Interested to know if anyone is taking an 'alternative' approach to their Covid19 risk assessment*, such as:

Using NHS/PHE/ONS data on hospitalisations and deaths to decide who might be harmed and how, and the actual likelihood of this happening.

Determining control measures on the basis of the above evidence, as opposed to simply implementing government guidelines.

Considering the severity and likelihood of harms that may occur from the government guidelines themselves.

Considering the impact government guidelines are having on the economy, businesses and workers' lives and livelihoods, and how this feeds back into the workplace setting.

* Non-healthcare settings

"Using NHS/PHE/ONS data on hospitalisations and deaths to decide who might be harmed and how, and the actual likelihood of this happening"

You jest.

Their 'numbers affected by death' drop to near zero at weekends, because nobody in admin is at work weekends.

I wouldn't believe PHE if they told me daytime started at dawn.

If you were going to do a “proper” risk assessment you would need to establish what the risk of catching Covid was to your workers in your work setting was and then decide on the best controls.

Nobody has been able to do that as we simply don’t know who has the infection and how easily it is spread in real life work situation. We just don’t have that information which means we cannot really measure the severity of the hazard, let alone the risk. The things that we are calling risk assessments are nothing of the sort. They’re checklists which we are using to make sure that we are applying the Public Health controls prescribed by government starting with avoiding coming into work at altogether to working with social distancing and enhanced hygiene measures to the use of face coverings or other barriers. They key point is the SFARP bit and to be honest we are simply following government requirements. Until few weeks ago their advice was to avoid coming into work if possible ie essential work only, which was easy except then the economy took a nose dive and so the guidance changed. Basically it’s now get as many people back to work as practicable. I am not sure that the actual risk of catching Covid fell during that time but the government decide we need to get the country back to work.

As Brian says this is a Public health issue and it is down to the government to tell us what to do but I do wish they wouldn’t hide behind Health and Safety terminology – basically it’s down to don’t overthink; do as you are told.

Originally Posted by: The Iron Chicken

Originally Posted by: Kate

The impact of government guidelines on the economy is surely well outside the scope of any workplace risk assessment.

Thank you for your reply, Kate.

This loss of control of organisations over their current and future activities must inevitably be impacting on the mental health of their people, resulting in anxiety and stress levels well above those that would be experienced in times of ‘normal’ recession, which is why I suggest these should be considered as part of the Covid-19 risk assessment.

Mine certainly look at that - dont yours? But im afraid ignoreing govenment guideline because of it is not an option. We have increased our staff support ext instead.

Iron Chicken

There is a much broader Q for society to consider.

First HSE tends to highlight numbers of deaths from accidents at work. Less than 200* per typical year in the UK for a long time, but only needs the sort of incident that happened in Lebanon yesterday to change that number dramatically.

* This number EXCLUDES many, many work-related deaths including almost all involving occupational travel.

In contrast it is estimated that about 12,000 per year die prematurely as a result of occupational ill health. So any Covid deaths that can be attributed to the work environment are likely to be a small fraction of that number, particularly outside e.g. healthcare and care home settings.

However, if Covid restrictions are too tight, there will be adverse effects not only on the economy but on general public health.

VERY, very difficult to expect employers to take these broader issues into account in making their assessments of when it is safe for their staff to return to work and with what precautions. 

Almost inevitably their decisions are going to be informed by Government guidance. No 1 duty on any Government is to protect its citizens.

Edited by user 05 August 2020 10:40:17(UTC)  | Reason: Statistical clarification

I think there are a number of separate issues here which I would say are mutually exclusive from each other but which manifest in different aspects of risk.  So my organisation has personal risk assessments for the likes of people in the clinically vulnerable groups, workplace risk assessments for personnel working in shared office accommodation and business impact assessments linked to business continuity plans.  I would be loathe to use a risk assessment based on the economic impact on the company as a justification for putting individual employees at risk!!

Originally Posted by: A Kurdziel

If you were going to do a “proper” risk assessment you would need to establish what the risk of catching Covid was to your workers in your work setting was and then decide on the best controls.

Nobody has been able to do that as we simply don’t know who has the infection and how easily it is spread in real life work situation. We just don’t have that information which means we cannot really measure the severity of the hazard, let alone the risk. The things that we are calling risk assessments are nothing of the sort. They’re checklists which we are using to make sure that we are applying the Public Health controls prescribed by government starting with avoiding coming into work at altogether to working with social distancing and enhanced hygiene measures to the use of face coverings or other barriers. They key point is the SFARP bit and to be honest we are simply following government requirements. Until few weeks ago their advice was to avoid coming into work if possible ie essential work only, which was easy except then the economy took a nose dive and so the guidance changed. Basically it’s now get as many people back to work as practicable. I am not sure that the actual risk of catching Covid fell during that time but the government decide we need to get the country back to work.

