The Department of Health’s Occupational Health and Safety Workstream has issued new guidelines for the monitoring and management of all workers, including health workers for SARS-CoV-2 infection.

What is new in this version?

1.       Reference to essential workers has been removed such that the guideline will apply to all workers covered by the Department of Employment and Labour Directive dated 4 June 2020

2.       Revised definition of a suspected COVID-19 case as outlined in National Department of Health guideline on Clinical Management of Suspected or Confirmed COVID-19 Disease Version 4 (25 May 2020) , which removed fever as a key symptom, and replaced this with loss of smell or loss of taste.

3.       Management of asymptomatic worker with high exposure risk and decision on return to work originally referred to workers in the essential services. This now applies to all workers, and reflects the revised stipulated period of isolation, with a different stipulation for health workers.

The aim of this guideline is to enable:

1. Early and timeous identification and diagnosis of workers at risk of SARS-CoV-2 infection

2. Early referral for appropriate treatment, care and timeous return to work of affected workers

3. The protection of other unaffected workers, consumers, visitors and clients of these groups of workers

According to the Department of Employment and Labour Direction, employers have a legal obligation to screen all employees for COVID-19 related symptoms and report such symptoms to a designated person and / or occupational health practitioner prior to entry into the workplace or work area in order for a decision to be made as to the employee’s continued attendance at work.

The Department of Employment and Labour Direction makes it a legal requirement for this screening to be reported to the National Department of Health. At the very minimum, when workers report for work and at appropriate intervals thereafter, designated persons and / or an occupational health practitioner must check with employees whether they have experienced sudden onset of any of the following symptoms as outlined in the current criteria for the identification of a suspected COVID-19 case: cough, sore throat, shortness of breath, loss of taste/smell, with or without any additional symptoms as outlined in the attached symptom monitoring sheet, in the past 24 hours. Should a worker report any of the abovementioned symptoms, s/he should not be permitted to report for work. If an employee is already present at work, s/he should not report to their workstation, be provided with a surgical mask and referred to the designated staff at the workplace so that arrangements can be made for clinical evaluation (referral to the occupational health clinic, family practitioner or primary care clinic, or the COVID-19 hotline) and where appropriate to be tested at the closest testing centre.

If the health professional determines that a test is necessary, the worker is quarantined while awaiting results.

 For health workers:

If the health professional believes that a COVID-19 infection is unlikely, the employee should be managed according to clinical protocols, and continue working, following specific workplace restrictions and appropriate PPE, as well as observing strict precautions including masks, social distancing and hygiene procedures. The employee’s condition should be monitored to assess response to clinical management.

All employees on returning to work after isolation or quarantine period, should follow general work restrictions that include:

• undergoing medical evaluation to confirm that they are fit to work should they have moderate or severe illness

• wearing of surgical masks at all times while at work for a period of 21 days from the initial test

• implement social distancing measures as appropriate

• in the case of health workers avoid contact with patients considered vulnerable for severe outcomes of a COVID-19 infection

• adherence to hand hygiene, respiratory hygiene, and cough etiquette

• continued self-monitoring for symptoms as per the symptoms checklist, and seek medical re-evaluation if respiratory symptoms recur or worsen.

Symptoms:

  • Cough
  • Sore throat
  • Shortness of breath
  • Loss of smell or taste
  • Fever/chills
  • Body aches
  • Fatigue
  • Red eyes
  • Vomiting, nausea, diarrhoea