Presidents' Letter - COVID-19, as a Work or Employment Injury in PHC Across all Europe

With the beginning of COVID-19 pandemic, the Family Doctors (FDs/GPs) health care workers have been under an enormously increasing risk in Europe.  

Many FDs/GPs had and still have the disease. The call for further need for encouragement and motivation succeeded to add extra payments for the PC health workers. The European Public Service Union (EPSU) web-site published the round-up of COVID-19 bonuses in July 2020. Depending on this already 4 months old information Portuguese, Netherlands, Germany, Belgium, Austria, Wale/UK, Bulgaria, Czech Republic, Sweden were providing somehow an additional payment in a non-standard way and to some PHC workers.  None of those so called bonuses were enough when thinking of the actual risk not only physicians are facing but also populations as the workforce has been losing many health workers. The pandemic progressed and a second wave occurred terribly hitting nowadays, and probably will be stronger.  Our MOs started to talk on occupational work related disease coverage and pointed out the social security funds or additional supportive fund coverage.

A significant number of colleagues died while members of our MOs tried to save their patients' lives. I would like to have photos or names of FDs / GPs in Europe so that the memory lives with us forever. As said earlier, FDs / GPs were the first to arrive and will likely be the last to come out when this pandemic is over. Some of the families of these doctors actually are having difficulties not only psychologically but also financially in this world. Citizens of low GDP countries are not being supported as much as high GDP countries in Europe. It is obvious to all of us that the European Region has marked diversity and is full of inequalities also for primary health care professionals. While in some low-populated areas with less density, family physicians are safe in their practice, many others practicing in dense and/or large populations are in a serious struggle for survival in a  pit called as COVID-19 pandemic. It looks like we do have many differences in between the primary health care in means of core values and a whole life experiences. I do not want to mention any discrepancies and I am not criticizing governments as they were giving different values to FDs/GPs but somehow it seems like the Southern & Northern, Eastern & Western, and central parts of Europe are all affected in this pandemic differently. Health Systems Researches shall illuminate different health and governance (PHC) responses in these regions in this panemic which occurs once in a hundred years.

A  question  that  needs  to  be  considered  is  whether,  in  certain  circumstances,  COVID-19  can  be  regarded  as  an  “occupational  (work-related) disease”. An “occupational disease” is any disease contracted primarily as a result of an exposure to risk factors arising from work activity. “Work-related diseases” have multiple causes, where factors in the work environment may play a role, together with other risk factors, in the development of such diseases.  The WHO Global Plan of Action on Workers’ Health called for improving the diagnosis, reporting and registration of occupational diseases and building capacities for estimating the occupational burden of diseases.

I think all our MOs shall work for and welcome recognition of COVID-19 as an occupational disease. The FOA sees it has a huge victory that COVID-19 is now recognised as an occupational disease and has also welcomed the fact that the process of proving infection has been relaxed.

While it is already clear that workers in hospitals and care homes will be covered because of the nature of their work, FOA says that there is now the possibility for more groups of workers to be included such as day care health workers, medical facility parking attendants and others who come into regular close contact with the public. Proof of risk of infection can now be based simply on a description of work and extent of contact with citizens.

During this outbreak workers are responsible for cooperating in the fulfilment by their employer of the Occupational Safety and Health obligations placed on them, complying with the prescribed safety.

Infection by COVID-19, if contracted as a result of work, could be considered as a work or employment injury. Workers who are infected by COVID-19 as a result of their work should be entitled to health care and, to the extent that they are incapacitated for work, to cash benefits or compensation.The dependent family members (e.g. spouses and children) of those who die from COVID-19 contracted in the course of work- related activities should be entitled to cash benefits or compensation, as well as to a funeral grant or benefit. For more details on national practices and additional information, you may see the ILO’s collection of state practice to address infection by COVID-19 as a work-related injury. In France recently a decision was made and an application started. People infected with Covid-19 in the course of their professional activity may benefit from specific care for occupational disease. Professionals working in the health sector can benefit from recognition. An example of this working recognition from France is under two simple conditions:

  • Their contamination with Covid-19 took place in the course of their work;
  • Their contamination with Covid-19 has resulted in a serious respiratory disease with the use of oxygen therapy or any other form of respiratory assistance.

Those sad subjects shall be worded in our council also. If something will be realized, we are the ones who should ask for changes. Who shall do that for us? We shall not be afraid of asking changes, or we shall not be late to do that as this pandemic is still ongoing and will probably hurt us much more. We are responsible to our population but also to our families, children. As the WONCA Europe with its MOs, and members of MOs it is clear that a need exists to work on legal, ethical, deontological sides and set fair criteria creating studies. In order to make the research/evidence based decision. I wish you all health and patience.

I am finalizing my words with this saying "Be like water my dear". If you wish to learn what I mean with that you may read my previous piece on our web site under the news letter sections.

Prof. Dr. Mehmet Ungan
WONCA Europe