What we will cover: o Review of where we are with COVID-19 o Absolute - PowerPoint PPT Presentation

COVID-19 An Occupational Health Update 29 th July 2020 Dr Munna Roy , Medical Director , Integral OH

What we will cover: o Review of where we are with COVID-19 o Absolute Risk from COVID-19 o COVID Age o Shielding Pause o Risk Assessment and Control Measures (overview) o COVID-19 Testing – Test and Protect o Pregnancy o Q&A

Where are we now? 22 weeks in into th the Pandemic th July • As of f 24 th ly 2020, estim imate 400 in infectious people le in in Scotland Th That is is 400/5,550,000 = 0.0 .007% OR OR 7 people le in in 100,000 • Numbers of f in infectious people le are reducing by about 25% a a week • 1:2 :20,000 in infectious people le predic icted (3 (31.7.20)

Where are we now? • 30 30 new in infections a day • 99.8% fewer daily in infections compared to th the peak nd March 2020) 22 nd (16-22 (1 • 7.6% of f th the population have been in infected wit ith COVID-19 19

Where we are not • Nowhere near herd im immunit ity • No proven vaccine • Very ry real l ris isk of in increases as people le mix ix/do more • Ordin inary cold lds and fl flu in in th the win inter wil ill l cause proble lems

Absolute risk from work in COVID-19 Individual Health Societal Prevalence Workplace X X and Demographic of COVID-19 Transmission Risk Factors infectious people = Absolute risk of death/severe illness from COVID-19

Individual and demographic risk factors Age an and Ge Gender ar are th the str trongest ris risk factors for a a poor ou outcome fr from COVID-19 19 in infection Age Ba Band In Infectio ion fatalit lity Odds of f dyin ing if if ratio io in infected (approx.) .) 20 20-29 29 0.0309% 1:3000 30 30-39 39 0.0844% 1:1250 40 40-49 49 0.161% 1:621 50 50-59 59 0.595% 1:168 60 60-69 69 1.93% 1:52 Verity, R., Okell, L. C., Dorigatti, I., Winskill, P., Whittaker, C., Imai, N., ... & Dighe, A. (2020). Estimates of the severity of coronavirus disease 2019: a model-based analysis. The Lancet infectious diseases .

COVID Age ▪ The Chie ief Medical Officer Dir irectorate in in Scotland has ju just sanctioned the use of COVID ID-age for use in in Scotla land. ▪ A scorin ing system to ascertain in in indiv ividual vuln lnerabil ility to COVID- 19. 19.

COVID Age ▪ A scorin ing system to ascertain in in indiv ividual vuln lnerabil ility to COVID- 19. 19. ▪ Takes in into account Chronologic ical Age, , Gender, , Ethnic icity and underlying medical conditions to ‘Adjust’ chronological age and convert it it to a COVID ID Age. . ▪ The COVID ID Age is is a ris isk score that can then be used to id identif ify the typ ype of work that could ld be safe for an in indiv ividual to work k in in. ▪ Let’s look at an example…..

65 65 year ear ol old Fem emale (su (subtract 5) 5) White Eth thnicit ity (a (add 0) 0) BMI BM I of of 37 37 (a (add 5) 5) COP OPD (a (add 6) 6) Covid id Age = = 71 71

35 35 year ear ol old Male le (ad (add 0) 0) White Eth thnicit ity (a (add 0) 0) BM BMI I of of 40 40 (a (add 9) 9) Mild ild as asth thma (a (add 1) 1) Covid id Age = = 45 45

COVID Age https: s://www.gov.scot/publi lications/coronavirus-covid-19 19-guid idance-on on-in individ idual-ris isk- assessment-for-th ass the-workpla lace/ ▪ Th The ins instructio ions for r use se and form rm can be found at t th the above li link. ▪ Emphasis is on in involv lvin ing th the work rker and havin ing a disc iscussio ion. . ▪ Comple lex or r hig igher risk risk situ situatio ions may requir ire OH in input.

Shielding Paused – what does it mean? Shie ielding Paused does not mean in indiv ividual l ris isk is is the same as every ryone els lse Shie ielding Paused allo llows in incr creased fr freedoms due to the lo low socie ciety prevalence ▪ “Physical distancing guidance for the at risk groups in Scotland” ▪ “Can return to a Covid safe workplace ”

Based on risk after control measures are implemented Low * Standard Medium High Risk ID COVID-19 Transmission Risk Factors ☐ ☐ ☐ ☐ 1 Travel ☐ ☐ ☐ ☐ 2 Workplace entry and exit Workplace ☐ ☐ ☐ ☐ 3 Workstation Spacing and Staff Density ☐ ☐ ☐ ☐ 4 Patient/Public/Service User facing transmission risk ☐ ☐ ☐ ☐ 5 Movement in the workplace ☐ ☐ ☐ ☐ 6 Rest and Welfare facilities ☐ ☐ ☐ ☐ assessment 7 Workplace surface hygiene ☐ ☐ ☐ ☐ 8 Hand hygiene ☐ ☐ ☐ ☐ 9 Symptomatic people in the workplace ☐ ☐ ☐ ☐ 10 Home visiting Provision of personal care/Direct ☐ ☐ ☐ ☐ healthcare – Special settings 11 Failure of workers to follow workplace control measures and guidance ☐ ☐ ☐ ☐ 12 Additional Risks Identified ☐ ☐ ☐ ☐ 13

COVID-19 Test and Protect ▪ New, continuous cough ▪ Fever ▪ Lo Loss of f or change in in taste or smell ………symptoms of potential COVID -19 in infection Sh Should ld all all get a a test. Help lps con onfir irm th the diag iagnosis an and id identify fy th those who need to o is isol olate an and have contact tr tracin ing

When and how to test? ▪ As soon as possib ible le and wit ithin in 5 days ▪ Go to NHS In Inform or call ll 111 ▪ Key y workers or household ld members of a Key Worker get prio iorit ity (prio ioritized wit ithin in that) ▪ Driv ive in in test sit ites and home test kit kits, some mobile le sit ites ▪ Must is isolate until il results are known (in individual l and household contacts) ▪ If If positive, , must adhere to 7 days, no fever for 48 hours before endin ing is isolation

Contact tracing ▪ Confirmed positive tests will be contacted (t (telephone or text xt) ▪ People you li live wit ith – will need to is isolate for 14 days (7 (7 fr from day or r onset of f Covid-19 symptoms) ▪ People you have been in in contact wit ith and where.

Contact tracing definition ▪ A clo lose contact can be defi fined as someone liv living in in th the same household ▪ someone who had dir irect or physical contact with an in infected person ▪ someone who has remained wit ithin tw two metres of f th the patient for lo longer th than 15 min inute

COVID-19 and Pregnancy ▪ RCOG have produced guid idance: “ Occupational l health advice for employers and pre regnant women during the COVID-19 pandemic ” v3 v3.2 .2 22 May 2020 ▪ Not updated sin ince 22 May 2020. . ▪ Last Trim imester is is thought to be the hig ighest ris isk ▪ Advic ice focuses on healt lthcare workers. . ▪ Referenced in in Scottis ish Government guid idance

COVID-19 and Pregnancy ▪ <28 weeks – remove ris isks that are greater than outside the workpla lace e.g. . physical dis istancing ▪ >28 weeks – RCOG recommends ‘stay at home’ ▪ Maternal Choic ice is is emphasised

Questions?