Case-by case risk and control judgements
Freedom Day finally arrived this week with the lifting of virtually all COVID-19 restrictions in England. But it didn’t get off to a great start with both the Prime Minister and Chancellor in self-isolation.
Thanks to the Delta variant, the number of COVID-19 cases is on a steep upward trajectory. Meanwhile the aptly named ‘pingdemic’ is seeing huge numbers in self-isolation, and fears over the prevalence of the Beta variant in France has seen the last minute creation of a special ‘amber plus’ category for incoming travellers. Our vaccine programme has weakened the link between infections, serious illness, hospitalisations and deaths, however it is clear that this pandemic is far from over.
So what are the consequences of all of this for environmental health professionals working on the front line? They have been placed in an invidious position, often being the first port of call for businesses wanting to do the right thing and workers aggrieved that their employers are not doing the right thing. They have an unenviable task, providing much needed advice and guidance as well as assessing the adequacy of business controls to keep people safe in the workplace.
With almost all COVID-secure legal requirements on businesses in England having been lifted on 19 July, all settings can now open with a gradual return to offices over the summer. Limits on social distancing have largely been removed, the legal requirement to wear face coverings has been lifted, although they are still recommended in crowded areas. And while businesses are encouraged to display QR codes, it is no longer a requirement. Businesses such as nightclubs and large events should be encouraged to use the NHS COVID Pass to check people are fully vaccinated, however they won't legally have to do so.
So what advice is being provided to environmental health professionals? The No.3 Regulations will remain in force enabling local authorities to give directions relating to premises, events and public outdoor places if the public health necessity and proportionality conditions are met. Under health and safety legislation businesses still need to think about how they can reduce risks to workers, review and update their risk assessment and consult their workforce on health and safety matters. The indication is that many businesses will retain some of the existing controls such as screens at checkouts to enhance customer confidence. The government position has shifted and the expectation is for less enforcement and more advice.
The need for adequate ventilation, sufficient cleaning and good hand hygiene as workplace controls as specified by the Health and Safety Executive (HSE) remain unchanged, while advice on ventilation including identifying poorly ventilated areas and using CO2 monitors is also available.
HSE has advised that its expectation is for judgements about risk and controls to be made on a case-by-case basis, considering the Government’s scientific advice and guidance. Officers should continue to be guided by the Enforcement Management Model (EMM) in reaching an initial enforcement decision in relation to social distancing (and other COVID-control measures) and take a proportionate approach.
The focus should be on work activities that makes it more likely that a worker will become infected over and above the general risk and any expectations of action by business should be in line with the requirements of the generic Working Safely guidance in England. If there is no risk assessment or a failure to implement the controls indicated in the risk assessment action should be taken although it is going to be more difficult to challenge risk assessments which are not ‘suitable and sufficient’.
This situation is further complicated with differences across the UK with devolved nations taking a more precautionary approach. In Wales, there are still restrictions on the number of people who can meet indoors in private homes and holiday accommodation and face coverings will remain a legal requirement indoors in public places for some time.
Employers are being urged to consider the use of face coverings in the workplace as part of their coronavirus risk assessment and people are being urged to continue to work from home. The government hopes to move to alert level 0 on 7 August. That will mean there are no legal limits on the number of people who can meet indoors, all premises will be able to open, including nightclubs and most restrictions will be replaced by risk assessments
In Northern Ireland, restrictions will be eased further on 26 July, if approved at a review on 22 July. Changes will mean that theatres and other indoor seated venues can reopen, live music indoors with no restrictions on sound levels, 10 people from three households able to meet inside a private home, 15 people from any number of households able to meet in a private garden and social distancing reduced to one-metre indoors and removed for outdoor activities (although maintaining a two-metre distance is still recommended).
In Scotland, the requirement to book two-hour slots to go to a pub or restaurant has ended, but customers still have to provide contact details and wear face coverings when not seated. Hospitality premises must close at midnight, nightclubs and adult entertainment remain closed and masks will remain compulsory on public transport and in shops "for some time". The government hopes to lift most of the remaining restrictions on 9 August.
One thing is clear. Environmental health professionals know what works in limiting the spread of COVID – opening windows and good ventilation systems, socialising outdoors, washing hands, wearing face coverings in crowded indoor places, working from home if possible and isolating people with the virus. However, they are seeing for themselves that other harms from the pandemic are now beginning to outweigh the direct harms from the virus.
There is no doubt that our unsung heroes will continue the fight, adopting their usual pragmatic approach to protect public health, but many are exhausted, with the demands of the last 16 months taking their toll. National and local government, regulators and CIEH must all step up to help build capacity and resilience in this fragile workforce that has gone beyond proving its worth. None of us know what the nature of the next big challenge that lies lurking around the corner will be, but we must be prepared and work must start now…