Coronavirus: The risks to essential workers with hidden health conditions

It’s a time of great uncertainty for many people across the workforce, but one group of workers have additional reasons for worry. In this op-ed, IWH Scientist Dr. Arif Jetha cautions that we can’t forget about workers who have invisible health conditions.

Published: April 28, 2020

The COVID-19 pandemic has left many in Canada’s workforce worried about their health and finances. Those worries are even greater for workers living with an underlying and invisible chronic health condition.

In the planning of health and safety responses to COVID-19 and the ultimate reopening of workplaces, employers should be aware of the unique needs of this potentially vulnerable group of workers.

Data show that some of the most commonly reported chronic health conditions experienced by Canada’s working population have no visible signs or symptoms and may go unnoticed by employers.

According to the 2019 Sanofi Canada Healthcare Survey on workplace benefit plans, 54 per cent of workers reported having such a condition, with high blood pressure, arthritis and diabetes among the top five. In the same survey, employers estimated that only 29 per cent of their staff had a chronic condition, pointing to a gap in awareness within workplaces.

Our growing understanding of COVID-19 illustrates that the virus poses a particular threat to workers with underlying health conditions.

A review of 46,000 people with COVID-19 in China found that the odds of having severe symptoms were two or more times higher for people with an underlying health condition. Although the data are limited, a recent analysis conducted by the Centers for Disease Control and Prevention also shows that 38 per cent of COVID-19 cases in the United States had an underlying health condition, such as diabetes, cardiovascular disease, chronic lung disease and immunocompromised conditions.

Going to work, therefore, could mean being exposed to a virus that disproportionately targets those with underlying health conditions. Even after the provinces ordered the closure of businesses, people in a large cross-section of essential services found themselves having to continue to show up for work. These include people who work in health care, grocery stores, drug stores, warehouses, gas stations, hotels, long-term care homes, among many others.

Despite the provinces encouraging workers who feel unwell to stay home and the availability of emergency relief for compensation, workers with chronic health conditions may not want to sacrifice a paycheque during a period of economic uncertainty. They may decide to accept the risk of going to work.

As the lockdown continues, people who have been off work may feel the urgent need to start earning an income again. Likewise, cash-strapped businesses may feel the mounting pressure to reopen their operations and resume their services as soon as they are allowed. As financial pressure builds, it may be especially difficult for individuals who fear the health impact of a COVID-19 infection to voice their concerns. 

Growing research conducted by the Institute for Work & Health (IWH) highlights the challenges that workers with chronic health conditions face when asking for accommodations that will allow them to continue working productively while maintaining their health. This is especially the case for those living with invisible health conditions that may fluctuate in severity, and for young workers, those new to their jobs and other vulnerable groups.

In the current health and economic crisis brought about by COVID-19, the inability of these individuals to ask for protective accommodation poses a potentially serious risk to the health and safety, and the long-term employment, of people with chronic health conditions in the workforce.

These are trying times, and from many accounts, employers are doing their best to keep essential services running while safeguarding the health and safety of workers. As they continue to navigate the way forward and develop back-to-work plans, employers should acknowledge that they may have workers with a chronic health condition who are reluctant to ask for support.

Employers should also be encouraged to open up the lines of communication with all workers so that those with underlying conditions feel supported in bringing forward their concerns. While workers are not obligated to talk about their health, more than ever, supportive workplace environments are needed to encourage people to communicate what assistance they need to stay healthy while working productively.

This article has been adapted from a version that first appeared in The Conversation, on April 15, 2020.