the spread of the coronavirus has consumed healthcare systems. The healthcare workforce’s pivotal role in our pandemic response has been in the public spotlight. The experience has exposed knowledge gaps in curriculums, bringing to the fore questions about the education and training of front line healthcare workers.

The pandemic has highlighted the importance of including infection control, mental healthcare and ageing and aged care in all educational programs for health professions.

Infection control

All healthcare disciplines are expected to include infection control contents and principles in the curriculum. However, the teaching of this content was not designed to address a pandemic of historic proportions. Nor are healthcare workers specifically taught to apply infection controls in their workplaces with a pandemic in mind.

Infection control protocol during this pandemic requires all front-line healthcare workers to wear protective personal equipment, observe strict hand hygiene and adhere to contact-tracing measures.

In addition to including the classic “chain of infection” in teaching healthcare, we need to ensure students can apply these concepts in specific clinical settings. For example, aged care homes have a different set of infection control challenges from hospitals. These include potential breaches of isolation and infection containment measures by COVID-positive residents visiting other residents, a lack of dedicated isolation rooms and staff with limited training.

Infection control goes beyond competence in the use of protective gear and isolation measures. Management skills are needed to ensure everyone follows recommended infection control practices within their organisations.

For example, registered nurses in aged care must oversee and manage staff adherence to infection control protocols with their facility. These workers include students, cooks and cleaners, so they too must have the essential infection control knowledge and training.

Aged care residents smiling as they exercise — Aged care homes that acted decisively to implement measures appropriate for a pandemic protected their residents from COVID-19.
belushi/Shutterstock

Ageing and aged care

Older people are unquestionably at greater risk of serious illness or death from COVID-19. To protect them, visits by family and friends are often curtailed, particularly in residential aged care facilities. Not surprisingly, loneliness and social isolation are increasing among older people.

Psychosocial issues like these underscore the importance of a focus on ageing and aged care in healthcare curriculums. In Australia, pre-pandemic evidence indicated a lack of ageing-related education for health professionals. This was highlighted by the Aged Care Royal Commission recommendation to integrate age-related conditions and aged care into healthcare curriculums as an accreditation requirement.

In the context of the COVID-19 pandemic, it is crucial that healthcare students are well prepared to provide optimal care for our most vulnerable age group.

Mental health

The mental health impacts of COVID-19 have affected all population groups. Preventing further mental health issues is now the main goal.

However, not all healthcare programs include content that incorporates approaches to psychological distress and a potential mental health crisis. COVID-19 has exposed this gap in the education of healthcare workers who have had to attend to patients’ mental health needs during the pandemic.

Lonely older man looking out of window — The lack of social contacts under COVID-19 restrictions has been challenging for people’s mental health.
Photographee.eu/Shutterstock

Education and training are essential as complex challenges can arise when non-expert healthcare workers manage mental health issues. There’s a need to consider the inclusion in healthcare curriculums of mental health education encompassing the lifespan and life transitions – for example, maternal mental health with pregnancy and childbirth during a pandemic.

Building in pandemic preparedness

The emergence of COVID-19 has highlighted the need for healthcare curriculums to include pandemic preparedness.

Preparedness of course includes clinical competence of healthcare workers. However, a successful pandemic response also requires building resilience at a time of change in health systems. Students need to be prepared for changes in health-service delivery such as the use of telehealth and digital platforms.

Access to healthcare must be maintained even in the midst of a pandemic.

Upholding human rights

COVID-19 has raised ethical and moral issues relating to the rights of every individual to health. The pandemic has exposed inequalities at every level – for example, rationing healthcare resources for older people. It’s vital that healthcare curriculums integrate content on upholding human rights during a pandemic.

Understanding the social determinants of health in a pandemic also helps provide contexts for infection control, care for vulnerable groups and prevention of mental health issues.

Attention to the most vulnerable groups, people and their families who experienced COVID-19 deaths, and an understanding of universal health coverage are fundamental for healthcare students during this pandemic and beyond.

Jed Montayre, Senior Lecturer (Nursing), Western Sydney University and Yenna Salamonson, Professor in Nursing, Western Sydney University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Here’s the proof we need. Many more health workers than we ever thought are catching COVID-19 on the job

Posted on August 30, 2020 by particularkev

Alicia Dennis, University of Melbourne

Yesterday, the Victorian government released much-anticipated figures showing the proportion of the state’s health-care workers who caught COVID-19 at work.

Victoria’s chief medical officer Andrew Wilson said yesterday that 70-80% of health workers testing positive to COVID-19 were infected at work. That’s compared with 22% in the first wave.

That figure, which equates to at least 1,600 people infected in the workplace, is shocking and tragic. This is because occupational exposure of health-care workers to SARS-CoV-2, the virus that causes COVID-19, represents a failing of hazard control in many workplaces — across multiple locations, in hospital and in aged care.

We also need to acknowledge this problem is fundamentally an occupational health and safety issue rather than simply an infectious disease problem. This means experts in occupational health and safety need to be intrinsically involved in recommendations and guidance to government and employers.