As Brian says this is a Public health issue and it is down to the government to tell us what to do but I do wish they wouldn’t hide behind Health and Safety terminology – basically it’s down to don’t overthink; do as you are told.

Thank you for your reply A Kurdziel.

The risk assessment should address the risk of harm caused by Covid-19 (the disease) as opposed to the risk of transmission of the SARS-CoV-2 (the virus); transmission of the virus does not in itself cause harm, whereas the resulting disease Covid-19 can have serious consequences.

The ‘harm’ caused by Covid-19 ranges from asymptomatic (low) to death (high).

The ‘likelihood’ of suffering this harm ranges conversely from high (asymptomatic) to low (death).

It was this ‘checklist’ approach to risk assessment that started my train of thought regarding an alternative approach in the first place – there is no assessment of risk involved at all.

There is now plenty of evidence-based information on ‘with Covid-19’ deaths available from the NHS, ONS and PHE on which to base risk assessments, and the data clearly shows that the risk has diminished significantly and is now negligible.

Increased Pillar 2 (PCR swab) testing has resulted in a rise in positive cases, but this has not translated into an increase in hospitalisations and deaths, which remain at a very low level.

You hit the nail on the head when you say we are simply following HMG guidelines – but why are businesses (and indeed many in the general population) not questioning the proportionality of these?

HMG continues to refer to Covid-19 as a ‘serious and imminent threat’, which in health and safety terms (regulation 8 of The Management of Health & Safety at Work Regulations 1999) means something so dangerous that everyone in the workplace must immediately evacuate to a place of safety – this is simply not that type or level of threat.

Originally Posted by: Hsquared14

I think there are a number of separate issues here which I would say are mutually exclusive from each other but which manifest in different aspects of risk.  So my organisation has personal risk assessments for the likes of people in the clinically vulnerable groups, workplace risk assessments for personnel working in shared office accommodation and business impact assessments linked to business continuity plans.  I would be loathe to use a risk assessment based on the economic impact on the company as a justification for putting individual employees at risk!!

Thank you for your reply HSquared14.

Several of you seem to have picked up on my mention of the economy rather than the other points in my initial post. I agree that the economy should not be the sole basis for a risk assessment, but has an effect that businesses may wish to consider, so let me explain my reasoning:

As I replied to Brian (5 Aug at 1549), the economy is driven by people both as producers and consumers.

The fear and anxiety many in society are currently suffering in their personal lives will inevitably roll over into their work lives; some are hesitant to even go into a shop, or panic when others around them get closer than 2m.

These people are consumers, but many of them are also producers. If consumers are not consuming, producers scale back producing, leaving people without jobs, or with reduced income, which reduces consumer spending further, which has the inevitable knock-on to further reductions in production… you see where I’m going with the vicious circle here.

If businesses use evidence-based risk assessments to demonstrate to employees that in fact Covid-19 has caused no more deaths than a bad flu season, and encourage them to question the HMG and MSM fear-based narratives, a return to normal (pre-Covid) life should start to at least arrest the downward spiral, if not start a positive upward one.

When people are less likely to lose their jobs, incomes and businesses, they are less likely to suffer from stress and are therefore in better mental and physical health – improving their lives in general, including at work.

“The risk assessment should address the risk of harm caused by Covid-19 (the disease) as opposed to the risk of transmission of the SARS-CoV-2 (the virus); transmission of the virus does not in itself cause harm, whereas the resulting disease Covid-19 can have serious consequences.”

This would be true if we were doing a risk assessment under COSHH using the guidance from ACDP etc as a starting point. But we are not. As said, this is public health matter not H&S, so the issue is NOT protecting staff but preventing the transmission of the virus. Or at least I thing that is the case since all of the legal measures that the government have imposed derive  for the Public Health Act not the Health and Safety at Work Act. It’s very hard to know exactly what the government want and rather than to to second guess them I would suggest we blindly follow whatever they say:

Checklists are in overthinking is out.    

