24th Collegium Ramazzini Statement: Prevention of Work-Related Infection in the COVID-19 Pandemic

Background: Workers whose occupations put them in contact with infected persons and the public are at increased risk of coronavirus disease (COVID-19) infection. Recommendations: The Collegium Ramazzini calls on governments at all levels to protect worker health by strengthening public health systems;maintaining comprehensive social insurance systems;establishing policies that presume all COVID-19 infections in high-risk workers are work-related;enforcing all occupational health standards;and developing pandemic preparedness plans. The Collegium Ramazzini calls on all employers-large and small, public and private-to protect the health of all workers by developing disease preparedness plans;implementing basic infection control measures;establishing disease identification and isolation policies;reducing hazardous exposures;supporting personal protective equipment (PPE) programs;and restricting unnecessary travel. Conclusion(s): Governments and employers have legal obligations to protect worker health. They are not relieved of these duties during pandemics.Copyright © 2020 American College of Occupational and Environmental Medicine.

Protecting Workers' Equal Rights during Crisis and Recovery: Constitutional Approaches in 193 Countries

This chapter analyses the scope, potential, and early impacts of constitutional protections for equal rights, social protection, and minimum labour standards in safeguarding workers' health and livelihoods during Covid-19. Across countries, both the pandemic itself and many policies enacted in response (eg economic shutdowns) disproportionately affected marginalized workers due to underlying disparities in terms and conditions of work, social protection coverage, and living conditions. While the right to health has clear relevance during a pandemic, protections for equality and fundamental economic rights also matter to workers' overall well-being, particularly when policy responses focus narrowly on preventing disease spread through closures without adequately addressing social determinants of health like workplace safety and income. This chapter: (1) draws on a unique global dataset to analyse the extent to which constitutions protect equal rights, decent work, and social insurance in 193 countries;(2) reviews early examples of how these constitutional protections provided tools to support both health and economic needs and uphold foundational equality amidst a crisis;and (3) identifies gaps likely to leave workers vulnerable if unaddressed. It finds that explicit constitutional protections for almost all aspects of equal rights, decent work, and social insurance have become more common over time;moreover, courts from wide-ranging countries have cited these protections in decisions addressing workers' rights and households' material needs amidst Covid-19. Nevertheless, most countries lack constitutional provisions specifically addressing safe working conditions or income protection during illness and unemployment-areas that matter to equality both during pandemics and more typical years. © The several contributors 2022. All rights reserved.

TRANSFORMATION OF SOCIAL INSURANCE SYSTEM IN THE POPULATION OF THE FEDERAL REPUBLIC OF GERMANY UNDER THE INFLUENCE OF THE CHALLENGES OF THE 21st CENTURY

The article presents the results of the analysis of changes in the insurance system of the German population in the 21st century, which occurred under the influence of globalisation processes, increased flows, demographic changes and economic crises. The current situation in German society shows that the sphere of risk requires an expected norm of regulation, which is observed as one of the main tasks. It has been established that in the modern mandatory accounting in Germany, the necessary prevention of loss of income due to illnesses, accidents and disability, old age and calculation, the correct principle of delegating the composition of tasks by the executive body and the principles of solidarity of plant resources, in which part of the production of the working part of the population. It is certain that in the frequently encountered situation of the development of Germany, under the threat of new challenges, there is a refusal to function on the suddenly emerging features of the welfare state. It has been established that for more than a hundred years the financing of the social security system in Germany was carried out at the expense of insurance contributions from the possibilities of the population and employers. However, in connection with the COVID-19 pandemic, which has attracted close attention, primarily affecting the employment and insurance of the unemployed, the question arises of checking the system of financing the social security system. All of the above indicated the stress of the beginning of the processes of destruction of the previously functioning ones. It is concluded that conducted in the 21st century. In particular, the reforms in Germany touched upon the exclusive area of social security, the most important problems and problems associated with the insurance system – the labour market and the pension system. © 2023, The Belarusian State University. All rights reserved.

In-service training policy during the COVID-19 pandemic: The case of the agents of the farmers, rural people, and nomads social insurance fund.

