Laid bare: The scandal of expendable workers before, during and after Covid

It is simple enough. The government had one eye on the budget and another on the Tory base, clamouring for an end to pettifogging rules and a loss of personal liberties. There had to be a swift return to ‘normality’, and that meant a return to work.

From July 2020 on, ministers embarked on a three-month mission to get us back into our ‘Covid-secure’ workplaces.

It took until 22 September 2020, with the government’s policy unravelling and outbreaks in workplaces, schools and universities on a sharp upwards trajectory, for Boris Johnson to reinstate the work-from-home recommendation, for some workers at least. The delay had come at a cost.

A Hazards analysis of official Public Health England figures up to the prime minister’s workplace policy flip reveals around four in 10 people testing positive for Covid-19 identified ‘a workplace or education event’ as their activity in the days prior to onset of symptoms, ahead of all other causes.

Thousands may have died because going to work placed them at avoidable risk. But the official statistics did not count them. The Health and Safety Executive’s workplace Covid database records just 152 Covid-19 deaths as related to work, a small fraction of 1% of the UK’s coronavirus deaths in working age adults.

Something had gone badly wrong.

Scare tactics

On 04 July 2020, prime minister Boris Johnson simultaneously relaxed social distancing rules in England and suggested getting back to work was a good thing.

As firms and their workers showed some initial reticence, the prime minister on 17 July added a return to workplaces by 01 August to his wish list. Johnson noted: “As we reopen our society and economy, it’s right that we give employers more discretion while continuing to ensure employees are kept safe.”

Ministers were anxious to placate impatient Tory backbenchers, apoplectic at ‘draconian’ government interference in our day-to-day lives.

The back-to-work rhetoric, described by the TUC as ‘reckless’, ramped up. On 28 August, Downing Street sought to distance the government from press reports that ministers planned a media campaign warning working from home could put employees at greater risk of being fired.  TUC general secretary Frances O’Grady commented: “The prime minister needs a credible plan to help more people travel and work safely, not a scare campaign.”

Still, government ministers queued up to affirm workplaces were ‘Covid-secure’ and populating them was an economic imperative and necessary to revive city centres. The first week in September saw the government putting pressure on civil servants to make a quick return to work, with 80% expected to be at their desks by the end of the month.

When concerns about high infection rates prompted a 09 September announcement by the prime minister of a tightening of restrictions and a new limit on gatherings to six people, he was clear “education and work settings are unaffected”. While seven people from the same household could no longer meet in the park, whole workforces were still encouraged to meet each working day all day.

Back to work was different. Back to work was safe.

The ministerial messaging had the desired effect. Office for National Statistics (ONS) figures released on 17 September showed the numbers travelling to work had increased from around 40% at the start of July to around the 50% mark at the start of August. By 13 September, six weeks after the prime minister’s first call to go back, 62% of adults reported commuting to work.

It was an ill-fated strategy that would lead to a humiliating about-face for the government, as infection rates re-entered the danger zone and the number of workplace clusters soared.

Get back to work

The increase in workplace clusters tracked an incubation period’s length behind the return to work numbers, some seeing hundreds of workers testing positive.

In the first week of August 2020, Public Health England (PHE) recorded 37 workplace clusters. By the first week of September, this had risen to 92 clusters; the following week the clusters total hit 102. The week up to 20 September – two days before Boris Johnson’s policy reversal called for office workers to switch back to working from home – saw a record 141 workplace clusters.

The policy change came after the Covid-19 alert level moved up to 4 on 21 September, meaning transmission is “high or rising exponentially”.

It was only after 10 August 2020 – when PHE contact tracing first started to record details about places people had been and activities they had done in the days before becoming unwell – that the first evidence of the possible workplace contribution to this rise became visible.

An analysis by Hazards revealed for the period 10 August to 24 September 2020 ‘Work and education events’ – both areas where there are legal requirements for the environment to be ‘Covid-secure’ – topped the list of activities prior to someone testing positive, identified by over 25,000 people. Nothing else came close.

‘Travel and commuting’ – activities most commonly linked to the school run or work commute – were not included in the ‘work and education’ grouping.

PHE said while the figures “can’t say for certain if this is where someone picked up the infection, the information might be helpful to indicate possible places where transmission is happening”.

