Who is minding our healthcare workers?

Occupational medicine physicians in the health service are not traditionally frontline workers. A good way to think of us is as the medical corps for healthcare workers. We assess whether they’re fit for duty, we assess what parts of the battle they’re fit to fight, who should go forward and who should not go forward. And then, when they get injured, we brush them down and we try and fix them up.

The first time I began to realise that Covid-19 was really serious was when whistleblower doctor Dr Li Wenliang died in China. The second thing was hearing some of the reports coming from Italy. It was shocking to hear about the deaths of so many healthcare workers, there and around the world. As the HSE's national clinical lead for workplace health and wellbeing, it was terrifying to think of the risks and hazardous situations in which our healthcare worker colleagues would be placed.

Healthcare workers are part of the community and part of families, and they are people, too; during this pandemic we cannot forget that. They have concerns about their own health conditions, pregnancies, perhaps their own immunocompromised status. They may have immunocompromised or vulnerable family members, too.

From the first emergence of Covid-19 we, alongside our infection control colleagues, have had to assess all the hazards facing healthcare workers. We’ve been working in this way, continually, from the very beginning of this year, and this hasn’t been easy.

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We've had to make decisions on a range of issues; everything from PPE to how we might prevent the transmission of infections in hospitals, and prevent healthcare workers from bringing the disease home. We have put together guidelines that have been rolled out across hospitals throughout Ireland. We have had to quickly identify our workers who had significant underlying medical conditions, and move them off site to protect them from the effects.

When, during this pandemic, the army of essential workers was being rapidly depleted, it was our job to risk assess those who could be redeployed, and those who could be sent back into the front line. As the pandemic has progressed, we have had to assess who might be fatigued and who might need greater support for their mental health, and have arranged for this support to be provided.

I have been an occupational medicine specialist for more than 30 years, and lived and worked through the ravages that HIV visited upon healthcare workers when I worked in San Francisco in the 1990s. One of the things we realised with HIV was that it wasn’t going away. It was here to stay and we had to change the way we did things because of the nature of the virus.

There’s a similar amount of learning for Covid-19. I have never seen a virus like this one. The speed at which we have had to mobilise this mass of healthcare workers and provide advice and support in a professional capacity has been phenomenal.

Occupational medicine is a very small area, but we have a really essential part to play in a pandemic of this nature. What made me so proud of our specialty is that every single occupational medicine colleague I know has stepped into, or come back into, the fray to aid in this time of crisis.

Prior to this, there may have been misconceptions about occupational medicine, or possibly people weren’t sure about what we do or what our role is. We’re the silent workers, the people who work behind the scenes to keep safe those who keep you safe.

Dr Lynda Sisson is dean of the Faculty of Occupational Medicine at the Royal College of Physicians of Ireland, and HSE national clinical lead for workplace health and wellbeing for health service employees.