Introduction: The COVID-19 pandemic has posed the in-service training of agents of the Farmers, Rural People, Nomads Social Insurance Fund (hereafter the Fund) to many problems. In-service training is one of the most effective development factors for organizational goals. This sort of training will increase employees' skills and subsequently improve their job performance. Accordingly, the present research mainly aimed to shed light on the effect of in-service training policy on employees' capabilities and job performance. Methods: The research was conducted among the agents of the Fund in Fars province, Iran (N = 197) out of whom 127 agents were sampled by simple randomization. The research instrument was a standard questionnaire whose face and content validity was confirmed by a panel of experts and its reliability was determined by calculating Cronbach's alpha in a pilot study. The results showed that the indicators used to measure the research variables were acceptably consistent with the factor structure and the theoretical framework of the research. Results and discussion: Based on the findings, in-service training in the Fund during the COVID-19 pandemic has had a positive and significant effect on the agents' capabilities (communication and team-working skills, creativity and problem-solving skills, commitment and responsibility, technical information and knowledge, and technical and practical skills) and job performance at the individual, technical, and general levels. Also, the agents' capabilities have had a positive and significant influence on their job performance. It can be concluded that in-service training can influence the agents' capabilities and job performance and improve organizational performance during the COVID-19 pandemic. Thus, the enhancement of in-service training courses' quantity and quality during the COVID-19 pandemic can influence the job performance of the agents at the individual, general, and technical performance levels.

Subsidizing Labour Hoarding in Recessions: The Employment and Welfare Effects of Short-time Work

Short-time work (STW) policies provide subsidies for hour reductions to workers in firms experiencing temporary shocks. They are the main policy tool used to support labour hoarding during downturns and were aggressively used during the coronavirus disease 2019 (COVID-19) pandemic. Yet, very little is known about their employment and welfare consequences. This article leverages unique administrative social security data from Italy and quasi-experimental variation in STW policy rules to offer evidence on the effects of STW on firms' and workers' outcomes during the Great Recession. Our results show large and significant negative effects of STW treatment on hours, but large and positive effects on headcount employment. We then analyse whether these positive employment effects are welfare enhancing, distinguishing between temporary and more persistent shocks. We first provide evidence that liquidity constraints and rigidities in wages and hours may make labour hoarding inefficiently low without STW. Then, we show that adverse selection of low productivity firms into STW reduces the long-run insurance value of the program and creates significant negative reallocation effects when the shock is persistent.

Changes in dispensing of anti-osteoporotic drugs during COVID-19 pandemic

Care of osteoporosis patients during COVID-19 pandemic is challenging. Due to lockdowns and restrictions, the management of osteoporosis has changed. Diagnosis of osteoporosis decreased and the influence of COVID-19 on drug prescriptions and dispensing is currently unclear. Therefore, the aim of the study was to assess the dispensing of anti-osteoporotic drugs during the Covid19 pandemic. Methods This study was a nationwide retrospective register-based observational study which included all patients in Austria aged >= 50 who received at least one prescription for anti-osteoporotic drug between January 2016 and November 2020. Pseudonymized individual-level patients' data were obtained from social insurance authorities and the Federal Ministry of Labour, Social Affairs, Health and Consumer Protection in Austria. Anti-osteoporotic agents were divided into: (i) oral bisphosphonates, (ii) intravenous bisphosphonates, (iii) selective estrogen receptor modulators (SERMs), (iv) teriparatide (TPTD) and (v) Denosumab (DMAB). We used interrupted time series analysis with autoregressive integrated moving average models (ARIMA) for the prediction of drug dispensing. Results There were 2,884,627 dispensing of anti-osteoporotic drugs by 318,573 patients between 2016-2020. The mean monthly prescriptions for oral bisphosphonates (-14.5 %) and SERMs (-12.9 %) decreased during COVID-19 pandemic, compared to the non-COVID-19 period. The dispensing for intravenous bisphosphonates (1.7 %) and teriparatide (9.5 %) increased during COVID- 19. The prescriptions for DMAB decreased during the first lock-down in March and April 2020 (24 %), however increased by 29.1 % for the total observation time. The ARIMA model for alendronate showed, that the estimated step change was minus 1443 dispensing (95 % CI - 2870 to - 17), while the estimated change in slope was minus 29 dispensing per month (95 % CI - 327 to 270). Thus, there were 1472 (1443 + 29) fewer dispensing in March 2020 than predicted had the lockdown not occurred. Discussion The total number of prescriptions dispensed to patients treated with anti-osteoporotic medications declined rapidly during the first COVID-19 lockdown. The largest drops in absolute terms were observed for ibandronate, followed by alendronate, denosumab, zolendronic acid and risendronate. The observed decrease of DMAB during the first lockdown, was compensated in the following months. Current evidence suggests no need for discontinuation of anti-osteoporotic drugs during COVID-19 pandemic, nor because of vaccination. Taking into account the massive treatment gap for osteoporosis, and the related fracture risk, clinicians should continue treatment, even in times of pandemics.