Getting a real measure of the true extent of the workplace problem was impossible. The primary system designed to identify workplace cases was failing badly.

Covid confusion

The Health and Safety Executive’s RIDDOR rules – the regulations requiring the reporting of work-related injuries, dangerous occurrences and diseases like Covid-19 – were missing thousands of cases.

Professor Raymond Agius of the University of Manchester’s Centre for Occupational and Environmental Health, in an Occupational Medicine paper published on 21 September 2020, warned HSE’s RIDDOR guidance on Covid “excludes reports from occupations where employees are working with the general public as opposed to persons known to be infected”.

The professor noted: “Available evidence suggests that it might have failed in capturing many thousands of work related Covid-19 disease cases and hundreds of deaths.”

HSE’s database shows it recorded “9,786 disease notifications of Covid-19 in workers where occupational exposure is suspected… over the period 10 April – 19 September, including 152 death notifications”.

The week up to 19 September saw 228 Covid-19 cases reported to HSE. That same week PHE, in a figure that did not include work-related clusters in hospitals, care homes, prisons, hospitality or educational settings, recorded 141 clusters in ‘workplace settings’.

With a cluster defined as two or more cases, PHE’s partial workplace cases figure indicated there were at least 282 cases, 54 more positive cases in a single week, or 24% higher.

But work clusters can involve dozens and sometimes several hundred cases, suggesting Professor Agius’ estimate of ‘thousands’ of missed work cases may fall significantly short of the true mark.

In some sectors, workplace Covid cases weren’t being missed. They fell victim to a statistical sleight of hand, with the blame shifted from the workplace to the workers and their behaviour outside work.

The implications were grave. Unreported deaths, a 23 September 2020 report from the ethical investments consultancy Pirc, concluded Covid-19 infections at food factories could be more than 30 times higher than reported. The Pirc investigation found just 47 notifications of Covid-19 workplace infections – and no deaths – had been reported to HSE by food manufacturing companies employing 430,000 people in the UK.

Pirc calculated there have been at least 1,461 infections and six deaths in this sector alone, with the true toll likely to be even higher. The research consultancy said the discrepancy was partly due to a loophole that left it to companies to determine whether employees were infected on the job, or elsewhere, when they submit RIDDOR reports to HSE. It also criticised ‘the myth of community transmission’ of what were really work-related cases.

Boardroom transmission

HSE, local authority and public health agencies have all been culprits. When clusters have been largely limited to workers in a particular firm, both public health agencies and HSE have chorused ‘community transmission’, often collaborating on statements explicitly absolving companies of responsibility (Hazards 150). Car shares, working while sick, failing to self-isolate and crowded housing were instead blamed.

But even where this is the case, it is rarely the result of bad decisions by feckless workers. It is the inevitable consequence of low wages and no company sick pay. Of decisions in the boardroom.

The TUC’s 10 September 2020 report, Sick pay and debt, noted: “Over four in 10 workers (43%) told us that they would have to go into debt or not pay bills if their income dropped down to £96 per week for two weeks,” the rate for statutory sick pay (SSP). It added “almost a quarter (23%) of workers receive only basic SSP if they are off work sick… with 9% telling us they receive nothing.” It means a large slice of the workforce can’t afford to be a statistic.

Pirc’s labour specialist, Alice Martin, said its investigation showed the Covid-19 figures volunteered to HSE by companies – who can be fined for lax workplace safety conditions or failure to report cases – “lack credibility”.

Covideluded

HSE has throughout the Covid crisis taken a different, more sanguine, view of the performance of businesses.

“The current picture is that the vast majority of workplaces are trying their best to be Covid-secure,” HSE told Hazards in a 07 August 2020 statement. “This is not only reinforced by more of the workplaces we’re contacting through our spot inspections, or by other means, actually being Covid-secure, but we also note from public health analysis that very few of the local outbreaks we’re seeing appear to be starting at work.”

Workers do not share HSE’s confidence in ‘the vast majority’ of businesses. The findings of a TUC poll, published on 12 September, revealed that fewer than half of employees (46%) say their workplaces have introduced safe social distancing. The survey also revealed that under two-fifths (38%) of workers say they know their employers have carried out Covid-secure risk assessments, a legal requirement. Just four in 10 (42%) report being given adequate PPE.

