Nursing and care: recognising Covid as an occupational disease

EPSU Health union SANITAS Romania

(12 May 2021) Long Covid has serious implications for both health and social care workers and the services they provide. The European Federation of Public Service Unions (EPSU) is marking International Nurses’ Day today (12 May) with a call to governments, employers and the European institutions to support these workers and ensure long Covid does not worsen already chronic staff shortages.

A recent World Health Organisation (WHO) report says that while the world has tracked the progress of the Covid-19 pandemic using data on cases and deaths, these provide only a partial picture.

What is long Covid?

“Many people struggle to recover from the acute infection, suffering often disabling symptoms that last weeks or months and, in some cases, with disabilities that are likely to be very long lasting,” it reports. These symptoms are known as long Covid.

A quarter of people who have had the Covid-19 coronavirus go on to experience symptoms that continue for at least a month, and one in ten are still unwell after 12 weeks, according to the WHO. Studies in Austria and France indicate that two-thirds of those hospitalised with Covid-19 experience persistent breathing problems weeks after being discharged. And the FNV Dutch trade union confederation reports that it is seeing more and more employees from the health and care sector who were infected during the first wave and have been ill for more than a year. 

Researchers at King’s College London have found two main groupings of long Covid symptoms. One is dominated by respiratory illness such as coughs and shortness of breath, as well as fatigue and headaches. The second is “clearly multi-system”, affecting many parts of the body including the brain, gut and heart. Long Covid sufferers reported palpitations or fast heartbeat, as well as pins and needles or numbness, and problems concentrating or “brain fog”.

Health and care workers at greater risk

While it can affect anyone, the WHO says women and health care workers appear to be at greater risk. In the UK alone, according to an analysis by the Office for National Statistics (ONS), an estimated 1.1 million people reported experiencing long Covid symptoms in the four-week period ending 6 March 2021.  These symptoms were affecting the day-to-day activities of 674,000 people, with 196,000 of these individuals reporting that their ability to undertake their day-to-day activities was “limited a lot”.  

Health and social care workers experienced the highest prevalence rates of self-reported long Covid (3.6% and 3.1% respectively), with an estimated 122,000 healthcare and 31,000 social care workers affected.

In the Netherlands, statistics reveal that by March 2021, 140,000 healthcare workers had been infected with Covid-19, 900 had been hospitalised and 30 had died. Of those who were infected with Covid-19 in the first wave, between March and June 2020, 90% said they were experiencing physical and mental health problems.

More than a quarter (27%) said they were also suffering, or expected to suffer, financial difficulties. They can lose as much as 30% of their salary and the FNV has called on the Dutch government to create a fund for health and social care workers who were infected with the coronavirus at work and who suffered financial damage as a result.

More than 7,500 nurses and midwives have contracted Covid-19 in Ireland, making up over a quarter of all Covid-19 cases among healthcare workers. The INMO nurses’ union is calling on the government and employers to put in place measures including tailored medical support, research into the impact of long Covid, a guarantee that healthcare workers with long Covid will not face a cut in their income, and flexible rehabilitation back into work.

INMO general secretary Phil Ní Sheaghdha called on the Health Services Executive, which runs public health and social care services in Ireland, to “lead the charge on this and implement the measures that our members are calling for”.

“This is a condition people are acquiring at work, and their workplaces need to step up and give them the support they need,” she added.

Urgent action needed to protect and health and care workers and systems

Without urgent action by governments and employers, long Covid will have a devastating impact on sectors that were already chronically under-staffed before the pandemic, and where the toll of working on the Covid frontline over the last year has left many workers exhausted, burned out and in some cases ready to quit their jobs.

Even before Covid, EPSU and many other organisations were pointing to a shortfall of around two million health and social care professionals across the European Union (EU).

Data collated and analysed by the human rights organisation Amnesty International identified more than 4,100 deaths among health and social care workers in Europe, and even this figure is likely to be a huge underestimate because of under-reporting due to a lack of testing, counting or transparency.

Covid has pushed many others to breaking point. Over the last year, reports have shown how healthcare workers have continued to provide care despite exhaustion, stress and anxiety, often working long shifts while wearing cumbersome and uncomfortable personal protective equipment and witnessing the deaths of both patients and their colleagues.

At the end of March 2021, for example, the UNISON public services union reported survey findings showing more than half of National Health Service and social care staff in London were considering quitting their job altogether due to the pressures experienced over the past year.

Sickness absence due to long Covid will only add to these pressures. One international patient-led survey found that 45% of long Covid sufferers had reduced their workload and more than one in five (22%) were not working because of their. Patients with long Covid reported “prolonged multisystem involvement and significant disability” and most had not returned to their previous levels of work six months after being infected.

Evidence from patients with non-critical Covid-19 who were discharged from hospital in France between March and June 2020 shows more than one in ten (11%) were still on sick leave 60 days later. The WHO says that the fact that half of this cohort were healthcare workers is a reminder of the risks that long Covid presents to health systems.

Classify Covid-19 as an occupational disease

Despite the wealth of evidence that health and social care workers have been infected at work, many European countries have been slow to recognise Covid-19 as an occupational disease and pay compensation to those infected.

At the end of March 2021, for example, despite finding evidence of a doubling of the risk of Covid infection for several occupations, including social care and nursing, the UK Industrial Injuries Advisory Council (IIAC) did not recommend prescribing Covid-19 as a work-related disease for industrial injury disablement benefit (IIDB) “at this time”. The IIDB scheme provides non-contributory, “no-fault” benefits for disablement because of accidents or prescribed diseases which arise during the course of work.

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