Parveen Lone
The SARS outbreak in 2003 “both from public’s perspective, and certainly within the healthcare system, was extremely frightening, extremely traumatic,” said Dr Brian Schwartz, chief of communicable disease. He recommended that knowledge, protocol, clear and timely communication is the key for prevention of an epidemic . One of the biggest challenges with SARS was that no one had the knowledge about the disease, its spread, treatment and tests to identify it. Clear procedures regarding health care workers, how to screen patients and protect themselves from getting infected were not known. It was a mystery to health community.
Similarly Covid-19 is an infectious disease caused by novel corona virus and most people experience mild to moderate respiratory illness but people with cardiovascular disease, diabetes, chronic respiratory disease and other underlying medical conditions develop more serious illness. It spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes.
As there are no specific vaccine, and treatment for covid 19 at present, the best way to prevent and slow down the transmission is to know about its spread and prevention thereof.
In July 2003, Senior Labour Officials from ASEAN countries met in Manila to share their experience coping with the employment impact of SARS. They had dealt with sudden job losses and business closures, new occupational hazards in the health-care sector, medical screening procedures in the travel industry and the urgent need to protect workers, in all sorts of workplaces, from a new risk to their health. One of the recommendations of that meeting was that the International labour office Geneva (ILO) publish a set of informal guidelines on coping with the threat of SARS at the workplace, drawing from internationally agreed standards on occupational safety and health, fundamental rights of workers, WHO guidance on SARS, and the lessons from dealing with other diseases at the workplace, such as HIV/AIDS. They recommended that Governments, employers, employees, all review systems that they have in place to contain new outbreak and resurgence of the disease, so that the cost in human suffering and economic loss can be kept at minimum.
For this following strategies were recommended.
Practical workplace strategy all workplaces should protect the health of their staff by providing satisfactory sanitation and hygiene and by ensuring unwell workers go on sick leave and receive medical treatment as appropriate. Thus, three different workplace settings can be defined according to the risk of infection by contact i.e. workplaces with no or slightly risk and Significantly increased risk places (front line workers & isolation quarantine and treatment areas).
The ILO Occupational Safety and Health Convention, 1981 (No. 155) Article 16
Workplaces with no or slight risk places : This is the usual workplace situation and applies to the vast majority of workers throughout the world. The following practices were recommended
The provision of
* Clean toilets, liquid soap and hand washing facilities individual towels or hand dryers for hand drying.
* Covered rubbish bins for used towels, handkerchiefs or litter.
* Individual, clean utensils for eating and drinking
* Encouraging workers to wash their hands after they use the toilet and before eating.
* Encouraging workers to use tissues to contain respiratory secretions, to dispose of the tissues immediately after use in a covered bin, and then to wash their hands.
* Not allowing spitting in the workplace.
* Ensuring daily cleaning of workplace areas and toilets, using normal household disinfectants or diluted household bleach.
The ILO Hygiene (Commerce and Offices) Convention, 1964 (No. 120) Article 7
All premises used by workers, and the equipment of such premises, shall be properly maintained and kept clean.
Article 8 All premises used by workers shall have sufficient and suitable ventilation, natural or artificial or both, supplying fresh or purified air.
Article 12 A sufficient supply of wholesome drinking water or of some other wholesome drink shall be made available to workers.
Article 13 Sufficient and suitable washing facilities and sanitary conveniences shall be provided and properly maintained.
* The Occupational Safety and Health Recommendation, 1981 (No. 164) II.
* Ensuring acutely sick or febrile workers or visitors do not come into the workplace, especially if they are coughing, sneezing, and vomiting or have diarrhoea.
* Encouraging sick employees to seek a medical opinion before returning to work, if they have persistent fever, respiratory or gastrointestinal symptoms.
* Prevention of close or physical contact in the workplace, such as handshaking or kissing as forms of greeting.
Workplaces that involve contact with general public
Many workers, jobs involve meeting not only work colleagues, but also members of the general public. Such jobs are found, in shops, banks, restaurants, sports and tourist facilities, educational institutions, conference centres and places of religious worship.
WHO recommends that those hosting the persons arriving from an area with recent transmission of an infectious disease should follow the principles as below
* A person who has been in close contact or thinks he or she has been in close contact with a suspected person over the last 10 days, should not leave his/her country and should contact the national health authorities of his/her country.
If however, the person has already left his/her country, he or she should contact the Medical Service of the hosting Organization / Institution in the country to be placed under active surveillance for 10 days after the date of his/her contact with a case and according to the standardized procedures of the hosting country.
* A person who develops symptoms within ten days of arrival in the hosting country (including sudden fever above 38 degrees C, dry cough, shortness of breath, and/or difficulty in breathing), should not leave the room and call for medical help
All countries should have in place arrangements for surveillance, contact tracing and isolation in case of the importation of a SARS case.
Administrative action to be ready for an outbreak like SARS
In the ILO Occupational Safety and Health Convention, 1981 (No 155), Clearly recommended that, in the field of occupational safety and health, national institutions need to develop coherent national policy to ensure effective occupational safety and health systems in organizations which are
* National coordination and surveillance one of the main responsibilities of national governments is to ensure the presence of an effective national policy in response to the threat epidemic infectious diseases, which is applicable and relevant to all sectors of society. Such policy should cover all aspects of daily life including the working environment and may be formulated as laws, recommendations, guidance, practical provisions, financial support and educational measures. In order to ensure good policy governments need to consult and coordinate with agencies that represent the different sectors of society, such as management from the public and private sectors as well as workers’ and voluntary organizations.
The ILO Occupational Safety and Health Recommendation, 1981 (No. 164) III.
* Knowledge-sharing despite many differences between infections by the HIV or SARS-CoV viruses, one thing that can be learnt from the experience with the HIV epidemic is that knowledge-sharing is a key weapon in the fight against a disease. If people are not informed about the mode of transmission and ways of avoiding spread of a disease, they cannot effectively protect themselves. In addition, lack of factual information can lead to false rumours and unfounded myths being spread, which can not only endanger the health of the community but can also lead to discrimination against the infected people. Provision therefore needs to be made for knowledge-sharing when planning a response to a disease outbreak.
* Education needs to be aimed at several different groups: The general public Information on the symptoms of epidemic and who may be at risk, Information on modes of transmission & ways to prevent infection by and reduce transmission of the disease. Information to avert panic in the general population with reassurances against unfounded anxieties about disease.
This may be the reason the countries where SARS outbreak too place in 2003 were able to contain the spread of Covid 19 more than other countries.
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