A week before TUC published its poll findings, Matt Hancock insisted the “vast majority” of workplaces were Covid-secure. The health secretary told LBC Radio: “We back people going back to work. It is safe to go back to Covid-secure workplaces.” TUC general secretary Frances O’Grady commented: “Rather than trying to bully people back into offices, ministers should change the law to require all employers to publish their risk assessments, and make sure workplaces are safe.”

Up in the air

There is a discomforting disconnect between evidence workplaces provide one of the main opportunities for transmission of the coronavirus, and low official estimates from both HSE and PHE of the rates of infection in workplaces.

It now seems the readiness of public health agencies to clear workplaces of responsibility for infections affecting sometimes several hundred of their staff may have been based on a misunderstanding of transmission routes.

The UK government Covid-19 prevention strategy is based on an assumption the disease is transmitted by close contact with larger virus-loaded droplets, and not a cloud of smaller, dispersed airborne particles that can hang in the air for hours.  This mirrors the World Health Organisation (WHO) line.

As a consequence, workers in health and social care were predominately those recognised as facing a potentially high occupational risk for infection. But WHO is becoming an outlier, criticised by leading experts and unable to explain why industries outside of caring occupations have been hit by major outbreaks and high death rates.

The World Health Organisation has admitted its guidance on personal protective equipment was deliberately lax, because it was concerned about availability of the correct materials. This prompted biohazards professor Raina Macintyre to comment: “Guidance should be based on evidence, not supplies.”

On 30 September 2020, in a move copied a week later by the US government’s Centers for Disease Control (CDC), PHE changed tack. New PHE guidance for England noted: “Airborne transmission may also occur in poorly ventilated indoor spaces, particularly if individuals are in the same room together for an extended period of time.”

Spaces like offices, schools, factories, meat processing plants and vehicle cabs.

A 30 September 2020 internal HSE report obtained by Hazards reveals in the week to 21 September, there were 175 new outbreaks in HSE enforced workplaces. Four were in health and social care. But 60 were in food manufacturing, 18 in other manufacturing, six in construction and five in waste and recycling.

Latest official Covid-19 death figures provide an indication how devastating airborne transmission can be at work. An Office for National Statistics (ONS) breakdown published on 22 September 2020 confirmed the high Covid-19 death rates in health and care jobs are also being observed in some service sector jobs and manual trades.

Soaring infection rates in Leicester saw it become the first city placed back in lockdown on 29 June 2020. Many of the workers in Leicester’s garment district were on illegally low wages and were forced to work in crowded factories even when ill. Between October 2017 and August 2020, HSE records reveal there had been only 58 inspections by the regulator of the 1,000 plus fast fashion factories in the city and no prosecutions.

In figures for England and Wales for the period up to 30 June, ONS noted: “Among men, four of the nine major occupation groups (elementary; caring, leisure and personal services; process, plant and machine operatives; and skilled trades) had statistically significantly higher rates of death involving Covid-19 both before and during lockdown…”

For women, “caring, leisure and other services also had a statistically significantly higher rate of death involving Covid-19.”

This compares to HSE’s observation that “over three-quarters” of RIDDOR reports “are for workers in the health and social work sector (including for example hospitals, residential homes and day care)”.

Up to 30 June, ONS had recorded 5,330 Covid-19 deaths in working age adults in England and Wales.

In the much lengthier period up to 19 September 2020 and for the whole of Great Britain, HSE recorded just 152 deaths. HSE’s RIDDOR data tables include just three deaths in manufacturing, two in transportation and storage, and one in education.

There were, according to HSE, no work-related Covid-19 deaths in agriculture, forestry and fishing, mining and quarrying, wholesale and retail trades or construction. HSE recorded no more than five deaths in any sector other than “human health and social care activities”, where there were 7,746 cases and 120 deaths.

ONS, by contrast, showed while death rates are high in these caring jobs, they are lower than the combined total for the other workplace sectors with elevated rates.

Elementary mistakes

For ‘elementary occupations’ – previously referred to as low paid ‘unskilled’ jobs – prior to lockdown, death rates exceeded those in health and care settings and came close after.

Not all the Covid-19 deaths in working age people are attributable to work. It is however unthinkable that, with around 40% of PHE recorded infections occurring in people previously indicating their exposure may have occurred at a ‘work or education event’, that only a small fraction of 1% of working age deaths could be related to work.