Utilization of community-based health centers (Puskesmas) to improve accessibility of health services for liver patients

Objectives: Liver disease is the fifth most prominent cause of death for the elderly in Indonesia and is 3.3 times more likely to cause death with the Sars-Cov2 virus. Fatty liver progression is very gradual and new cases are known after an advanced stage. Utilizing Community- Based Health Centers (Puskesmas) that provide sub-district-based integrated services, is expected to be early detection for liver disease. However, little is known about the effectiveness of Puskesmas in the framework of controlling liver disease. Materials and Methods: We utilize a longitudinal survey dataset from the 2014 Indonesia Family Life Survey to analyze and evaluate the effectiveness of the Puskesmas in improving the function of early liver disease detection. Results: The analysis shows that the liver disease prevalence among observations is 1,9%. However, the percentage increases in senior citizens by two times or 3,8%, and 60% are men. The elderly with liver disease, whether they have government social insurance or not, tend to access treatment at the Puskesmas. Given that Indonesia uses the Gate-Keeper system, the first-level health facilities are at the subdistrict or community level. Posyandu Lansia, as an extension of Puskesmas, is also utilized by older people for routine health checks, obtaining food/supplements, and various meetings and counseling. The Posyandu Lansia is also a space for the elderly to access savings and loan financial services, religious activities, and political activities. Community-based health care is highly effective in improving the senior QoL in various aspects of life. However, 56% of older people who do not have insurance prefer traditional practitioners. Conclusion: The Posyandu Lansia can be a forum that carries out early detection of liver disease and is very accessible in preventive programs and improving the elderly QoL through various health activities, hobbies, counseling, economics, religion, and politics. It also needs to address the covered social insurance for treatment and caregiver.

Factors Affecting the Job Satisfaction of Caregivers in a Home-Based Elderly Care Program.

Population aging has increased the demand for elderly care worldwide. The home-based elderly care system plays an important role in meeting this demand in developing countries. The quality of home-based elderly care is associated with the job satisfaction of caregivers in home-based elderly care programs, which has rarely been studied. This paper explores the factors that affect the job satisfaction of these elderly caregivers, including personal characteristics, working conditions, employment status, training, caregiver-client relationships, welfare, work experience, and burnout. It utilizes data from the Shanghai Domestic-work Professionalization Survey (SDPS), which was conducted among four types of in-home caregivers (n = 1000) in Shanghai over the period from May to September 2021. This paper selected a sample of elderly caregivers (n = 285) to examine their job satisfaction. The results show that gender, age, marital status, how they earned the job, relation with clients, social insurance, and work experience are significantly associated with the job satisfaction of in-home elderly caregivers, and their job satisfaction is negatively associated with their burnout levels. However, training and working conditions have no significant effect on the job satisfaction of in-home elderly caregivers, which is different from previous studies on formal care workers, such as nurses, in the institutional care system.

How well-targeted are payroll tax cuts as a response to COVID-19? evidence from China.

Numerous countries cut payroll taxes in response to COVID-19, including China, which reduced employer contributions by up to 21 percentage points. We use administrative data on more than 800,000 Chinese firms to evaluate payroll tax cuts as a business relief measure. We estimate that the tax cuts cover 31.5% of the decline in business cash flow, but labor informality causes 53% of registered firms-24% of aggregate economic activity-to receive no benefits at all. We quantify the targeting of the policy in terms of how much benefits flow to small firms less able to access external finance and to sectors worse hit by COVID-19. We find that (1) small firms and vulnerable industries are comparatively more labor intensive, which leads to desirable targeting; (2) labor informality worsens, but does not eliminate, targeting by firm size; and (3) labor informality is uncorrelated with the COVID-19 shock, and therefore does not affect targeting by sector. Supplementary Information: The online version contains supplementary material available at 10.1007/s10797-022-09746-w.