What else did the report find?

The report found infection of health-care workers was greatest in areas where there were many patients with COVID-19 being cared for together (known as “cohorting”), and where health-care workers congregated, such as tea rooms.

Other contributing factors were the increased risk associated with putting on and taking off (donning and doffing) personal protective equipment (PPE), staff moving between health-care facilities, and poor ventilation systems with inadequate air flow.

The report tells us health-care workers in aged care accounted for around two in five infections, and hospital workers around one-third.

However, further details were not provided. These include the actual number of health-care workers infected at work, and a detailed breakdown of the category of health-care worker infected, as well as their age ranges and gender.

We also don’t know the severity of health-care worker infections (number of people who are or have been hospitalised, in ICU, or died).

How big a problem is this?

The number of health-care workers infected with COVID-19 in Victoria has reached 2,799. That makes a seven-day average of 43 new cases each day.

This means that while the state’s total number of new cases continues to decline, health-care worker infections make up around 30% of new cases each day.

Controlling the number of new health-care worker infections is essential, not only for health-care workers but for the sustainability of our health-care system, and to reduce the overall number of cases.

As the total number of health-care worker infections has risen, key groups representing doctors and nurses have called on the government to produce data on the number of health-care workers infected at work and a breakdown of the data by health-care worker type, age, location and severity.

Yesterday the government released its keenly awaited analysis.

What should we do about it?

In light of the report, the Victorian government has established a new health-care worker infection prevention and well-being taskforce.

This is an important step forward and hopefully includes representation from all expert groups, especially occupation health and safety exerts.

Data from earlier in the year, and indeed prior experiences with SARS (severe acute respiratory syndrome), have already given us a blueprint for how to protect health-care workers today.

The blueprint includes implementing a system of hazard control measures (called a hierarchy of control model) in all health-care settings using experts in the field of occupational health and safety, including occupation hygienists.

The government report also outlines plans to develop ventilated and heated marquee-type tents for workers to have their tea breaks in, which is also good news. This recognises the contribution poor air flow makes to the transmission of SARS-CoV-2.

The planned introduction of PPE “spotters” in workplaces is also positive but further details are needed to understand exactly what they will do.

This will hopefully reduce staffing pressure in the workplace and ensure correct donning and doffing of PPE.

What about ‘fit testing’ respirators?

The report also included the surprising announcement that the government was going to undertake a fit-testing trial of respirators.

Testing that respirators, such as N95 face masks, fit and that staff are trained to use them are essential parts of workplace safety, in any industry. It is required as part of Australian standard AS 1715.

So, there is no need to trial fit testing. This is clear from experience in other industries where workers are exposed to hazards such as asbestos or dangerous laboratory fumes.

What is needed is immediate implementation of fit testing and training so health-care workers can be assured their masks fit correctly and do not allow the virus in. This is especially important for females, with many reporting the standard respirator size does not fit properly.

The government needs to do more

The government’s report acknowledged the likelihood of aerosol spread as a mechanism for the transmission of SARS-COV-2. So it has engaged the Victorian Health and Human Services Building Authority to conduct a study aimed at investigating aerosols and their spread on surfaces.

We do not have to wait for the results of this research. The government can act now and take the next step and immediately change its guidelines for PPE for health-care workers.

The Victorian PPE guideline for health-care workers still does not recommend universal PPE designed to protect health workers from aerosols when caring for COVID-19 suspected or positive patients.

The guidelines instead recommend PPE to protect against droplet transmission (such as surgical masks), even in the situation where a person with COVID-19 is severely coughing.

Disappointingly, national guidance still remain unchanged regarding its advice for health-care workers caring for COVID-19 suspected or positive patients. It too does not recommend universal aerosol precaution PPE (including respirators) when health-care workers care for patients with COVID-19.

These guidelines need to be urgently updated to protect health-care workers.

There is also an urgent need for a comprehensive, publicly accessible state and national registry of health-care worker infections that provides regularly updated disaggregated data about health-care worker infections.

This is essential so the magnitude of the problem can continue to be addressed and immediate preventative strategies put in place.

Finally, now the problem of occupational exposure of health-care workers to SARS-CoV-2 has been acknowledged, we must make all these changes immediately.

Alicia Dennis, Associate Professor MBBS, PhD, MPH, PGDipEcho, FANZCA, University of Melbourne

This article is republished from The Conversation under a Creative Commons license. Read the original article.

There may not be enough skilled workers in Australia’s pipeline for a post-COVID-19 recovery

Posted on June 7, 2020 by particularkev

Pi-Shen Seet, Edith Cowan University and Janice Jones, Flinders University

Scott Morrison wants to overhaul the skills workforce to ensure a better post-COVID-19 recovery. But there may not be enough people with the necessary skills to do so. And travel restrictions, which will reduce migration, will only compound the issue.

