Education & Company Policy key in containing Workplace Risk amid potential Covid-19 2nd wave

Old Mutual and CareWorks share their learnings on managing healthcare crisis in the workplace, including reflections on how SA’s response to COVID-19 was reminiscent of the response to HIV in the 90s

The second wave of Covid-19 currently impacting the UK and Europe has highlighted that now is not the time for South African employers to become complacent. Our lockdown restrictions were eased to Level 1 in mid-September, but hyper vigilance and caution need to remain firmly in place.

Although employees, the frontline workers of the economy, need to be brought back to work as safely and quickly as possible to help repair our battered economy, we need to continue taking steps to keep the infection curve as flat as possible, says Urvashi Ramjee, Head of Claims Management at Old Mutual.

Between May and August this year, Old Mutual Corporate partnered with CareWorks, a specialist disease management, counselling and support provider, to help businesses manage continuity and contain risk.

According to the Medical Adviser at CareWorks, Dr Nkateko Msimeki, the onward transmission of Covid-19 in the workplace was reduced by between 21% and 41%, due to intensive clinical case management offered by the programme.

She observes that much of the initial public response to the pandemic was reminiscent of the public’s reaction to HIV in the early 1990s. For many people, having Covid-19 carried a stigma. “It is essential to recognise that each South African holds a unique experience of the pandemic linked to their upbringing, social environment and education,” she explains.

“Stigmatisation, social disapproval and discrimination against those infected can significiantly undermine efforts to prevent and treat health conditions.

“As we saw in the 90s, pervasive stigma experienced by people living with HIV created an environment of fear and denial which undermined testing and treatment. The number one learning from our call centre during the height of this pandemic was the importance of education and company policy to combat stigma and ignorance,” she says.

As many South Africans return to work in the coming weeks, Ramjee and Dr Msimeki will be sharing their learnings with business owners and HR consultants, suggesting ways in which employers can make the workplace safer to protect against a second wave.

Follow the trends

The call centre followed the national trends, meaning the right people were being managed at the right time. In other words, as Covid-19 infections increased in various provinces, the number of calls received by the call centre correlated with those increases.

“We began seeing cases mainly in the Western Cape in May. In June, we had more cases from Gauteng and KwaZulu-Natal combined, and in July, KwaZulu-Natal became the main hotspot. We identified 152 positive cases out of 1 350 cases. This is an 11% positivity rate, slightly lower than the national rate of about 17%,” says Dr Msimeki.

“With intensive clinical management, we were able to track their progress from the first contact to testing, treatment, and recovery. This process provided invaluable information about who was particularly susceptible to the virus and which co-morbidities appeared to increase the risk factor of an individual.”

Contact tracing helps reduce onward transmission

Reducing[1] the time between symptom onset and a positive test result is the most important factor for improving contact tracing effectiveness.

The average timespan between the client’s first call to the call centre to actual testing decreased over time, which was attributed to the call centre improving its capability of identifying clinical signs and symptoms of Covid-19, changing algorithms to better detect cases, engaging more electronically with laboratories for orders, and increased capacity at laboratories.

“From March through to August, we estimate the call centre reduced onward transmission by between 21% and 41%,” says Dr Msimeki. “The average duration of positive cases was within the norm or even reduced in some instances, saving many businesses up to 14 days of sick leave per client and enabling more employees to return safelyto work .”

Mitigate the risk of workplace infections

According to the call centre’s findings, the close contact experienced by empoyees driving together to and from work, eating lunch together and being in rest rooms posed the greatest risk. This was an important learning as it indicates where to improve prevention methods and which risk mitigating strategies need to be reviewed.

Dr Msimeki says that through these learnings, they were able to implement strategic measures at the CareWorks office and Old Mutual Call Centre to mitigate their own risk of infection. “Our call centre team was split across two floors, and the teams weren’t allowed contact with one another. This meant that if someone tested positive and the entire floor had to be quarantined, only half of the overall team was compromised.”

CareWorks call centre agents and field staff were also provided with fabric masks that were washed, ironed, and left at the office every day, ensuring minimal exposure to external contaminants.

Education should inform company policy

CareWorks engaged with more affected workplaces than was initially anticipated to recommend corporate education programmes, review workplace risk assessments, and reassess prevention strategies, particularly among drivers, port workers, and particular office spaces.

“At the onset of the pandemic, there were a lot of known unknowns, especially of the risk factors associated with contracting the virus. Being the healthcare provider to Old Mutual clients, we knew exactly who had co-morbidities like high blood pressure, diabetes and HIV, enabling us to take even greater care,” she says.

With a second wave still a possibility, Dr Msimeki cautions employers not to relax just yet.

“It is crucial to ensure that employers continue to make their workplace as safe as possible by arming themselves with the basic tools like hand sanitisers, mandatory masks, social distancing, and regular temperature readings.” She also urges employers to remain up-to-date with the latest information and risk mitigation strategies to help reduce the threat of transmission should an employee test positive.

Ramjee adds: “Thankfully, South Africa’s health system was not overwhelmed nor were its ICU beds filled during the first six months of lockdown. This can be attributed not only to the government’s firm strategy but also to intervention from the private sector, such as Old Mutual’s partnership with CareWorks.

“Over the next few weeks, as economic activity increases, businesses throughout South Africa will need to remain on full alert to safeguard the health of South Africa’s workforce.”

The pandemic of 2020 is not yet behind us.

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[1] A modelling study conducted by Kretzschmar et al looking at Impact of delays on effectiveness of contact tracing strategies for COVID-19 concluded that “reducing the testing delay—ie, shortening the time between symptom onset and a positive test result, assuming immediate isolation—is the most important factor for improving contact tracing effectiveness.”