Why a labour market boom does not necessarily bring down inequality: putting together Germany's inequality puzzle

After an economically tough start to the new millennium, Germany experienced an unprecedented employment boom after 2005, only stopped by the COVID-19 pandemic. Persistently high levels of inequality despite a booming labour market and drastically falling unemployment rates constituted a puzzle, suggesting either that the German job miracle mainly benefitted individuals in the mid- or high-income range or that other developments offset the effects of the drastically improved labour market conditions. The present paper solves this puzzle by breaking down the observed changes in the distribution of disposable incomes between 2005–06 and 2015–16 into the contributions of eight different factors, one of them being the employment boom. Our results suggest that, while the latter did have an equalising impact, it was partially offset by the disequalising impact of other factors, and substantially dampened by the transfer system. Our results point to a strong role of the German transfer system as a distributional stabiliser implying that, if the COVID-19 shock were to persistently reverse all the employment gains that occurred during the boom, this would only have a moderately disequalising effect on the distribution of net incomes. © 2022 The Authors. Fiscal Studies published by John Wiley & Sons Ltd. on behalf of Institute for Fiscal Studies.

What Is Out There and What Can We Learn? International Evidence on Funding and Delivery of Long-Term Care

This article describes the social care funding and delivery arrangements of a varied selection of developed countries, focusing on long-term care of older people. International evidence and latest reforms can inform the debate as countries struggle economically. Some have opted for mandatory social insurance that provides universal coverage. A premium is paid and if the insured individual or relatives require support, they are entitled to it. Others opted for a similar universal system but with earmarked taxation, while others fund their social care entirely from general taxation. Many chose a safety-net system in which benefits are means-tested leaving wealthier individuals to secure private arrangements of care. Within the UK, the level of support varies as Scotland provides personal care free of charge, being more generous than England, Wales and Northern Ireland. There is no “one solution”, but understanding different options can help in the discussion of current and future reforms.

The work of an occupational health nurse in Finland during COVID-19

Introduction: The OHN has an important role in coordinating the services and cooperating with the client organizations and enterprises. The main tasks of OHN are promotion of health and wellbeing at work and prevention of work-related ill-health and disability OHNs do health surveillance and counselling. Assess working environments and communities and their impact on health in liaison with the other experts in the occupational health care team Materials and Methods: Some of the Finnish Occupational Health Nurses’ efforts and practices during Covid-19. Results and Conclusions: In Finland Covid-19 accelerated telecommuting and chat with contacts. Covid- 19 caused changes in the work of occupational health nurses. Health examinations and workplace visits have been conducted remotely. Similarly, work ability negotiations have been conducted remotely. Medical treatment has also been accustomed remotely. The cleaning of stations have further been enhanced. The reimbursement of remote medical care in occupational health care has changed. In the future, The Social Insurance Institution of Finland may reimburse the costs of remote services even more extensively when remote services no longer require the use of a video connection. Once Covid-19 vaccinations have started, occupational health nurses have joined the vaccination process. The vaccination schedule is defined in accordance with the Finnish COVID-19 vaccine strategy, with social and health care professionals caring for COVID-19 patients and those working in nursing homes being the first to be vaccinated

Comparing formal and informal social protection: a case study exploring the usefulness of informal social protection in Pakistan

In most global south countries, various informal institutions provide welfare to a large segment of the neglected, poor and vulnerable populations through informal social protection. Despite being a major source of welfare in the global south, the usefulness of informal social protection at the household level remains an under-researched area. In this exploratory study, we have determined the usefulness of informal social protection provided through religious institutions, such as madrassas and compared it with formal social protection at the household level utilising the case study of a lower-income country such as Pakistan. A mixed methodology of data collection comprising a survey and semi-structured interviews in 14 different cities of Pakistan of the poor and eligible households for receiving formal social protection was conducted for the research. The results suggest the coverage of informal social protection provided by madrassas is greater than formal social protection. The poor and vulnerable population value and considers it more useful than formal social protection. We conclude that integrating informal and formal social protection would help improve the effectiveness of social policies in developing and less developed countries.