A Productivity Commission interim report released today found the proportion of people without qualifications at a Certificate 3 level or above decreased from 47.1% in 2009 to 37.5% in 2019. This will not be enough to meet a Council of Australian Governments (COAG) target of 23.6% set for 2020.

The report also found while the number of higher-level qualifications (diplomas and advanced diplomas) sharply increased between 2009 and 2012, it has since fallen to its 2009 level.

The 2020 target was set out in the 2012 National Agreement for Skills and Workforce Development (NASWD), which identified long-term federal and state objectives in skills and workforce development.

The report noted the skills agreement is no longer fit for purpose, and the A$6.1 billion governments spend annually on vocational education and training can be better allocated to improve outcomes.

What the report found

The National Agreement for Skills and Workforce Development was intended to significantly lift the skills of the Australian workforce and improve participation in training, especially by students facing disadvantage. Several targets, performance indicators and outcomes were agreed to.

These included to:

halve the proportion of Australians aged between 20-64 without qualification at certificate 3 level and below, from 47.1% in 2009 to 23.6% by 2020
double the number of advanced diploma and diploma completions nationally from 53,974 to 107,948 in 2020.

The commissioners admit some of the targets agreed to were arbitrary and ambitious.

The report says:

If targets are unattainable, they quickly become irrelevant for policymakers. The NASWD’s performance indicators were reasonable general measures but needed to be linked to specific policies to allow governments to monitor progress.

The commissioners state the failure to meet the targets is not an indication the national agreement has failed overall. This is because the targets only looked at those with formal education.

It noted a large proportion of the workforce aged over 25 are more likely to do informal training to increase skills for their current occupation, as opposed to formal training to get a new job.

About 85% of workers’ non-formal learning is paid for by employers, but government policies are largely silent about this kind of training.

Noting these caveats, the report identified factors that contributed to the failure to meet the targets. These included:

a lack of uniform commitment and execution to meet the reform directions set as part of the original national agreement. This was meant to improve training accessibility, affordability and depth of skills through a more open and competitive VET market, driven by user choice
the reputational damage of the VET FEE-HELP scheme that facilitated rorting of the system
a reduction in governments’ commitment to a competitive training market. This includes a lack of accessible course information for students and inadequate sector regulation
unclear pathways to jobs through the VET system – for example through lack of proper employment advice through school career advisors.

The fall in VET participation also coincided with an increase in university enrolments. This suggests students were choosing university over VET. VET and traineeship funding also tightened from 2014.

What the report recommends

Treasurer Josh Freydenberg asked the Productivity Commission to undertake the review of the National Agreement for Skills and Workforce Development in November 2019, before the bushfires and COVID-19 hit the economy.

The request came a few months after former New Zealand skills minister Steven Joyce released a report and recommendations of his review of Australia’s VET system.

The findings of the Productivity Commission’s interim report appear to dovetail well with those of the Joyce review. This recommended the formation of the National Skills Commission, which can facilitate an overarching national and consistent approach to vocational education and training.

The interim report’s main recommendation is for governments to consider reforms to make the VET system a more efficient, competitive market. This must be driven by informed choices of students and employers, with the flexibility to deliver a broad suite of training options.

The commissioners also advocate for the use of common methods of measurement among states and territories to achieve nationally consistent VET funding and pricing.

For example, one of the most popular VET courses in Australia is the Certificate 3 in individual support — the course you’d study to work in aged or disability care. Standard subsidies for this course vary by as much as A$3,700 across Australia.

The report calls for more submissions and consultation as part of the next phase of the review.

The initial assumption of the commissioners was that the changing nature of work largely driven by new technology would be the main driver of changes to VET requirements.

But given the disruptions to the economy, and learning delivery having moved online, the commissioners note that while their current options and recommendations are unlikely to change in the general sense, COVID-19 is probably driving longer-term changes to the economy.

They say the pandemic may lead to structural changes in the VET sector which will also be relevant to any future agreements between governments.

Pi-Shen Seet, Professor of Entrepreneurship and Innovation, Edith Cowan University and Janice Jones, Associate Professor, College of Business, Government and Law, Flinders University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Sharing my thoughts with the world from a Particular Baptist perspective

Remind me, what is Worksafe?

Why did Worksafe charge the health department?

Is it unusual for a government regulator to fine a government department?

What does this mean for other employers?

What happens next for the Vic health department?

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Level 1: vaccination and working from home

Level 2: safe indoor air

Level 3: administrative measures

Level 4: masks

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A range of concerns

The risks

How can we all stay safe?

1. Don’t judge

2. Work out what works

3. Ensure supply and access

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What have health workers had to deal with so far?

That was then – what has changed?

How can our health system cope?

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What do the new guidelines say?

Guidelines miss the mark on ventilation

No updated advice on hand-washing

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Infection control

Ageing and aged care

Mental health

Building in pandemic preparedness

Upholding human rights

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What else did the report find?

How big a problem is this?

What should we do about it?

What about ‘fit testing’ respirators?

The government needs to do more

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What the report found

What the report recommends

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