The emerging evidence suggests that alongside a previous list of health-related physical conditions there are three key demographic factors that can affect people’s vulnerability, or ‘risk factor’ in relation to COVID-19 health outcomes:
This risk assessment looks to holistically assess individual staff risk to safeguard GWH staff at most risk of adverse or serious reactions to Covid-19, based on the emerging data and evidence available.
Put simply, older people, men, and people from Black and Asian and Minority Ethnic (BAME) communities seem to be at greater risk from Covid-19. The causes of these increased risk factors are not yet fully understood, and further research is taking place right now. Even if we don’t know the causes, it is important for us to respond quickly to what the evidence is telling us.
We are asking colleagues who, in light of the emerging evidence are concerned that they may be at greater risk, to carry out an individual risk assessment; this should take into consideration colleagues’ age, gender, and ethnicity risk factors – especially where there is a combination of factors. We also ask you to look again, very closely, at the health vulnerabilities described by the government, in combination with the other risk factors described above. If, on completion of the risk assessment, you find yourself in Category B, C or D (where action has not yet been taken) we would ask you to meet with your line manager to discuss appropriate options.
The risk assessment meeting should be a meaningful conversation and exploration of the risk factors and perception of the colleague. Where there is agreement that the risk factors can be mitigated to everyone’s satisfaction no change is needed. Where however it is clear there are increased risks for a colleague the line manager must provide support and make necessary adjustments to mitigate those risks.
HR and OH can provide advice and support to the line manager and colleague in concluding an approach that supports the individual, and, should any adjustment to staff working arrangement place a strain on services, these issues must be escalated to ensure support is provided to resolve the issues as quickly as possible.
IMPORTANT INFORMATION ABOUT THE DEMOGRAPHIC AND
PHYSICAL HEALTH RISKS ASSOCIATED WITH COVID 19
A number of colleagues have been contacted by letter as they fall into the “Extremely Vulnerable” group.
People falling into this group are:
- Solid organ transplant recipients.
- People with specific cancers:
- People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer.
- People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment.
- People having immunotherapy or other continuing antibody treatments for cancer.
- People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
- People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.
- People with severe respiratory conditions including all cystic fibrosis, severe asthma* and severe COPD (chronic obstructive pulmonary disease).
- People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as SCID (severe combined immunodeficiency), homozygous sickle cell).
- People on immunosuppression therapies sufficient to significantly increase risk of infection.
- Women who are pregnant with significant heart disease, congenital or acquired.
The advice for these colleagues is that they isolate for 12 weeks from the day they receive their letter. For the purposes of the risk assessment If colleague has received a NHS shielding letter they automatically score 4 in the final column below and are therefore covered by the red outcome box “Category D”.
Are you aware of the health conditions associated with an elevated COVID-19 Risk?
The Government are advising those who are at increased risk of severe illness from coronavirus (COVID-19) to be particularly stringent in following social distancing measures. This group includes those who are:
With an underlying health condition listed below (i.e. anyone instructed to get a flu jab as an adult each year on medical grounds):
- chronic (long-term) respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis
- chronic heart disease, such as heart failure
- chronic kidney disease
- chronic liver disease, such as hepatitis
- chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
- problems with your spleen – for example, sickle cell disease or if you have had your spleen removed
- a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy
- being seriously overweight (a body mass index (BMI) of 40 or above)
- those who are pregnant
Are you aware of the Demographic factors associated with an elevated Covid-19 Risk?
The emerging evidence suggests there are three key things that can affect people’s vulnerability, or ‘risk factor’: Age, Gender, and Ethnicity. Put simply, older people, men, and people from Black, Asian and Minority Ethnic (BAME) communities seem to be at greater risk from Covid-19. The causes of these increased risk factors are not yet fully understood, and further research is taking place right now. Even if we don’t know the causes, it is important for us to respond quickly to what the evidence is telling us.
The evidence shows that age is a clear risk factor. This is why the government measures are in place for the over-70s in terms of self-isolation. So in our teams we need to make sure we are taking action to reduce older colleagues’ exposure to the Coronavirus.
There is some emerging evidence to suggest that COVID-19 may impact more on men than women, so we need to consider people’s gender when assessing their risk from COVID-19, especially amongst older colleagues.
Emerging evidence that is currently being reviewed by Public Health England shows that black, Asian and minority ethnic (BAME) communities are disproportionately affected by COVID-19. This concerning evidence suggests that the impact may also be higher among men and those in the higher age brackets. The reasons for this are not yet fully understood, but the health inequalities present for BAME communities have long been recognised. One hypothesis is that people from BAME communities have higher rates of underlying health conditions, such as type 2 diabetes and hypertension, and this may increase their vulnerability and risk.
Within the NHS, 40 per cent of doctors and 20 per cent of nurses are from BAME backgrounds, as are substantial numbers of health care support workers and ancillary staff. The exposure faced by frontline health and care workers puts them at a greater risk of catching COVID-19.
Line managers should have thorough, sensitive and comprehensive conversations with your BAME staff. Identify any existing underlying health conditions that may increase the risks for them in undertaking their frontline roles, in any capacity. Most importantly, the conversations should also, on an on-going basis, consider the feelings of BAME colleagues, particularly with regard to their safety and their mental health. Managers should also seek and follow occupational health advice where appropriate.