1999-2000 there were 48,000 excesss WINTER deaths in the UK, of which 22,000 were flu related. The COVID hit over spring, which historically has lower rates of death than the winter. Even by this measure this is twice as bad as the worst flu season for around 100 years, and it isn't nearly over yet.

To tackle a few of your other points, higher testing does increase the number of cases found. This is not what lockdowns are based on though. It is based on the number of positive tests for each test carried out. You sound like Trump, he too does not understand testing.

The death rate no increasing as rapidly as before as a lot more due to the demograph of those infected. Younger people are now disproportionally represented in positive cases (those below 25) as you know, these have a much lower rate of complications.

It is not our place to look after the economy, or even judge the socio-economic impacts of our safety measures. It is our jon to protect those that rely on us in places of work.

You obviously have an agenda, that is not at all related to H&S at work. The message you are preaching is dangerous, and I do not feel the a health and safety forum is the right place to air it.

Thanks Cpt - i was trying to think of a polite way of saying that!

Iron chicken.

(quote)

I have also seen a number of other similar templates produced by such as trade bodies and various other organisations – they all gave the residual risk level to be no lower than ‘medium’, after implementing all control measures within the HMG guidance

You would be shocked as i dont have any scoreing or residual risk on any of my risk assessments! But they all have every measure that we belive is "Resonably Practicable" to prevent the Hazard hurting some one. And as Cpt has said - we have no idea what the residual risk is - we dont even realy know why some people die and some dont!

I too think you are just looking for an excuse to not follow the guidance - well feel free but good luck explaing that to the courts when the HSE/LA call.

We have been given guidance to try and limit this PUBLIC HEALTH ISSUE and I belive we Have a Moral and Legal duty to impliment that guidance as best as we are able, while trying to help our collegues with issue in mental health etc at the same time.

Edited by user 06 August 2020 11:47:58(UTC)  | Reason: Not specified

Originally Posted by: chris.packham

Yes. but what is the actual risk? We really have so little hard data on COVID-19 on which to identify the real risk. 

We don't have any real data on how many people have been infected, possibly with few or no symptoms but who could infect others. The data on deaths is highly suspect in that, for example someone dies some weeks after having recovered from the infection, but from a different cause and, it appears, that could be included in the COVID-19 deaths! We have little evidence on the main ways in which infection is passed on. Test and trace only identifies the tested person at that moment in time. A few hours later, in the pub, they inhale the virus and are then positive. They were in your workplace today but not a carrier, but back in there tomorrow with the infection and without you being aware of this. Every member of your workforce will have a different propensity to become infected and respond at differing levels of severity (or none at all). 

Even if you decide you can estimate a level of risk, you then need to manage this. I would like to know how, other than by closing the workplace completely.

Thank you for your reply Chris.

As you say, the data on deaths is highly suspect - but as you also note, the number of Covid-19 deaths are more likely to have been over-counted than undercounted.

Death data is the most consistent metric available, so that is the evidence on which the actual likelihood of harm can be based – cumulative deaths for England & Wales for 2019/2020 are currently running at 14,523 less than those for the 1999/2000 flu season (InProportion2 has a lot of excellent information and graphs – all kept up-to-date and based on ONS data – and also links to interesting articles).

There is enough data available from mass testing to indicate that an increase in ‘cases’ does not result in a corresponding increase in deaths – take Leicester for example: between mid-May and the end of June, local testing capacity was ramped up from 1 site to 8, and City Council workers were going door-to-door offering swab tests to all and sundry, symptomatic or not; ‘with Covid-19’ deaths in Leicester have remained at a negligible level throughout.

ONS and NHS statistics show which sectors of the population are most at risk – the elderly and those with underlying health conditions.

31.1% of Covid-19 deaths occurred in care home/hospice settings.

Between 28 Dec and 24 Jul 2020 in England and Wales (ONS Section 3 Figure 3): deaths of working age persons registered ‘with Covid-19’ = 5,479 = about 1 in 6753 people = 0.015%

Compare this with 2018 (ONS link here): working age deaths in total for all of 2018 = 79,220 = about 1 in 467 people = 0.21%

Mid-2018 (ONS Sec 6 Fig 4) and mid-2019 (ONS Section 6 Figure 4) estimated working age (16 to 64 years) population in E&W = 37M.

‘With Covid-19’ deaths are comparable to those in a bad flu season and rising ‘cases’ are not causing rising deaths, so why would we implement completely disproportionate measures to control a risk that is negligible?

