Analysis: Managing Infection Risk

The Government has published a new paper on managing infection risk in high contact occupations. The full paper is available on their website, whilst we publish the summary below. Although not directly aimed at people with disabilities, it’s an interesting read as it gives a little bit more detail and insight into how to keep yourself safe around other people and what the main risk factors are, all of which is useful information.

1. Raising awareness of the problem of high social connectivity
• There is emerging evidence that some occupations and situations pose particularly high risk of infection due to high levels of social connection. This higher risk is linked to increased mortality in some occupations and sectors of the population, including lower income and BAME communities1
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• People in occupations involving numerous social contacts of longer duration and close proximity may be at increased risk of both contracting and spreading Covid-19. Examples of potentially higher risk occupations may include: bus and taxi drivers, social care and healthcare workers and people working in some retail, catering, security, and manufacturing settings.

• Other situations involving numerous social contacts of longer duration and close proximity also carry a higher risk of spreading Covid-19. Examples include: using public transport; large family gatherings; religious and cultural events; pubs, restaurants and cafes.

• As risk levels reduce in the general population, it is vital that all members of the public, employers, employees and self-employed people are aware of which situations will continue to pose higher risk and of what actions need to be taken by everyone to reduce the risks in these situations.

2. Communicating two key principles for managing higher infection risk due to social connectivity
2.1. People who have large numbers of contacts with different people are at higher risk of infection and transmission. Those in high contact or high disease exposure occupations should therefore pay particularly close attention to the social distancing and hygiene recommendations that are also recommended for the rest of the population. This is especially important when mixing with those at high risk of severe consequences of infection, such as older people or those at high risk from
infection due to health conditions. It is vital that the responsibility for managing infection risk due to multiple contacts is shared between the people at risk, their employers and all the people they meet. A Covid-secure risk assessment must be undertaken to ensure that risks are minimised. Wherever possible, changes to
the structuring of workplace activities and enironments should be prioritised. Taking extra care to manage infection risk may also involve everyone concerned undertaking additional actions such as handwashing at appropriate times, avoiding touching face or surfaces, cleaning all shared surfaces, changing/washing clothes, using and disposing of tissues, ventilating shared spaces, social distancing, wearing a face covering when close to others if social distancing is not possible. The EMG paper on Transmission of SARS-CoV-2 and Mitigating Measures (04/06/2012) sets out how to select appropriate measures.

2.2. People with different social networks should try to avoid meeting (especially close, prolonged, indoor contact) or sharing the same spaces
For example:
• people who share a workspace (e.g. office, section, floor) should try to avoid meeting or sharing spaces (e.g. kitchens, toilets) with people who share a different workspace
• contact should be avoided between teachers and pupils from different classes and especially different schools
• sports teams from different areas should avoid sharing facilities and enclosed spaces.

3. Developing practical solutions to reduce social connectivity
The steps listed below are based on co-design principles previously described by SPI-B2,3,4 for successfully developing, communicating, implementing and regulating guidance for reducing infection transmission, in order to maximise adherence. Note that all the steps listed below need to be taken, and it is vital to involve everyone in these occupations and communities in working together to find practical and acceptable solutions.

3.1 Carry out an extensive education campaign for employers, employees, self-employed people and the general public, working with diverse members of the target workforce/user groups and multidisciplinary experts in supporting behaviour change to provide toolkits suitable for different user audiences, with clear and convincing explanations, detailed guidance and effective behaviour change techniques

3.2 Co-create guidance and positive solutions with input from diverse members of all the different target workforce/user groups and their representatives (both organisational and community leads, employees and community members, including members of BAME communities) to identify opportunities, concerns, barriers and solutions. Positive solutions must be equitable, reassuring and supportive, should maintain social cohesion and support, and should promote a shared sense of responsibility for infection control.

3.3 Redesign shared activities and spaces to minimise contacts, for example, by adopting new shift patterns or patterns of workspace use, setting up teams or “buddies” to ensure that contact is limited to small groups of people, restricting access to communal spaces or allocating spaces to particular groups at particular times with ventilation and cleaning between use. This should be part of the Covid-safe risk assessment process described in 3.4 below.

3.4 Use existing organisational structures and processes for implementation, for example Health and Safety regulations and enforcement processes, including personal and workplace risk assessments to identify, apply and monitor appropriate control measures which reduce infection spread

3.5 Monitor and feedback to all concerned to check and reassure that infection control is being implemented effectively. All guidance developed must be extensively and iteratively tested and optimised through real-world implementation and feedback, taking particular care to consider and minimise the possible burden or anxiety that this may place on individuals and to ensure that new working practices do not result in discrimination, stigmatisation or interpersonal conflict.

The full paper is available here