Tasmania, and indeed all of Australia, is watching the evolving situation with COVID 19 in Victoria. There is a sense of unreality combined with nervousness with the realization “that could be us” at any time.

Doctors are no different to the rest of the community sharing concerns about risks to the health and well-being of Tasmanians and the secondary problems affecting industry, businesses and other organisations. There is also the realization that health care workers (HCW) have a special role to play in response to this unprecedented threat; their health and well-being is critical.

Doctors working in occupational medicine can have an important role in COVID19 response. TFOM has an important role coordinating the efforts of Tasmanian Occupational Physicians in collaboration with other medical organizations, including the Australasian Faculty of Occupational & Environmental Medicine (AFOEM) and the Australian Medical Association (AMA).

The Australasian Faculty of Occupational & Environmental Medicine (AFOEM) has developed important guidelines including “COVID-19: Workplace Risk Management”. The AFOEM executive has asked occupational physicians to be active in their local area in COVID response while providing them with important resources and tools for risk management.

At a recent meeting of Tasmanian Occupational Physicians attended by Dr Malcolm Sim (AFOEM National President) and Dr Warren Harrex (AFOEM President-elect and representative on the RACP COVID-19 Expert Clinical Reference group), we heard from Victorian Occupational Physician, Dr John Parkes about the important role the team of 19 occupational physicians and registrars recruited to work with Health Department “Case Contact and Outbreak Management Teams”. The occupational physicians have important roles due to their medical knowledge applied in an occupational setting, both in the prevention of infection, management of outbreaks and to assist businesses to continue to operate safety wherever possible.

COVID19 is not only a serious threat to public health, but an unprecedented occupational risk to the health for workers in all occupations, once community transmission becomes established, as in Victoria. HCW are at the front line, both in acute hospital settings where serious infections are managed, as well as in other health care settings with vulnerable people, such as Aged Care facilities. In Victoria more than 2,000 HCW have become infected, while in Tasmania there have already been nearly 50 claims for Workers Compensation for COVID19 associated conditions with the now-controlled outbreak on the NW Coast earlier in the year.

TFOM will approach relevant Government, Private, Business and Employee organisations to offer assistance with planning to prepare for a further local outbreak. TFOM recommends a robust approach to protect the health, safety and well-being of Tasmania’s workforce, particularly HCW and other frontline essential service providers.

Lessons learned from SARS and the evolving information about COVID with lack of certainty about mechanisms of transmission, effectiveness of PPE and other aspects of this disease, necessitate a PRECAUTIONARY approach to prevention i.e.

‘if there is a perceived material risk to public health, lack of full scientific certainty should not be used as a reason for postponing measures to prevent, control or abate that risk’,

To complement existing measures, planning is needed now to develop systems to be in place before any outbreak. These include:

  • Mandatory reporting of occupationally acquired COVID19 infections
  • Acceptance that prevention of occupationally acquired infection requires application of accepted Workplace Health & Safety (WHS) principles, including use of the “hierarchy of controls”
  • A precautionary approach to PPE with adoption of P2 / N95 as the minimum standard for protection of potentially exposed workers
  • Engagement with workers about risk and outbreak management
  • Educational efforts to promote a “mask-wearing” culture amongst the general public in response to evidence of community transmission

TFOM will co-ordinate efforts to ensure Tasmania has adequate occupational medical resources to contribute to a combined response to the challenges of COVID19.

TFOM plans a resource list of occupational medicine practitioners that can assist organisations with COVID19 response.

Peter Sharman

Secretary & Newsletter Editor