Protecting health care workers is essential for public and patient health

The COVID pandemic has highlighted the extent to which protecting health workers is key to ensuring a functioning health system and a functioning society. Since the beginning of the COVID outbreak, health care providers have been shown support, solidarity and gratitude. Nevertheless, attacks on health care have continuously been reported and now also include incidents linked to the COVID-19 pandemic across the world.

17 September is World Patient Safety Day, and Humanitarian Advisors call on governments and leaders running health services at local levels to take five actions to better protect health workers. These include steps to protect health workers from violence; to improve their mental health; to protect them from physical and biological hazards; to advance national programs for health worker safety; and to connect health worker safety policies to existing patient safety policies.  At least one in five healthcare professionals report symptoms of depression and anxiety.  Almost four in ten healthcare workers experience sleeping difficulties and/or insomnia.  Rates of anxiety and depression are much higher for female healthcare workers and nursing staff.

Mounting reports of infections, illness and attacks among health workers fighting COVID-19

COVID has exposed health workers and their families to unprecedented levels of risk.  COVID pandemic has the potential to significantly affect the mental health of healthcare workers. Governments and health care authorities should systematically monitor rates of mood, sleep and other mental health issues in order to understand mediating factors and inform tailored interventions. Although not representative, data from many countries indicate that COVID infections among health workers are far greater than those in the general population.

While health workers represent less than three percent of the population in the large majority of countries and less than two percent in almost all low- and middle-income countries, around 14 percent of COVID cases reported to WHO are among health workers. In some countries, the proportion can be as high as 35 percent.  However, data availability and quality are limited, and it is not possible to establish whether health workers were infected in the work place or in community settings. Thousands of health workers infected with COVID have lost their lives worldwide.

In addition to physical risks, the pandemic has placed extraordinary levels of psychological stress on health workers exposed to high-demand settings for long hours, living in constant fear of disease exposure while separated from family and facing social stigmatization. Before COVID emerged, medical professionals were already at higher risk of suicide in all parts of the world.

Steps to improve health worker safety and patient safety

On World Patient Safety Day, governments must remember that they have a legal and moral responsibility to ensure the health, safety and well-being of health workers. Governments should:

1. Establish synergies between health worker safety and patient safety policies and strategies

• Develop linkages between occupational health and safety, patient safety, quality improvement, and infection prevention and control programmes.
• Include health and safety skills in personal and patient safety into education and training programmes for health workers at all levels.
• Incorporate requirements for health worker and patient safety in health care licensing and accreditation standards.
• Integrate staff safety and patient safety incident reporting and learning systems.
• Develop integrated metrics of patient safety, health worker safety and quality of care indicators, and integrate with health information system.

2. Develop and implement national programs for occupational health and safety of health workers

• Develop and implement national programmes for occupational health for health workers in line with national occupational health and safety policies.
• Review and upgrade, where necessary, national regulations and laws for occupational health and safety to ensure that all health workers have regulatory protection of their health and safety at work.
• Appoint responsible officers with authority for occupational health and safety for health workers at both the national and facility levels.
• Develop standards, guidelines, and codes of practice on occupational health and safety.
• Strengthen intersectoral collaboration on health worker and patient safety, with appropriate worker and management representation, including gender, diversity and all occupational groups.

3. Protect health workers from violence in the workplace

• Adopt and implement in accordance with national law, relevant policies and mechanisms to prevent and eliminate violence in the health sector.
• Promote a culture of zero tolerance to violence against health workers
• Review labour laws and other legislation, and where appropriate the introduction of specific legislation, to prevent violence against health workers.
• Ensure that policies and regulations are implemented effectively to prevent violence and protect health workers.
• Establish relevant implementation mechanisms, such ombudspersons and helplines to enable free and confidential reporting and support for any health worker facing violence.

4. Improve mental health and psychological well-being

• Establish policies to ensure appropriate and fair duration of deployments, working hours, rest break and minimizing the administrative burden on health workers.
• Define and maintain appropriate safe staffing levels within health care facilities.
• Provide indemnity and insurance coverage for work-related risk, especially those working in high-risk areas.
• Establish a ‘blame-free’ and just working culture through open communication, including legal and administrative protection from punitive action on reporting adverse safety events.
• Provide access to mental well-being and social support services for health workers, including advice on work-life balance and risk assessment and mitigation.

5. Protect health workers from physical and biological hazards

• Ensure the implementation of minimum patient safety, infection prevention and control, and occupational safety standards in all health care facilities across the health system.
• Ensure availability of personal protective equipment (PPE) at all times, as relevant to the roles and tasks performed, in adequate quantity and appropriate fit and of acceptable quality. Ensure an adequate, locally held, buffer stock of PPE. Ensure adequate training on the appropriate use of PPE and safety precautions.
• Ensure adequate environmental services such as water, sanitation and hygiene, disinfection and adequate ventilation at all health care facilities.
• Ensure vaccination of all health workers at risk against all vaccine-preventable infections, including Hepatitis B and seasonal influenza, in accordance with the national immunization policy, and in the context of emergency response, priority access for health workers to newly licenced and available vaccines.
• Provide adequate resources to prevent health workers from injuries, and harmful exposure to chemicals and radiations; provide functioning and ergonomically designed equipment and work stations to minimize musculoskeletal injuries and falls.

Humanitarian Advisors hopes that on this World Patient's Day, more is done to protect the health care workers that care for them.