Abstract
Health, safety and wellbeing should be the highest priority for all organisations. But as they reopen, businesses need to consider what a COVID-safe workplace looks like and how it can be effectively managed. The COVID-19 pandemic has highlighted the risks that can be involved in healthcare work. In this paper, we explore the issue of staff safety in clinical work using the example of personal protective equipment (PPE) in the COVID-19 crisis. We articulate some of the specific ethical challenges around PPE currently being faced by front-line clinicians, and develop an approach to staff safety that involves balancing duty to care and personal well-being. We describe each of these values, and present a decision-making framework that integrates the two. The aim of the framework is to guide the process of balancing these two values when staff safety is at stake, by facilitating ethical reflection and/or decision-making that is systematic, specific and transparent. (Rosalind J McDougall 2020).
Since its emergence, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19, has become a global health threat. As of July 22, 2020, more than 15 million cases of COVID-19 have been documented worldwide, with nearly 6,18, 000 deaths. In the UK and the USA, Black, Asian, and minority ethnic communities have been disproportionately affected. With ongoing community transmission from asymptomatic individuals, disease burden is expected to rise. As a result, there will be an ongoing need for front-line health-care workers in patient-facing roles. Because this work requires close personal exposure to patients with SARS-CoV-2, front-line health-care workers are at high risk of infection, contributing to further spread. (Schwartz A, 2020).
Initial estimates suggest that front-line health-care workers could account for 10–20% of all diagnoses, with some early evidence that people from Black, Asian, and minority ethnic backgrounds are at higher risk. Based on experience with other respiratory viruses, consistent use of personal protective equipment (PPE) is important to reduce nosocomial transmission. (CDC COVID-19 Response Team Characteristics of health care personnel with COVID-19: United States, 2020) Guidelines from the UK and the USA recommend mask use for health-care workers caring for people with COVID-19. However, global shortages of masks, respirators, face shields, and gowns, caused by surging demand and supply chain disruptions, have led to efforts to conserve PPE through extended use or reuse, and disinfection protocols have been developed, for which scientific consensus on best practice is scarce. Although addressing the needs of front-line health-care workers during the COVID-19 pandemic is a high priority, data to inform such efforts are scarce, and particularly so among Black, Asian, and minority ethnic communities. (Anderson RM, 2020)
While health care workers often accept increased risk of infection, as part of their chosen profession, they often exhibit concern about family transmission, especially involving family members who are elderly, immunocompromised, or have chronic medical conditions. While the CDC and Occupational Safety and Health Administration provide clear recommendations, it is evident that more is required to optimize safety in the current environment. (Livingston E, 2020).