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COVID-19 Exposes Fault Lines on Protecting Vulnerable Workers

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By Mahinda Seneviratne*

SYDNEY (IDN) — As twilight approaches, Rakesh (not his real name) mounts his bicycle with a large thermal backpack over his narrow shoulders. He lost his regular job at a small suburban restaurant when the family business could not sustain itself during the Covid-19 pandemic lockdown. With the recent shocking road deaths of three food delivery riders heavily on his mind, Rakesh pedals cautiously into the growing traffic lanes to commence his first home delivery gig.

The demanding, dangerous and dedicated work of those battling the Covid-19 virus during the past twelve months of the global pandemic has drawn the appreciation and gratitude of millions around the world in many ways. On the annual International Workers’ Memorial Day on April 28 this year, we will have a special place in our hearts for those workers who lost their lives while caring, treating and protecting others from the deadly virus.

While the exact numbers of these workplace deaths will not be known, health care workers from several different occupations who succumbed to the infection at work will be gratefully recognised, remembered, and mourned on this day.

The Workers’ Memorial Day is for remembrance and action for workers killed, disabled, injured or made unwell by their work. On this day, we must give particular attention to recognise and remember those ‘non-heralded’ workers doing essential tasks at heightened risk of infection from the deadly virus.

The Covid-19 pandemic exposed stark ‘fault lines’ of growing inequalities in an already fragile global workforce. Over two billion people, consisting of large sectors of the workforce in several countries, are engaged in informal labour globally. The pandemic has exacerbated the vulnerabilities due to the precarious nature of their work, often unsafe work environments and the lack of adequate social protection.

Informal, insecure work such as street hawking, sanitary services or other manual labour are mostly done in public spaces. Working from home and social distancing was not a choice for these workers for whom it was equally a crisis of livelihood as well as health.

Many of the 150 million migrant workers worldwide regularly face barriers in accessing adequate health care, housing, transport and other basic services. The pandemic worsened the situation for them. This was dramatically seen on TV screens when internal migrant workers in India were forced to walk hundreds of miles to home villages following the sudden nationwide lockdown, with some losing their lives in the circumstances.

Reports from high migrant worker destinations such as the USA, Europe and the Gulf States document how migrant workers became more vulnerable and were disproportionately affected by the pandemic. Workers who were already in precarious working and living conditions were now exposed to additional stressors from the virus. The International Organisation of Migration (IOM) had to assist thousands of migrant workers around the world who were affected by border closures and movement restrictions and were unable to work or return to their home countries.

The pandemic has also affected action on other serious respiratory diseases that affect vulnerable workers in several countries. Tuberculosis (TB) caused by inhaling an infectious bacterium is the world’s largest killer infectious disease, accounting for more than 1.4 million deaths globally each year.

The International Commission on Occupational Health (ICOH) drew attention to how workers who develop the deadly lung disease silicosis from exposure to dust in various occupations easily succumb to TB. ICOH urged urgent action to promote simple control measures to prevent silica dust exposures among thousands of vulnerable workers mostly in mining, quarrying, construction and stonework industries. Meanwhile, thousands of workers diagnosed each year with silicosis and susceptible to TB are also at greater risk of CoVid-19 infection.

The attention now given to modes of airborne microbial transmission and the use of respiratory protection (albeit face masks) for exposure prevention can provide some impetus to promote these practices in workplace prevention.

Decent Work for All is the eighth Sustainable Development Goal (Goal 8) that were actioned by the UN to achieve by 2030. The Covid-19 pandemic has set SDGs back by several years. Professor Michael Quinlan of the University of NSW in Sydney in an editorial in a leading international workplace health journal wrote that “the contribution of precarious work and the informal sector to exacerbating the pandemic and rendering societies more vulnerable has largely escaped detailed scrutiny or policy debate globally”.

The pandemic has shown the important link between work, living environments and public health and how various social factors determine the health of societies. Many commentators have alerted that this pandemic is a warning signal and is thus an opportunity to seriously address these underlying structural problems that can contribute to other similar catastrophes.

Amidst the devastation of the pandemic, several smaller nations with lesser income have shown rays of hope and resilience through actions on vulnerable sectors of their societies. Mongolia, Bhutan, Vietnam, Sri Lanka, Thailand and Ghana are some of the few nations that had relative early success in addressing the first wave of the pandemic. Collective action and innovative approaches taken by communities in these nations may provide useful insight into the critical role of well-resourced primary health care and the value in public health integration with working environments.

After more than 100 million cases and 2.5 million deaths globally, the world is eagerly awaiting the success of the COVID vaccines that are being administered at a rapid pace. While global collaboration among scientists led to its rapid development, the vaccine manufacture, supply and distribution is again exposing inequities with several countries and their vulnerable workers at the back of the queue for the jab. The intellectual property ‘protectionism’ of the World Trade Organisation (WTO) has not helped the needs for technology transfer and for expanded vaccine production during this global emergency.

A recent Call for Global Vaccine Equity by a group of over 1000 scientists, public health and legal experts stated that “limited vaccine supplies are being allocated by wealth and geography, not by science, public health or human need”. They noted that countries in Latin America with some of the highest COVID death rates get far fewer doses than countries with less need, but more wealth. Data indicates that ten rich countries accessed 75% of the vaccines while over 100 countries have yet received none. In African countries, hospitals overwhelmed by Covid-19 patients are reported to have no vaccines to protect their health care workers.

With enormous global inequities exposed by the Covid-19 pandemic, a truly global COVID vaccination program can achieve “immunological equity”. This can provide much-needed hope and relief to people who have already been unequally affected in both health and economic terms.

* Mahinda Seneviratne is an occupational health professional in Sydney, Australia. He chairs the International Commission on Occupational Health’s scientific committee on the occupational health of informal workers. He can be reached at mahindas@hotmail.com [IDN-InDepthNews – 27 April 2021]

Image credit: TUC

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