COVID-19: The Time for Collaboration Between Long-Term Services and Supports, Health Care Systems, and Public Health Is Now.

Policy Points To address systemic problems amplified by COVID-19, we need to restructure US long-term services and supports (LTSS) as they relate to both the health care systems and public health systems. We present both near-term and long-term policy solutions. Seven near-term policy recommendations include requiring the uniform public reporting of COVID-19 cases in all LTSS settings; identifying and supporting unpaid caregivers; bolstering protections for the direct care workforce; increasing coordination between public health departments and LTSS agencies and providers; enhancing collaboration and communication across health, LTSS, and public health systems; further reducing barriers to telehealth in LTSS; and providing incentives to care for vulnerable populations. Long-term reform should focus on comprehensive workforce development, comprehensive LTSS financing reform, and the creation of an age-friendly public health system. CONTEXT: The heavy toll of COVID-19 brings the failings of the long-term services and supports (LTSS) system in the United States into sharp focus. Although these are not new problems, the pandemic has exacerbated and amplified their impact to a point that they are impossible to ignore. The primary blame for the high rates of COVID-19 infections and deaths has been assigned to formal LTSS care settings, specifically nursing homes. Yet other systemic problems have been unearthed during this pandemic: the failure to coordinate the US public health system at the federal level and the effects of long-term disinvestment and neglect of state- and local-level public health programs. Together these failures have contributed to an inability to coordinate with the LTSS system and to act early to protect residents and staff in the LTSS care settings that are hotspots for infection, spread, and serious negative health outcomes. METHODS: We analyze several impacts of the COVID-19 pandemic on the US LTSS system and policy arrangements. The economic toll on state budgets has been multifaceted, and the pandemic has had a direct impact on Medicaid, the primary funder of LTSS, which in turn has further exacerbated the states' fiscal problems. Both the inequalities across race, ethnicity, and socioeconomic status as well as the increased burden on unpaid caregivers are clear. So too is the need to better integrate LTSS with the health, social care, and public health systems. FINDINGS: We propose seven near-term actions that US policymakers could take: implementing a uniform public reporting of COVID-19 cases in LTSS settings; identifying and supporting unpaid caregivers; bolstering support for the direct care workforce; increasing coordination between public health departments and LTSS agencies and providers; enhancing collaboration and communication across health, LTSS, and public health systems; further reducing the barriers to telehealth in LTSS; and providing incentives to care for our most vulnerable populations. Our analysis also demonstrates that our nation requires comprehensive reform to build the LTSS system we need through comprehensive workforce development, universal coverage through comprehensive financing reform, and the creation of an age-friendly public health system. CONCLUSIONS: COVID-19 has exposed the many deficits of the US LTSS system and made clear the interdependence of LTSS with public health. Policymakers have an opportunity to address these failings through a substantive reform of the LTSS system and increased collaboration with public health agencies and leaders. The opportunity for reform is now.

Stepping up during a crisis: The unintended effects of a noncontributory pension program during the Covid-19 pandemic.

We use a regression discontinuity design to study the impacts of a noncontributory pension program covering one-third of Bolivian households during the COVID-19 pandemic. Becoming eligible for the program during the crisis increased the probability that households had a week's worth of food stocked by 25% and decreased the probability of going hungry by 40%. Although the program was not designed to provide emergency assistance, it provided unintended positive impacts during the crisis. The program's effects on hunger were particularly large for households that lost their livelihoods during the crisis and for low-income households. The results suggest that, during a systemic crisis, a preexisting near-universal pension program can quickly deliver positive impacts in line with the primary goals of a social safety net composed of an income-targeted cash transfer and an unemployment insurance program.

COVID-19 and the US Safety Net.

We examine trends in employment, earnings and incomes over the last two decades in the United States, and how the safety net has responded to changing fortunes, including the shutdown of the economy in response to the COVID-19 pandemic. The US safety net is a patchwork of different programmes providing in-kind as well as cash benefits, and it had many holes prior to the pandemic. In addition, few of the programmes are designed explicitly as automatic stabilisers. We show that the safety net response to employment losses in the COVID-19 pandemic largely consists only of increased support from unemployment insurance and food assistance programmes, an inadequate response compared with the magnitude of the downturn. We discuss options to reform social assistance in the United States to provide more robust income floors in times of economic downturns.