Originally Posted by: A Kurdziel

“The risk assessment should address the risk of harm caused by Covid-19 (the disease) as opposed to the risk of transmission of the SARS-CoV-2 (the virus); transmission of the virus does not in itself cause harm, whereas the resulting disease Covid-19 can have serious consequences.”

This would be true if we were doing a risk assessment under COSHH using the guidance from ACDP etc as a starting point. But we are not. As said, this is public health matter not H&S, so the issue is NOT protecting staff but preventing the transmission of the virus. Or at least I thing that is the case since all of the legal measures that the government have imposed derive  for the Public Health Act not the Health and Safety at Work Act. It’s very hard to know exactly what the government want and rather than to to second guess them I would suggest we blindly follow whatever they say:

Checklists are in overthinking is out.    

Thank you for your follow-up A Kurdziel.

Interestingly, there seems to be no mention of the HSE in the ‘Authorities administering Act’ section of the PH Act 1984!

HMG seems to be giving out so many mixed messages now that it's hard to keep abreast of what we are "allowed" to do - even more so in those parts of the country subject to local lockdown.

HMG guidance: Covid-19 risk assessment; cleaning, handwashing and hygiene procedures; working from home; 2m social distancing (language used - ‘should’ and ‘where possible’).

HSE Working safely during the coronavirus (COVID-19) outbreak: guidance

So the above is just guidance, right?

Oh, wait. Business owners must implement this ‘guidance’, under threat of enforcement action by the HSE, EHOs and Police in the event of non-compliance.

So it’s not guidance after all.

Why are measures needed to prevent transmission of this virus when none have been required for more virulent viruses in the past?

I think HMG are quite happy that many people are blindly following whatever they say…

Originally Posted by: CptBeaky

1999-2000 there were 48,000 excesss WINTER deaths in the UK, of which 22,000 were flu related. The COVID hit over spring, which historically has lower rates of death than the winter. Even by this measure this is twice as bad as the worst flu season for around 100 years, and it isn't nearly over yet.

To tackle a few of your other points, higher testing does increase the number of cases found. This is not what lockdowns are based on though. It is based on the number of positive tests for each test carried out. You sound like Trump, he too does not understand testing.

The death rate no increasing as rapidly as before as a lot more due to the demograph of those infected. Younger people are now disproportionally represented in positive cases (those below 25) as you know, these have a much lower rate of complications.

It is not our place to look after the economy, or even judge the socio-economic impacts of our safety measures. It is our jon to protect those that rely on us in places of work.

You obviously have an agenda, that is not at all related to H&S at work. The message you are preaching is dangerous, and I do not feel the a health and safety forum is the right place to air it.

CptBeaky, thank you for the further character assassination attempts.

1957/1958 Asian Flu – 33,000 UK deaths

1968/1969 Hong Kong Flu – 80,000 UK deaths

The local lockdown in Leicester was based on the number of ‘cases’ per 100K population, not the number of positive tests as a percentage of the total number of tests.

This was deemed to be high when compared with the number of cases per 100K population in other areas of the country.

Leicester at the point of lockdown had 8 testing stations plus a (still ongoing) door-to-door swab test campaign, so with much more testing here than elsewhere in the UK inevitably more cases were found per 100K population.

Therefore, the Leicester Local Lockdown was based on misrepresented data.

The death rate is not increasing at all; the number of UK Covid-19 deaths per week continues to fall, as shown by the ONS stats for the last few weeks – 606, 532, 366, 295, 217.

I have a right to voice my opinion. Opinions are not right or wrong. You may not agree with my opinion, but that does not mean I am wrong and you are right.

Chris i have been bying to say that!

i dont know what Iron Chickens agenda is here - i still think he or she is just trying to make trouble and find a reason to stop people following the guidance.

Dont know if everyone else new (I only found out this week) but all the member voluntears who used to moderate this forum either resigned or were removed over 12 months ago - IOSH clearly have no interest in whats posted anymore.

Iron Chicken.

I would not call you a moron - your post are elequent and reasoned argument - but unfortunatly they are based on purly your ideas of what should be included and give no indicatiuon of what you are trying to achieve. I have a number of family members who are shielding, i have 2 family members and a very close friend who have had Covid who thankfully survived - i will continue to impliment the guidance to try and limit the impact on both the economy and individuals in this time of a public health crisis.

And on that note i will make no further comment on this post - no point when someone will argue black is white reguardless of the number of other people who digagree - i wish i was perfect!

