A Workers’ Health Centre’s perspective on the COVID-19 Pandemic

It’s been a challenging two years for workers in Manitoba

From exhausted health care workers to COVID-19 outbreaks among workers in meat processing plants – workers have born the effects of the pandemic while needing to continue to show up to engage in the important and essential work that our society depends on, which the pandemic has only highlighted further.

Not all workers have experienced the pandemic in the same way – we know that racialized workers and communities have been disproportionately impacted by the pandemic.

61% of those who tested positive for COVID-19 in Manitoba were Black, Indigenous & People of Colour (as of May 15, 2021).
Only 35% of people in Manitoba belong to a BIPOC group.
Province of Manitoba, COVID-19 Case Data and Racial/Ethnic/Indigenous Identity, March 2021

The first workplace outbreak in Manitoba– not surprisingly to us – was in a meat processing plant where many newcomer and migrant workers are employed. Workers organized and made desperate calls to close the plant – but these calls were ignored, their work and the profits of their employer deemed too important, their health not important enough.

Migrant farmworkers did not fare any better. The Auditor general released a scathing report at the end of 2021 that found that federal inspectors did not properly enforce pandemic regulations to protect farmworkers from COVID-19. The report found inspectors approved employers’ pandemic plans with little or no evidence collected.

Migrant workers deemed ‘disposable’ before and during pandemic, Manitoba advocates say
Winnipeg Free Press, December 2021

OHC spent the two years of the pandemic working with nail salon workers – mostly racialized women workers from the Vietnamese community. These workers lost much of their income when their salons closed for almost half of the entire first year of the pandemic.

Like other women workers, many of these workers were mothers –parenting children of all ages through the pandemic. Trying to support the educational needs, social needs and mental health needs of their children. With everyone at home more, the increase in domestic work was also disproportionately born by women workers. Single mothers experienced this even more keenly and many left their jobs and had difficulty returning to the paid workforce.

Employment rate for single mothers (with children younger than six) was down 36% between February 2020-December 2021
CBC Radio, The Current, February 2022

The care work that was primarily born by women at home, was also born by workers in personal care homes, caring for the elderly. Both workers and residents were subjected to far too many COVID-19 outbreaks and deaths – calling into question the very way we care for the elderly in this country.

As a workers’ health centre, we view occupational health as having a key role to play in protecting workers during a pandemic.

The World Health organization describes occupational health in this way:

“Occupational health should aim to promote and maintain of the highest degree of physical, mental and social well-being of workers in all occupations; the prevention amongst workers of departures from health caused by their working conditions; the protection of workers in their employment from risks resulting from factors adverse to health; the placing and maintenance of the worker in an occupational environment adapted to their physiological and psychological capabilities…”

The “highest degree” means we must do more than the minimum, we must create workplaces that enhance and promote health, not just reduce or manage some acceptable level of illness. It means that we do our utmost to provide workers with the most effective protections they need to stay safe.

An occupational health approach uses a Hierarchy of Controls to determine how to best protect workers. Dealing with hazards at the source is a key feature of this approach. We understand that approaches that focus on worker behavior are simply less effective at preventing injuries and illness. We need strategies that pay attention to the working environment rather than the individual.

Of course, limiting exposure to biological hazards has always been an occupational health challenge – especially for a virus as contagious as this one.

For this reason, most occupational health experts support a multilayered approach to prevent the spread of COVID-19, commonly referred to as the “Swiss Cheese Model”. Multiple layers are used in combination including remote work where possible, improving ventilation, vaccines, frequent testing, & effective masks and respirators.

Workers’ health and safety rights are also fundamental to occupational health. These rights were fought for and won by working people represented by the labour movement across Canada in the 1970s.

OHC’s work with newcomer workers largely focuses on training on the topic of health and safety rights. The pandemic showed us where these rights proved inadequate in a time of crisis.

Over the past couple of years, we’ve received many inquires from front-line workers who were afraid they were being unnecessarily exposed to COVID-19. Yet we began to learn that exercising the Right to Refuse was exceedingly difficult. While employers needed to show they were taking some prevention measures, they were not held to any clear standards of what would represent an effective approach from an occupational health perspective – particularly one that considers the source of the hazard and environmental controls, or the need for multiple layers of protection. Workers were then left without much to back up their concerns of dangerous work to exercise a work refusal.

More Canadians are refusing work due to COVID-19 — but it’s tough to get authorities to agree
CBC News, June 2020

Health and safety activists who advocated and campaigned for workers’ rights to be enshrined in the 1976 legislation in Manitoba, recognized that the Right to Participate and the Right to Refuse unsafe work would be of limited use without the Right to Know.

Here is where the approach to the pandemic in Manitoba really fell short in a very fundamental way for workers. The reluctance of international and governmental bodies of all levels to recognize the airborne nature of COVID-19 in a timely way hampered our ability to prevent its spread.

Public health guidelines sidelined workplaces and offered insufficient guidance to employers on how to address indoor air quality. Workers have a Right to Know about the hazards they face and how they can work safely to deal with these hazards. It is critical to understand how an airborne virus spreads in order to understand how to work safely.

