(5 March 2020) Cases of the coronavirus disease (COVID-19), which first broke out in China, have now been reported in 28 states across the EU/EEA, UK, Monaco, San Marino and Switzerland. As of 4th March, 3351 cases and 85 deaths have been reported in Europe, the majority of which are in Northern Italy. Whilst these numbers remain relatively low, in the two months since the first case of coronavirus was reported, there have been tens of thousands of cases globally, and thousands of deaths. Recognising the strain this puts on public health systems and the increased occupational risks faced by public health workers, the European Commission must take immediate action to protect health workers and strengthen the resilience of public health infrastructure.
Healthcare workers are particularly vulnerable for a number of reasons. Firstly, the coronavirus is highly contagious and medical workers are exposed to more viral particles than the general public. On 24 February, the National Health Commission in China stated that more than 3,000 healthcare workers nationwide had been infected, demonstrating the acute vulnerability of those at the frontline of the COVID-19 outbreak. Secondly, the problems are being exacerbated due understaffing and shortages of supplies as the tide of patients rises. Thirdly, a combination of stress and long hours can weaken health workers’ immune systems, making them even more vulnerable than normal.
EPSU calls on the European Commission to take concrete action to guarantee the safety of health workers and the continuity of public and emergency services, in line with the measures and protocols agreed during the extraordinary EPSCO council on 13th of February. As well as supporting national governments, the Commission should consider the following elements to ensure a strong overall level of preparedness for this and potential future health crises:
- Ensure the full and prompt availability of personal protective equipment (PPE): Compliance with standards of PPE use is important for disease prevention. EPSU affiliates, particularly in Italy, are reporting shortages of PPE. It is therefore imperative to include emergency mechanisms in the Personal Protective Equipment Directive 89/686/EEC, to ensure immediate provision and availability of necessary equipment for hospitals and medical staff.
- Reinforce the coordination and the uniform application of safety protocols and health guidelines in all hospitals across Europe: A well-equipped and healthy workforce is critical to ensuring the resilience of public health in cases of emergency. The health workforce should be an integral part of national and international public health preparedness plans. In this framework, we underline the obligation of all national member states and hospital management to put in place the necessary measures to ensure that safety protocols are available in all hospitals and that all professionals are properly trained to work in accordance with them. At the moment, our unions are reporting the application of different protocols not only between member states, but also between different hospitals and regions in the same country. This may create gaps in the safety infrastructure needed to protect staff involved in the crisis. It is essential that national governments and the European Commission further enforce occupational safety and health guidelines in their Integrated Situation Awareness and Analysis (ISAA), beginning with infection prevention and control strategies to protect health care workers.
- Tackle the healthcare staff shortages: The capacity of Europe to respond to this emergency is severely challenged by serious staff shortages in healthcare, in particular for those services that represent the first line of defence against any epidemic or pandemic (eg. the emergency services, ambulance services and general practitioners). In particular, our Italian affiliates report that hospitals face shortages of medical personnel, leaving them unable to keep up with the influx of patients. This shows once again the importance of investing in infrastructure to forecast the demands on health care workers during such outbreaks. We therefore call on the European Commission to continue to strengthen the models that forecast the availability of health personnel, existing and predicted changes in demand, and strategies for deployment of additional workers in emergency situations.
- Address critical factors related to the health and well-being of medical personnel, including stress management and fatigue: As the WHO highlights, fatigue and psychosocial stress are among the most common risks to safety and health in emergencies. Its recommendations for reducing fatigue include implementing policies on working hours, duration and rotation of shifts and rest periods, as well as advance measures to prevent fatigue involving delegation of responsibilities, support services, and contingency planning.
- Reinforce coordination and communication among member states: We call on the European Commission, member states and health care institutions to ensure a clear system for coordination and communication with frontline workers so that staff are aware of the most up to date recommendations.
The COVID-19 crisis provides an opportunity to reflect upon ways to limit the impact of infectious diseases on health workers and upon strategies to ensure the health workforce is fully equipped to respond to such crises. Governments, health care institutions, and other stakeholders should learn from the lessons of previous outbreaks to improve the care of health care workers and target innovations in the health workforce. As the COVID-19 virus continues to spread, EPSU extends its sincere gratitude to the health care workers who are dedicating their lives to helping others, and insists they receive the support that they deserve.