HSE has failed demonstrably to record thousands of Covid-19 cases in workers. HSE has failed workers. And explicit government policy is the reason why.

Inspections and enforcement action by the resource-starved workplace safety regulator HSE have plummeted since the Conservative’s moved into No.10 a decade ago.

Boris Johnson, laying out new Covid restrictions, told the Commons on 22 September 2020 that the UK had reached “a perilous turning point”. He said “we are once again asking office workers who can work from home to do so.  In key public services – and in all professions where homeworking is not possible, such as construction or retail – people should continue to attend their workplaces.”

Justifying the limited new workplace restrictions, Cabinet Office minister Michael Gove claimed this was because “workplaces are now safer”. Gove’s comments came as workplace outbreaks hit a record high.

TUC general secretary Frances O’Grady was unimpressed. “With infections rising, the government must get a grip on test and trace and safety at work,” she said. “Workers are still telling us that employers are not enforcing social distancing or providing PPE to keep them safe. Ministers must make it a legal requirement for companies to publish their risk assessments. If we don’t deal with the public health crisis, we won’t be able to deal with the economic one.”

The government had plenty of warnings action was needed to head off a workplace Covid crisis, and of the inability of a hobbled HSE to respond.

Larger penalties and new money to enforce social distancing rules will mean ‘we’ll be policed all the way to the factory gates‘, while workplace scrutiny remains threadbare.

In a BMJ Rapid Response published on 11 July 2020, Stirling university occupational health professor Andrew Watterson said: “The HSE has been weakened in terms of policy, inspections, enforcement and staff over decades of cuts and, in many respects, went missing during the pandemic.”

Professor Watterson added: “Prevention of future pandemics will also require much better workplace sick pay and support schemes as well as urgent actions on low pay, long hours, night working and welfare conditions.”

A Covid-19 briefing and workplace safety charter published by the independent scientific advisers’ group I-Sage on 28 August 2020 called for all workplaces to be ‘certified’ safe before employees return. It added that unannounced workplace inspections should be increased to ensure employers continue to follow the rules.

I-Sage member Stephen Reicher, a professor of social psychology at St Andrew’s University, said: “We have seen how poor working conditions and pressure on employees to come to work when unwell have contributed to outbreaks of infection which have then affected whole communities.” He added HSE’s oversight had been “largely dismantled” over the last decade.

“It is quite clear that rigorous procedures to ensure workplace safety must be central to any overall pandemic strategy,” he said. “And yet the government has abdicated responsibility for this, simply telling employers to make workplaces safe but without any support or procedures to make sure this happens.

“You simply can’t fight Covid-19 on a wish and a prayer.”

Lawless workplaces

HSE had been critically damaged by a decade of government cuts, amplified by a government-mandated retreat from its enforcement role. HSE undertook 33,000 in 2009/10, the year before the Conservatives came to power (Hazards 120).  The findings of a Unite freedom of information request to HSE, published on 03 July 2020, revealed this had fallen to just 6,381 in 2019/20, a fifth of the number in 2009/10.

HSE’s funding was £239.4m in 2009/10. By 2019/20 the government contribution had fallen to £129.4, according to HSE’s latest business plan. The regulator has had to rely on cash-generating consultancies and charges to balance the books, but its overall budget of £226m is still £13m shy of the 2009/10 figure.

On 14 September 2020, Mike Clancy, general secretary of Prospect, the union representing HSE inspectors, warned the number of inspectors is now lower than the number of MPs. There are now only 390 full-time equivalent main grade inspectors for the whole of mainland UK. Clancy, whose union is campaigning for a fully funded HSE, said the prime minister’s promised Covid-19 spot inspections were a ‘figment of his imagination’ because the organisation lacks the capacity to do the job.

On 01 August 2020, former Tory safety minister Sarah Newton was appointed by the government as the new chair of HSE. Janet Newsham, chair of the national Hazards Campaign said the move confirmed a drift towards the political ‘capture’ of HSE.

“The Tory party has starved and neutered HSE over the last decade, and Sarah Newton as a former safety minister and MP is complicit in this disaster. These are not safe hands,” she said.

The pandemic has exposed a regulatory system in disarray. Today, HSE can’t even count the bodies.

But for this government, it appears, the bodies increasingly don’t count.

This article was orginally published in Hazards Magazine