key: cord-0046276-0k9hr9i7
authors: Ross, Mary; Singh, Tanusha
title: COVID-19: an occupational health view from South Africa
date: 2020-06-01
journal: Occup Med (Lond)
DOI: 10.1093/occmed/kqaa081
sha: 276182a6b0485b28e1bab2e965ebb90daf3a6ab0
doc_id: 46276
cord_uid: 0k9hr9i7

nan

At the 2009 Cape Town ICOH Congress, Professor Barry Schoub, then Director of our National Institute for Communicable Diseases (NICD) declared that, 'Two of the most serious public health concerns of the 21st century are the threat of pandemic influenza and HIV/AIDS' [1] . The NICD and the National Institute for Occupational Health (NIOH) are divisions within the National Health Laboratory Service (NHLS) which, since the COVID-19 threat in January 2020 prior to our first case of a returning traveller from Italy on 5 March 2020, has been involved in the testing, public health, and occupational health planning and response.

The rapid response in South Africa is noteworthy. By 15 March 2020, a national state of disaster was declared; thereafter, guidance for employers on COVID-19, workplace preparedness planning, regulations on quarantine, restriction of gatherings, closure of public places and schools, and a travel ban were successively introduced, culminating in a nationwide lockdown from 27 March 2020 [2] .

Health personnel are the major occupational focus, but many essential workers from retail to security personnel require appropriate protection and guidance [3] . On 20 March 2020, occupationally acquired COVID-19 was recognized for compensation in workers arising from exposure during employment, including work travel to high-risk countries [2] . To date, 25 COVID-19 cases have been reported to the Compensation Commissioner. Our first four occupational fatalities were an insurance industry employee, a teacher, a driver and a renowned medical scientist following travel to lecture in Europe.

There is major difficulty in distinguishing occupational from community-acquired infectious diseases, particularly in non-health workers, and occupational COVID-19 transmission risk is amplified by the socio-economic circumstances of many South Africans, necessitating cramped housing and public transport with no opportunity for adequate social distancing.

The perils of lockdown include an exacerbation of unemployment coupled with increased levels of anxiety, stress and depression among workers. Changing evidence-based recommendations cause confusion on interventions ranging from safe social distancing, asymptomatic transmission, droplet versus aerosolization, through to the rational use of personal protective equipment (PPE). However, ongoing research advantageous to South Africa is exemplified by the reuse of respirators now being explored due to critical shortages during emergencies, although handwashing and social distancing remain the mainstay.

The NIOH is playing an important role in online training, following current epidemiology and evidencebased best practice, providing an advisory hotline for occupational health practitioners, and initiating local databases and research to protect workers' health within and beyond our borders. Public and private sector innovations include an intubation box to protect health workers [4] ; antimicrobial coating for metal surfaces; sanitizers from gin distillation by-products and an array of physical barriers.

Lockdown with other containment measures have limited both spread of SARS-CoV-2 (R 0 ≈ 1) and community transmission to date by delaying the exponential curve until South Africa is better prepared; however, as yet, insufficient data are available to assess our triple epidemic of HIV infection, tuberculosis and COVID-19 [5] . And, in the midst of the challenges that COVID-19 presents, the rights of workers must be upheld according to our health and safety legislation.

Tanusha Singh e-mail: profmaryross@yahoo.com

Pandemics and HIV/AIDS: an update

Regulations and Guidelines -Coronavirus Covid-19

Occupational risks for COVID-19 infection

African doctors design virus 'box' to prevent infection. MSN Lifestyle

SA's COVID-19 epidemic: trends and next steps