Challenges and paradoxes of the return to work amidst the COVID-19 pandemic

The issue of planning and returning to work is a global concern. On May 29, the World Health Organization (WHO) held a virtual seminar on “return to work”¹, a discussion that took place when several European countries began the process of relaxing physical and social distancing-following the stabilization and decline of the pandemic in the region-and gradually resuming economic activities. For such an endeavor, the WHO established the following criteria²:

• 1) Surveillance must be strong, the number of cases must be declining and transmission controlled.

• 2) The national health system must have the capacity to detect, isolate, test and treat all cases and track all contacts.

• 3) Outbreak risks should be minimized in special environments, such as health facilities and nursing homes.

• 4) Preventive measures should be implemented in workplaces, schools and other places where the movement of people is essential.

• 5) The risks of importing the virus must be managed and controlled.

• 6) Society must be fully informed, engaged and empowered to adhere to the new norms of social interaction.

As an example of this perspective, New York City started its reopening on June 8 according to parameters and indicators defined by the Centers for Disease Control and Prevention (CDC): decline in total hospitalizations, decrease in deaths, number of new hospitalization cases below the established limits, number of infirmary and ICU beds available, diagnostic testing capacity and ability to track contacts^{3), (4}.

After ensuring the necessary conditions for recovering the health system, the step following closing the economy is the progressive resumption of activities.

When resuming activities, the supposed normality of daily life is sought. However, we are far from what would be a normal situation, on the contrary. This is a critical moment, given the risk of a new wave of the pandemic. It requires strong political and health leadership in favor of an action coordinated by different governmental and private sectors, based on a systemic view that includes the different spheres of life, at work and in society^{6), (7}. Thus, going back to the example of New York, there was great concern on the safety of users of public transport, as 400 thousand workers were expected in the first of the four stages planned for resuming activities³.

The progressive resumption process requires robust organization and care, especially in the workplace, since, as observed during the pandemic, the conditions for carrying out essential activities can favor widespread viral transmission. Work situations with many people in close proximity or in contact with the public, spaces with poor ventilation, provide a high risk of transmission, as it happened in call centers⁸, slaughterhouses⁹ and oil and refining production plants¹⁰. It should also consider maintaining remote work when feasible and isolating people pertaining to risk groups. With more people at home, fewer workers will be circulating in public transport, reducing the circulation of the virus.

Within policies for resuming activities, one must deal with its conditions and planning: specific areas of the Occupational Safety and Health (OSH) community. The regulations, knowledge, and techniques already available in the field of OSH add to recent constructs produced in the search for protecting workers during the pandemic, serving as pillars for planning and implementing the return to work designed by companies and institutions^{7), (11}.

According to the International Labor Organization (ILO), return to work must be considered and, later, implemented as a national public policy that coordinates and regulates actions in companies and institutions. It must be carefully studied, planned and organized as to mitigate risks and protect workers on their return^{7), (12}.

For the ILO, national policies must address conventions and regulations to ensure workers’ rights, avoid discrimination, ensure the application of standards that guarantee decent work, the prevention of risks and safe working conditions regarding the current situation, including mental health issues. National prevention systems, as well as tripartite negotiating bodies, should promote social dialogue, favoring ample information for workers. To be effective, according to the ILO, coordinated action is needed, integrating different government sectors and involving representation from employers and workers⁷.

As for the companies, safe return to work depends on elaborating a careful plan, prepared by a skilled team, in which several aspects and criteria must be considered. Guided by the risk assessment of the various jobs, companies can define the stages of return, operations and/or services and how many and which workers must return¹².

Measures must be implemented according to the hierarchy of controls: engineering and administrative controls, such as an adequate ventilation system, screens between workstations, rearrangement of space to maintain distance between workers, scheduling work teams, systematic cleaning of surfaces and environments, among others; use of protective equipment and training of workers^{5), (11), (12}.

Workers must integrate and actively participate in preparing and implementing the return plan^{5), (11}. They will be able to detect correct and/or flawed preventive measures and propose corrective measures, when necessary.

However, some practical experiences in progress show the difficulties and contradictions of conceiving a plan to implement return to work based on the recommendations of the control bodies¹². How to prevent your employees from using public transport services? How to maintain the circulation of people in companies, using elevators in corporate buildings, for example, when distancing is recommended and limits the number of people⁵?

