What we will cover: o Review of where we are with COVID-19 o Absolute - - PowerPoint PPT Presentation
COVID-19 An Occupational Health Update 29 th July 2020 Dr Munna Roy , Medical Director , Integral OH What we will cover: o Review of where we are with COVID-19 o Absolute Risk from COVID-19 o COVID Age o Shielding Pause o Risk Assessment and
Dr Munna Roy , Medical Director , Integral OH
22 weeks in into th the Pandemic
f 24th
th July
ly 2020, estim imate 400 in infectious people le in in Scotland Th That is is 400/5,550,000 = 0.0 .007% OR OR 7 people le in in 100,000
f in infectious people le are reducing by about 25% a a week
:20,000 in infectious people le predic icted (3 (31.7.20)
30 new in infections a day
infections compared to th the peak (1 (16-22 22nd
nd March 2020)
f th the population have been in infected wit ith COVID-19 19
immunit ity
ry real l ris isk of in increases as people le mix ix/do more
inary cold lds and fl flu in in th the win inter wil ill l cause proble lems
Individual Health and Demographic Factors Workplace Transmission Risk Societal Prevalence
infectious people
Absolute risk of death/severe illness from COVID-19
Age an and Ge Gender ar are th the str trongest ris risk factors for a a poor ou
from COVID-19 19 in infection
Age Ba Band In Infectio ion fatalit lity ratio io Odds of f dyin ing if if in infected (approx.) .) 20 20-29 29 0.0309% 1:3000 30 30-39 39 0.0844% 1:1250 40 40-49 49 0.161% 1:621 50 50-59 59 0.595% 1:168 60 60-69 69 1.93% 1:52
Verity, R., Okell, L. C., Dorigatti, I., Winskill, P., Whittaker, C., Imai, N., ... & Dighe, A. (2020). Estimates of the severity of coronavirus disease 2019: a model-based analysis. The Lancet infectious diseases.
▪The Chie ief Medical Officer Dir irectorate in in Scotland has ju just sanctioned the use of COVID ID-age for use in in Scotla land. ▪A scorin ing system to ascertain in in indiv ividual vuln lnerabil ility to COVID- 19. 19.
▪A scorin ing system to ascertain in in indiv ividual vuln lnerabil ility to COVID- 19. 19. ▪Takes in into account Chronologic ical Age, , Gender, , Ethnic icity and underlying medical conditions to ‘Adjust’ chronological age and convert it it to a COVID ID Age. . ▪The COVID ID Age is is a ris isk score that can then be used to id identif ify the typ ype of work that could ld be safe for an in indiv ividual to work k in in. ▪Let’s look at an example…..
65 65 year ear ol
Fem emale (su (subtract 5) 5) White Eth thnicit ity (a (add 0) 0) BM BMI I of
37 (a (add 5) 5) COP OPD (a (add 6) 6)
Covid id Age = = 71 71
35 35 year ear ol
Male le (ad (add 0) 0) White Eth thnicit ity (a (add 0) 0) BM BMI I of
40 (a (add 9) 9) Mild ild as asth thma (a (add 1) 1)
Covid id Age = = 45 45
https: s://www.gov.scot/publi lications/coronavirus-covid-19 19-guid idance-on
individ idual-ris isk- ass assessment-for-th the-workpla lace/
▪Th The ins instructio ions for r use se and form rm can be found at t th the above li link. ▪Emphasis is on in involv lvin ing th the work rker and havin ing a disc iscussio ion. . ▪Comple lex or r hig igher risk risk situ situatio ions may requir ire OH in input.
Shie ielding Paused does not mean in indiv ividual l ris isk is is the same as every ryone els lse Shie ielding Paused allo llows in incr creased fr freedoms due to the lo low socie ciety prevalence
▪“Physical distancing guidance for the at risk groups in Scotland” ▪“Can return to a Covid safe workplace”
Workplace transmission risk assessment
Based on risk after control measures are implemented Risk ID COVID-19 Transmission Risk Factors Low * Standard Medium High 1 Travel ☐ ☐ ☐ ☐ 2 Workplace entry and exit ☐ ☐ ☐ ☐ 3 Workstation Spacing and Staff Density ☐ ☐ ☐ ☐ 4 Patient/Public/Service User facing ☐ ☐ ☐ ☐ 5 Movement in the workplace ☐ ☐ ☐ ☐ 6 Rest and Welfare facilities ☐ ☐ ☐ ☐ 7 Workplace surface hygiene ☐ ☐ ☐ ☐ 8 Hand hygiene ☐ ☐ ☐ ☐ 9 Symptomatic people in the workplace ☐ ☐ ☐ ☐ 10 Home visiting ☐ ☐ ☐ ☐ 11 Provision of personal care/Direct healthcare – Special settings ☐ ☐ ☐ ☐ 12 Failure of workers to follow workplace control measures and guidance ☐ ☐ ☐ ☐ 13 Additional Risks Identified ☐ ☐ ☐ ☐
▪New, continuous cough ▪Fever ▪Lo Loss of f or change in in taste or smell
………symptoms of potential COVID-19 in infection Sh Should ld all all get a a test. Help lps con
irm th the diag iagnosis an and id identify fy th those who need to
isol
and have contact tr tracin ing
▪As soon as possib ible le and wit ithin in 5 days ▪Go to NHS In Inform or call ll 111 ▪Key y workers or household ld members of a Key Worker get prio iorit ity (prio ioritized wit ithin in that) ▪Driv ive in in test sit ites and home test kit kits, some mobile le sit ites ▪Must is isolate until il results are known (in individual l and household contacts) ▪If If positive, , must adhere to 7 days, no fever for 48 hours before endin ing is isolation
▪Confirmed positive tests will be contacted (t (telephone or text xt) ▪People you li live wit ith – will need to is isolate for 14 days (7 (7 fr from day or r onset of f Covid-19 symptoms) ▪People you have been in in contact wit ith and where.
▪A clo lose contact can be defi fined as someone liv living in in th the same household ▪someone who had dir irect or physical contact with an in infected person ▪someone who has remained wit ithin tw two metres of f th the patient for lo longer th than 15 min inute
▪RCOG have produced guid idance: “Occupational l health advice for employers and pre regnant women during the COVID-19 pandemic” v3
v3.2 .2 22 May 2020
▪Not updated sin ince 22 May 2020. . ▪Last Trim imester is is thought to be the hig ighest ris isk ▪Advic ice focuses on healt lthcare workers. . ▪Referenced in in Scottis ish Government guid idance
▪<28 weeks – remove ris isks that are greater than outside the workpla lace e.g. . physical dis istancing ▪>28 weeks – RCOG recommends ‘stay at home’ ▪Maternal Choic ice is is emphasised