Edited by user 07 August 2020 07:55:29(UTC)  | Reason: No spell check Still i see. Can i claim discrimination againt us dislexic members?

"The identified gene sequence of SARS-CoV-2 shows it’s related to the 2002 SARS virus SARS-CoV - note the similar name that the 2019 version has been given. So… is this virus really ‘new’?"

YES, it may be a corona virus, but it is a new strain, hence the term "novel". I take this from WHO. They are the experts, I have no reason to doubt them. Just because it is related to SARS does not mean it is the same as SARS. Lions are not tigers.

You seem to link me to an article, not a peer reviewed paper. I prefer to read peer reviewed papers, so that I am protected against biases. The article is published on medium.com which (acording to the media bias site) has the following rating

"Overall, we rate Medium Left-Center biased based on story selection that moderately favors the left and Mixed for factual reporting due to a lack of sourcing and some articles that promote conspiracy theories and pseudoscience."

The article linked was published june 10th, and states the virus is in decline, well given the numbers now, that seems a little off... It even includes the line "The virus is gone for now. It will probably come back in winter, but it won’t be a second wave, but just a cold.". Death rates have been steadily rising (worldwide) since June. He says "If we observe a significant rise in infections in 14 days [after the Swiss relaxed the lockdown], we’d at least know that one of the measures was useful." By June 20th the numbers in Switzerland started going up again....

The graphs (in your second link) don't take into account that in previous pandemics there were no controls. You are comparing a flu with no controls, with a virus that shut down the world, and then ask why there hasn't been as many infections. Then you recommend re-opening the economy, with no controls as the safest thing to do.

Do we have immunity to it?

All the peer reviewed evidence I have seen suggests that previous exposure to corona viruses, such as the common cold, my reduce symptoms in some people, but nobody has a natural immunity to it, in the same way nobody has a natural immunity to the common cold. Given that the complications with COVID-19 are so much worse than the common cold, or influenza (again read the WHO site for more info) it can be extremely dangerous.

My calculations were based on your assumption that this is no worse than a bad flu season, combined with your belief that lockdown controls are not necessary, and the scientific consensus of the lack of  immunity. This is of course a worse case scenerio (assuming the 0.1% death rate, some think it may be as high as 0.3%), but your vision of safer seems to point that way. Basically you seem to be taking a high risk approach. Even by your own admission there is a lot we don't know about this virus. I prefer to err on the side of caution and be proved wrong, you seem to want to gamble with people's lives.

You are pursuing a dangerous agenda, based on biased "facts". I could spend an entire ripping that second link apart, especially when it completely fails to understand why Japan has less cases and passes it off as it being because they didn't lock down, rather than look at the fact they all started wearing masks straight away, they have previous experience with SARS and they showed greater disipline in following the rules. It asks why the strictest lockdowns only happen in places with the most cases, eluding to them not working, rather than being the cause of the lockdown. It questions wether lifting lockdown rules change the infection rate at all, when the shambles happening in the USA at the moment show that lifting restrictions too early causes people to die. It has a stringency graph that it completely mis-represents (eluding to a negative correlation by highlighting select countries, rather than looking at the trend in the whole graph). I can continue if you like.

Why not just come out and reveal your reasons for wanting the economy to open? It certainly has nothing to do with H&S at work.

Seems we have the return-to-work-even-if-you-die troll on the site. Loads of them about now.

I have just finished anal-ising the comments section on a leading economics/right-wing website. Many of the comments are seen on various other sites, twitter for one, and seem to point to a troll-factory with an agenda.

Sadly, they are spreading quite fast.

There was an article in The Lancet which they may like to troll to death: https://www.thelancet.co...nf/article/PIIS1473-3099(20)30484-9/fulltext

As for the comments about Ferguson, he said that if action was not taken to prevent transmission, the number of deaths may exceed 500,000. Action was taken, and *only* 46,000+ poor souls died.

The long-term effects after recovering from an infection of Sars-CoV-2 will blight the lives of many.

Assessments of the impact on the economy have been and are being done - by economists.

Assessments of the impact on individual businesses have been and are being done - by business leaders and owners.

Assessments of the likely development of the outbreak have been and are being done - by epidemiologists.

Being none of the above, I am in no position to make any such assessments.

What is within my abilities as a health and safety adviser is to interpret workplace guidance and propose proportionate control measures that are suited to the organisation I work for.  So that's what I'm doing.

As for challenging the guidance and whether it strikes the right balance, that is a political matter.  I suggest writing to your MP with objections to it.