Besides, planning and implementing return policies in work environments that will require several safety protocols¹³ can put those involved in a contradictory situation, rendering it meaningless⁵. A recent article published in The New York Times highlighted some challenges and contradictions regarding the return to work in offices of American companies⁵. A question posed by a person responsible for implementing the face-to-face return of a North American corporation express this loss of meaning: if what justifies the presence of workers in corporate spaces is the need for collaboration, how to do it when keeping distance, avoiding close contact and wearing masks? Why bring workers back if collaboration is constrained by so many protocols?

This fundamental contradiction, associated with the uncertainties that will remain regarding safety and the risks in public transportation, materializes the current challenges for the OSH community. These aspects also evoke the need to assist and mitigate the associated psychosocial risks and mental health problems that may affect workers¹⁴. In fact, we are far from normal.

Finally, other countries, including Brazil, Mexico, India and Russia, are resuming economic activities without respecting the WHO protocols^{15), (16}. The recent chaos observed in some Brazilian cities¹⁷ shows that, in the context of economic reopening, without observing the necessary premises, the problem will overcome work spaces, putting at risk not only the working population, but the population as a whole.

Referências

• ¹
  World Health Organization. Webinars by WHO's Information Network for Epidemics. EPI-WIN COVID-19 Webinar on returning to work [Internet]. Geneva: WHO; 2020 May 29 [citado em 17 jun 2020]. Disponível em: https://www.who.int/publications/m/item/returning-to-work
  » https://www.who.int/publications/m/item/returning-to-work
• ²
  World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 6 May 2020 [Internet]. Geneva: WHO; 2020 [citado em 6 maio 2020]. Disponível em: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-6-may-2020
  » https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-6-may-2020
• ³
  Goodman D. After 3 months of outbreak and hardship, N.Y.C. is set to reopen. New York Times [Internet]. 2020 Jun 7 [citado em 17 jun 2020]. disponível em: https://www.nytimes.com/2020/06/07/nyregion/new-york-reopening-coronavirus.html?referringSource=articleShare
  » https://www.nytimes.com/2020/06/07/nyregion/new-york-reopening-coronavirus.html?referringSource=articleShare
• ⁴
  New York (US) . Percentage positive results by region dashboard. New York Forward [Internet]. 2020 Jun 16 [citado em 17 jun 2020]. Disponível em: https://forward.ny.gov/percentage-positive-results-region-dashboard
  » https://forward.ny.gov/percentage-positive-results-region-dashboard
• ⁵
  Gelles D. When the Office Is Like a Biohazard Lab. New York Times [Internet]. 2020 Jun 7 [citado em 17 jun 2020]. Disponível em: https://www.nytimes.com/2020/06/07/business/coronavirus-offices-cdc-guidelines.html?referringSource=articleShare
  » https://www.nytimes.com/2020/06/07/business/coronavirus-offices-cdc-guidelines.html?referringSource=articleShare
• ⁶
  Bavel JJV, Baicker K, Boggio PS, Capraro V, Cichocka A, Cicara M, et al. Using social and behavioural science to support COVID-19 pandemic response. Nat Hum Behav. 2020;4:460-71. doi: 10.1038/s41562-020-0884-z.
  » https://doi.org/10.1038/s41562-020-0884-z
• ⁷
  International Labour Organization. International Labour Organization: A safe and healthy return to work during the COVID-19 pandemic - Policy Brief [Internet]. Geneva: ILO; 2020 [citado em 17 jun 2020]. Disponível em: https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/briefingnote/wcms_745549.pdf
  » https://www.ilo.org/wcmsp5/groups/public/---ed_protect/---protrav/---safework/documents/briefingnote/wcms_745549.pdf
• ⁸