In a recent focus group OHC did with newcomer workers, it was clear that mixed messages and conflicting advice from their employers and from government has been confusing to workers. They were not aware of the importance of ventilation to reduce transmission, or the enhanced protection provided by an N95 respirator compared to other masks. When they followed employer and government guidelines and still got COVID, it led to decreased trust in the information they were receiving, as well as increased fear in the absence of understanding what mitigation measures are most effective. Public health messaging placed a heavy emphasis on individuals’ personal responsibility to avoid infection, while downplaying the social, economic and workplace conditions that contributed to acquiring COVID-19. This approach has put blame on individual workers and communities, compounding racism and racist incidents, for those workers and communities already disproportionately affected by higher case rates.

“I just feel worried everywhere because I know the virus can spread in the in air, or by the item they touched and maybe I will touch, you never know. No, I don’t feel confident at all. I just pray every day.”
– Newcomer focus group participant

We also believe there hasn’t been nearly enough attention paid to the mental health needs of workers given the high-stress work environments many experience. Workers everywhere are having a difficult time coping with chronic pandemic-related stressors – and have received limited support from their employers, or in the community where mental health services are overextended and chronically underfunded.

Bringing an occupational health lens to mental health during the pandemic, we know that it is crucial to address the root causes that result in chronic stress at work and potential harm to our mental health. Root causes such as a lack of protection from COVID-19 at work, minimum wage earners not making enough to make ends meet, racism at work and in the systems that are supposed to protect us, an intensification of work demands, and a lack of control at work.

“…Workers who felt safe at their physical worksites had better mental health than workers who felt workplace COVID-19 safety practices were inadequate.”
– At Work, Issue 102, Fall 2020: Institute for Work & Health, Toronto

What happens at work often doesn’t stay at work. For example, when a worker is off sick and recovering at home it impacts not only their colleagues, but more importantly their families and their communities.

Workplaces and workers do not exist in isolation. The division between community and workplace exposures during the pandemic was somewhat artificial, and workers in a number of settings felt that the determination that they acquired COVID in the community rather than at work did not match their experience in terms of where they were most likely exposed. Workers are embedded in the fabric of society and protecting workers’ health at work must be a high priority during a pandemic or any other health crisis.

Many workers and their families have lost loved ones during the pandemic. In Manitoba, we have now lost over 2,000 people due to COVID-19. As we begin to imagine a future when we finally emerge from this pandemic, we know better than ever that this future must center the health, wellbeing and recovery of the workers who have laboured so hard, and born so much illness, uncertainty, fear, and loss. Many of the problems that were exposed during the pandemic were structural – and that is where many of our solutions will be found.

OHC has advanced & will continue to promote several different recommendations throughout the pandemic which include:

1. Strengthen public health education in the province – Develop clear messages about the transmission of COVID-19 as an airborne virus and widely communicate appropriate guidelines for reducing transmission based on airborne spread. This public health education should be done in clear, simple language and be widely shared through various mediums. Information should be available in multiple languages.

2. Adopt and enforce standards on ventilation for workplaces that will ensure clean and healthy air in all workplaces and public spaces. While this may seem daunting, it is not impossible. As Dr. Linsey Marr points out in the New York Times, at the beginning of the 20th century improvements to water and sewage systems dramatically reduced common waterborne diseases such as typhoid and cholera. Advances in water waste management are now considered one of the greatest public health achievements of the previous century. Investing in improvements to air quality to reduce disease should be our public health focus for this century.

“You wouldn’t drink a glass of water full of pathogens, chemicals and dirt. Why should we put up with breathing contaminated air?”
Dr. Linsey Marr, New York Times, October 2021

3 Strengthen the health and safety rights of workers to ensure they can be exercised when they are most needed. This requires a strong and vibrant labour movement that can help counteract the power held by employers over workers’ health and safety. If you are part of a union, consider becoming more active. If you are not part of a union, consider organizing one.

4. Work against systemic racism and structural inequities that result in marginalizing workers and communities who bore the brunt of this pandemic. This requires preferentially directing resources to those communities experiencing oppression and listening to and supporting organizations who represent them and are advocating for their interests.

5. Implement universal Paid Sick Days for all workers in this province to ensure that low waged workers’ income is protected when they must be off work due to illness. A voluntary program for employers does not meet the needs of the workers who need this protection the most.

6. Raise the minimum wage to reflect a living wage and meet basic needs. Poverty crushes lives and causes illness. The workers who put their health on the lines to keep our society functioning during this global health crisis, deserve to live with dignity, health, and a decent standard of living. Everyone deserves this.

7. Strong public investment in the Care Economy that prioritizes higher wages and better working conditions and health and safety for the mainly women and racialized workers in childcare, long term care, and gender-based violence service provision. This will benefit women working in these jobs, the people needing care, as well as all those who need these supports to maintain employment.

We recognize that these are no small tasks in front of us as a society. However, we believe that in order for OHC to meet our values as a worker-centred healthcare organization, and promote the highest standard of health and safety, we must push forward on these initiatives and act for change within our communities. We hope you’ll join us.