Strengthening Social Compact and Innovative Health Sector Collaborations in Addressing COVID-19 in South African Workplaces.

Workplaces are nodes for Severe Acute Respiratory Syndrome Coronavirus 2 transmission and require strategies to protect workers' health. This article reports on the South African national coronavirus disease 2019 (COVID-19) strategy that sought to ensure workers' health, protect the economic activity, safeguard livelihoods and support health services. Data from the Occupational Health Surveillance System, Surveillance System of Sentinel Hospital Sites, and government databases (public sector health worker and Compensation Fund data) was supplemented by peer-reviewed articles and grey literature. A multipronged, multi-stakeholder response to occupational health and safety (OHS) policy development, risk management, health surveillance, information, and training was adopted, underpinned by scientific input, through collaboration between government, organized labour, employer bodies, academia, and community partners. This resulted in government-promulgated legislation addressing OHS, sectoral guidelines, and work-related COVID-19 worker's compensation. The OHS Workstream of the National Department of Health provided leadership and technical support for COVID-specific workplace guidelines and practices, surveillance, information, and training, as well as a workplace-based vaccination strategy.

Development and challenges of a National Occupational Health Surveillance System for COVID-19 in the workplace

IntroductionSouth Africa does not have a comprehensive occupational health surveillance system for COVID-19. The data collection processes were fragmented and did not provide a comprehensive view of the workforce affected by the pandemic. The National Department of Health initiated the Occupational Health Surveillance System (OHSS).ObjectivesTo develop a COVID-19 surveillance platform to collect and report on data on workforce vulnerability, COVID-19 positive rates, severe disease outcomes and return to work status of workers.MethodsThe OHSS commenced data collection on the 1st October 2020 following the promulgation of the Department Employment and Labour Directive to legally require employers to submit the data on a regular basis. Awareness campaigns were conducted to obtain the compliance of employers to report.ResultsAfter a period from 1 October 2020 to 31 March 2021, which coincided with the second wave, a total of 3111 businesses had registered covering a total 1,829,897 employees. During this period 3,704 positive cases were reported, with the majority from Gauteng province (48,2%), the economic hub of the country and from the banking and insurance (57,0%) followed by the health and social sector (27,3%). A workplace contact was reported in 33% of positive cases. Eighty-nine percent (89%) were symptomatic at the time of diagnosis. Among those with COVID-19, 2,617 (70.6%) had returned to work. There were only 38 (1.5%) deaths reported and 195 (7.5%) employees had been hospitalised.ConclusionOnly 1% of all businesses had registered during this period and only 12.2% of the formal sector employees were represented. Major challenges included missing information, failure of businesses to register and report data. Measures to improve this are currently being undertaken. The enforcement of legislation and ongoing training and awareness of employers is essential to provide the necessary information required so as to plan targeted interventions for COVID-19.