  Park SY, Kim YM, Yi S, Lee S, Na BJ, Kim CB, et al. Coronavirus disease outbreak in call center, South Korea. Emerg Infect Dis. 2020;26(8). doi: 10.3201/eid2608.201274.
  » https://doi.org/10.3201/eid2608.201274
• ⁹
  Santiago A. Abatedouro no Paraná registra mais casos de coronavírus que cidade inteira. UOL [Internet]. 2020 Jun 4 [citado em 17 jun 2020]. Disponível em: https://noticias.uol.com.br/saude/ultimas-noticias/redacao/2020/06/04/abatedouro-no-parana-registra-mais-casos-de-covid-19-que-cidade-inteira.htm
  » https://noticias.uol.com.br/saude/ultimas-noticias/redacao/2020/06/04/abatedouro-no-parana-registra-mais-casos-de-covid-19-que-cidade-inteira.htm
• ¹⁰
  Petroleiros das bases do LP cobram ação contra coronavírus, respeito ao ACT e AMS e lembram os mortos pelo Covid-19. Notícias Sindpetro-LP [Internet]. 2020 Jun 12 [citado em 17 jun 2020]. Disponível em: http://www.sindipetrolp.org.br/noticias/27601/petroleiros-das-bases-do-lp-cobram-acao-contra-coronavirus-respeito-ao-act-e-ams-e-lembram-os-mortos-pelo-covid-19
  » http://www.sindipetrolp.org.br/noticias/27601/petroleiros-das-bases-do-lp-cobram-acao-contra-coronavirus-respeito-ao-act-e-ams-e-lembram-os-mortos-pelo-covid-19
• ¹¹
  Barnes M, Sax PE. Challenges to "return to work" in an ongoing pandemic. N Eng J Med. 2020 Jun 18 [citedo em 19 jun 2020];(Special Report). Disponível em: https://www.nejm.org/doi/full/10.1056/NEJMsr2019953
  » https://www.nejm.org/doi/full/10.1056/NEJMsr2019953
• ¹²
  International Labour Organization. Safe return to work: ten action points. Geneva: ILO; 2020 [citado em 17 jun 2020]. Disponível em: https://www.ilo.org/global/topics/safety-and-health-at-work/resources-library/publications/WCMS_745541/lang--en/index.htm
  » https://www.ilo.org/global/topics/safety-and-health-at-work/resources-library/publications/WCMS_745541/lang--en/index.htm
• ¹³
  Department of Health & Human Services (US). Considerations for events and gatherings. Atlanta: CDC; 2020 [citado em 17 jun 2020]. Disponível em: https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/considerations-for-events-gatherings.html
  » https://www.cdc.gov/coronavirus/2019-ncov/community/large-events/considerations-for-events-gatherings.html
• ¹⁴
  Finnish Institute of Occupational Health. Guidelines for supporting mental well-being when returning to work. Helsinki: FIOH; 2020 [citado em 17 jun 2020]. Disponível em: https://www.ttl.fi/en/guidelines-for-supporting-mental-well-being-when-returning-to-work/
  » https://www.ttl.fi/en/guidelines-for-supporting-mental-well-being-when-returning-to-work/
• ¹⁵
  Gettleman J. As virus infections surge, countries end lockdowns. New York Times [Internet]. 2020 Jun 10 [citado em 17 jun 2020]. Disponível em: https://www.nytimes.com/2020/06/10/world/asia/reopening-before-coronavirus-ends.html?referringSource=articleShare
  » https://www.nytimes.com/2020/06/10/world/asia/reopening-before-coronavirus-ends.html?referringSource=articleShare
• ¹⁶
  Almeida C, Branco L. Critérios adotados para reabertura da economia no exterior terão de ser adaptados no Brasil. O Globo [Internet]. 2020 May 23 [citado em 17 jun 2020]. Disponível em: https://oglobo.globo.com/economia/criterios-adotados-para-reabertura-da-economia-no-exterior-terao-de-ser-adaptados-no-brasil-24442474
  » https://oglobo.globo.com/economia/criterios-adotados-para-reabertura-da-economia-no-exterior-terao-de-ser-adaptados-no-brasil-24442474
• ¹⁷
  Diniz A. Na reabertura do comércio em São Luís, Rua Grande amanhece lotada e loja tem até fila para entrar. Rede Mirante [Internet]. 2020 May 25 [citado em 17 jun 2020]. Disponível em: https://g1.globo.com/ma/maranhao/noticia/2020/05/25/na-reabertura-do-comercio-em-sao-luis-rua-grande-amanhece-lotada-e-loja-tem-ate-fila-para-entrar.ghtml
  » https://g1.globo.com/ma/maranhao/noticia/2020/05/25/na-reabertura-do-comercio-em-sao-luis-rua-grande-amanhece-lotada-e-loja-tem-ate-fila-para-entrar.ghtml

Edited by

*

Editor-in-Chief of RBSO

Publication Dates

• Publication in this collection
  13 July 2020
• Date of issue
  2020