"We are in uncharted territory," said WHO chief Tedros Adhanom Ghebreyesus last week as the world continues to learn about the novel corona virus, also known as COVID-19.
The novel virus is serving to be a challenge to modern healthcare systems where many are unsure of how to respond. As a public health issue, governments are trying to balance ‘business as usual’ with the measures needed to reduce the spread of the virus. This includes a national workforce and a shrinking economy.
Conversely, this week, Italy introduced measures to isolate its own citizens, despite the obvious economic and workforce implications. China too is in its third month of quarantining. Early this year it aggressively introduced mandatory lockdowns of Wuhan and nearby cities in the Hubei province, which put at least 50 million people under quarantine. The forecasted losses on the Chinese market look bleak, not to mention the disruption to workforce conditions, and the emotional and psychological impact of long-term quarantining. But most of all, the human impact of the outbreak is significant, where fear in community is driving up racism and panic buying – think toilet paper and pasta.
The Australian Government is seen to provide little assurances and comfort to those who are scared; they admit they are still working on plans and finer details. They have shed light on their plan to assist struggling sectors that have been hit hardest by COVID-19, including universities, tourism operators, the building sector and seafood exporters - their action will be "targeted," "measured" and "scalable". However, this does little for workers and their families who are today directly impacted and scared.
Another issue the governments is yet to troubleshoot is the confusion of where federal and state roles play. This is particularly a sticking point on questions of direct funding to mitigate the impact of quarantining and social distancing; an issue the Morrison government seems keen to neglect and forget.
I argue that supporting low-income workers who do not have any or enough sick leave is critical to a public health response. Indeed, COVID-19 will undeniably and disproportionality affect low income earners and working families. COVID-19 doesn’t have a social conscious and will not discriminate if you are a corporate businessman with no dependents and access to purchased leave, or a casual cleaner with 4 children and no sick leave.
Indeed, there was a recent story of a man with COVID-19 ignoring instructions to self-isolate pending test results. He instead worked several shirts at Hobart's Grand Chancellor Hotel. Sally McManus, Secretary of the Australian Council of Trade Unions, said the Morrison Government should cover costs for sick leave and bail out casual workers who self-isolate - just like the government bailed out the banks.
McManus is right – the government should provide sick leave to workers who are currently undertaking voluntary or mandated control measures. Experts who support this continue to suggest that the Morrison Government should follow the example of other countries offering direct payments.
This is particularly important for low income workers in retail, hospitality, childcare, cleaning, self-employed and the gig economy, where the choice may come down to heeding the advice of experts in order to pay bills and feed family. This issue is also heightened given access to healthcare remains an issue for these workers in Australia where many are on temporary visas, and seldom have access to Medicare.
Our industrial laws clearly need to be improved, regardless of a public health crisis or not; and there is going to be no greater test to our system than a pending pandemic.
As many as two million Australia’s have no right to paid sick leave, according to the Australian Council of Trade Unions. This, with an estimated RO of 2.8 for COVID-19 (the average number of people who will be infected from one contagious person), poses a significant public health risk.
Health experts, the business sector, union officials and members of Parliament have stressed that given these poor conditions and entitlements for workers, many will hide the fact they have COVID-19; reducing any chance of containment.
We need greater leadership and guidance, and it’s certainly not coming from the government or companies like Uber and Deliveroo. Indeed, gig economy workers reported they have had limited to no support in order to prepare for COVID-19.
These workers are exposed to environmental elements daily, interacting with the general public is core business, and the nature of their work transporting people to airports and delivering food means they are vital to a public health response.
Looking into the future, our healthcare system needs to reflect greater flexibility and not respond to moments of crisis. This flexibility must match the flexibility of our workforce; since we have learnt by recent events, the success of our ongoing public health response relies on modern, fair workforce conditions which provide public health to all.
Jack Whitney is an honorary clinical fellow at the University of Technology Sydney, a policy consultant and ex-health worker.