Sustainability in Business

Severe COVID-19 Risk Factors

Organizations need to consider the risk factors in terms of comorbidities when preparing to operate while the COVID-19 (or other infectious diseases) pandemic is present

The Western Cape Government has published a document that was primarily aimed at schools reopening during the COVID-19 pandemic. The risk factors are equally applicable to businesses during this time.

It is necessary to ensure that, as employers, we know if any member of our staff does have a record or suffers from any of these comorbidities. We can obtain the information from employees through a questionnaire, and we can then take the necessary precautions to protect vulnerable employees. Just ensure that employees provide you with confirmation from a doctor if they claim to suffer from any of these conditions!

(Comorbidities are conditions that may co-exist with the symptoms of the Corona Virus infection and that would make the person more susceptible to serious conditions that could cause fatalities).

I thought it would be a good idea to copy the list supplied by the Dept of Health for the benefit of business leaders.

Risk Factor	Detail	Definition
Age	People 60 years and older with comorbidities	Aged 60 years or older with one or more disorders or conditions
People all ages with the following underlying medical conditions, particularly if not well controlled:
Cardiovascular Disease	Moderate / severe hypertension	Moderate hypertension: Systolic BP 160 – 179mmHg and or diastolic BP 100-109mmHg Severe hypertension: Systolic BP equal to or higher than 180mmHg and / or diastolic BP equal to or higher than 110mmHg
	Congestive cardiac failure or other serious cardiovascular disease	Confirmed clinical diagnosis of congestive cardiac failure or other severe cardiovascular disease
	Cerebrovascular disease, including stroke or transient ischaemic attack	Confirmed clinical diagnosis of Cerebrovascular disease
Respiratory Disease	Pulmonary Tuberculosis – untreated or in early treatment	People who have not completed the intensive phase or first 2 months of treatment in line with the National Department of Health Standard Treatment Guidelines
	Moderate to severe asthma	Asthma which requires treatment with high dose inhaled corticosteroids plus a second controller (and / or systemic corticosteroids) to prevent it from becoming “uncontrolled” or which remains “uncontrolled” despite this therapy
	Chronic Obstructive  Pulmonary Disease (COPD)	Confirmed clinical diagnosis of COPD
	Other severe chronic lung pathology, including cystic fibrosis and bronchiectasis	Confirmed clinical diagnosis – irrespective of severity
Kidney Disease	Chronic kidney disease	eGFR<45
Pregnancy	Third trimester pregnancy	Estimated to be further than week 27 of pregnancy
Immunosuppression	Poorly controlled type 2 Diabetes Mellitus	HBA1c equal to or higher than 7,5% within the last 6 months
	Cancer undergoing active treatment	Currently undergoing chemotherapy or radiotherapy
	Human Immunodeficiency Virus with advanced Immunosuppression	HIV positive persons with CD4 count <200 cells.mm3 who are ART-naïve or who initiated ART within last 3 months
	Chronic immunosuppressant use	Chronic use of ccarticosteroids of >20mg  prednisone per day or equivalent, methotrexate, biologicals or other immunosuppressants
	Transplant	On chronic immunosuppressants
Metabolic Syndrome	Severe obesity	Body mass index (MBI) of 40 or higher

It would be a good idea to hand out a questionnaire to employees to find out if they are affected by any of these conditions. The organization must decide on an action plan regarding how to handle each case individually, depending on the severity. It is also possible that the organization may decide to treat all cases the same. But what is important is that an action plan, based on the severity of the risk, must be put in place to protect employees from exposure to the Corona Virus. As I have stated earlier, we need to obtain medical evidence for all cases where employees claim to be affected by one or more of these conditions.

The best course of action is to include these conditions in the risk assessment regarding the pandemic. We know that these conditions all pose a risk. The potential severity is a fatality, in each of these cases. The probability would be determined by the potential exposure to the virus and the person contracting the COVID-19 Flu, which could create a higher risk of fatality than normal, as a result of the presence of any of these conditions. It is important to bear in mind that persons are not only potentially exposed to the virus at work, but also outside the workplace. Having said that, it is important to limit the potential exposure to the virus at the workplace as much as possible. This is done through screening, policies regarding social distancing, etc. All these factors have to be considered when doing the risk assessment.

In schools children with evidence of any of these conditions will most probably not be allowed to return to school during the pandemic.

The choice would be that of the employer as to how to react, but under the current conditions employers should rather exercise caution.

I think it is extremely important in our quest to curb the spread of the virus that we do consider these comorbidities in our risk assessments. It may mean that we have to disallow certain employees from entering our premises. How we are going to react to that reality as organizations depends purely on us, since we may not be able to pay salaries to employees who cannot work. If possible we can make use of government interventions that may be available to compensate the employees who are affected.

Once again, we see that good leadership has to consider risks and our reactions to those risks. Good leadership will not expose employees unnecessarily to the possibility of serious consequences. But good leadership will also not turn its back on these employees without at least considering what is best for the employee, both in terms of there health and their welfare.

I sincerely hope that this article will help leadership in organizations to better manage the effects of the pandemic on our day-to-day activities!

For more information or assistance, please feel free to contact me at koosgouws10@gmail.com

You can also visit our website at www.sheqmanagementsystem.co.za.

Koos Gouws

SHEQ Management Systems