Opening the Workplace After COVID-19: What Lessons Can be Learned from Return-to-Work Research?

Journal of Occupational Rehabilitation https://doi.org/10.1007/s10926-020-09908-9 EDITORIAL Opening the Workplace After COVID‑19: What Lessons Can be Learned from Return‑to‑Work Research? William S. Shaw1 · Chris J. Main2 · Patricia A. Findley3 · Alex Collie4 · Vicki L. Kristman5 · Douglas P. Gross6 © The Author(s) 2020 The on-going COVID-19 crisis has had an unprecedented effect on workplaces across the globe. The extent of viral infection, illness, and fatalities has transformed or closed many workplaces and resulted in large numbers of temporarily furloughed or unemployed workers. Those most susceptible to the virus and its effects are the elderly or medically vulnerable, but physical distancing, stay-at-home orders, and isolation have produced drastic social, economic and health consequences for workers of all ages, with a disproportionate impact on those more disadvantaged. Some businesses and workplaces are beginning to reopen, albeit under extraordinary rules pertaining to physical distancing, personal protective equipment, and physical guards. The efficacy of such measures in the workplace are unknown, and we have much to learn about how workers adapt and function under these circumstances. Some of the challenges of inviting workers back to the workplace mirror some of the issues that we recognize as commonplace in the return-to-work and occupational rehabilitation literature—the idiosyncratic nature of health and work, individual disease vulnerability, susceptibility to environmental hazards, the need for job flexibility and modification, and differences in workstyle, social capital, and organizational support. A recurring theme in the work disability literature is the heterogeneity of return-to-work outcomes for * William S. Shaw Chris J. Main Patricia A. Findley workers with a wide range of injuries, illnesses, and medical procedures (e.g., cardiac arrest, major trauma) [1, 2]. Within medical conditions, this variation has been attributed to demographic and health variables (age, fitness, health status, anthropometry), to workplace factors (e.g., supervisor support, ability to accommodate, physical demands), to psychological factors (e.g., perceived impairment, job stress, coping, fears of re-injury or worsening health conditions, catastrophizing), and to social factors (e.g., family caregiving roles, social support, economic factors) [3–7]. The COVID-19 workplace opening process may also need to address this complexity of factors. Worker Factors Just as injury and illness have variable effects on workability, the COVID-19 crisis is likely to impact workers differently because of issues like threat of viral infection, health vulnerability, organizational perceptions, income levels, and seniority/job tenure. Perhaps we can learn from studies in occupational rehabilitation [3–7] that have demonstrated how job stress, depressed feelings, job dissatisfaction, fears of injury or retaliation, catastrophizing, perceived incivility, and other factors can complicate rehabilitation and recovery. 1 University of Connecticut School of Medicine, 263 Farmington Ave, Farmington, CT 06030, USA 2 Keele University, Keele, North Staffordshire ST5 5BG, UK 3 Rutgers, the State University of New Jersey, 120 Albany Street, New Brunswick, NJ, USA 4 School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia 5 EPID@Work Research Institute and Department of Health Sciences, Lakehead University, 955 Oliver Road, Thunder Bay, ON P7B 5E1, Canada 6 University of Alberta, 2‑50 Corbett Hall, Edmonton, AB T6G 2G4, Canada Alex Collie Vicki L. Kristman Douglas P. Gross 13 Vol.:(0123456789) Journal of Occupational Rehabilitation The COVID-19 crisis has created a new workplace hazard that will be a significant source of stress and anxiety for many workers. This is especially true where infection risks are greatest, where workers are deemed essential to continue working, and for workers who are particularly vulnerable. Opening of workplaces during COVID-19 is occurring against a backdrop of heightened levels of psychological distress in the community that crosses all sociodemographic divides. Distress may result from increased personal financial pressure, social isolation, fear of infection, or the threat of job loss. Returning to an uncertain working environment presents an additional stressor that will further affect the mental health of workers [8]. Workers who experience COVID-19 symptoms and return to work after a period of illness and quarantine may experience fatigue, anxiety, and/or reduced work tolerance [9]. They may face difficulties in access/travel to work, restrictions in social contact with others, and new training, equipment, or responsibilities. The social stigma associated with a COVID-19 diagnosis may alter social relationships and access to or interactions with colleagues. It is unclear how conjoint work that necessitates close physical proximity will be managed, though it seems that mandatory physical distancing will be a condition for workplace opening. The social support of longstanding colleagues may fracture, and it may be difficult or impossible to work side-by-side with peers for any prolonged duration. The workplace has never had such seismic shifts at a global level. One concern is that workers who have been away from physically demanding work for several months may experience deconditioning that poses risks upon returning to work. In occupational rehabilitation after injury, workers build tolerance for work gradually before resuming heavy physical work demands. The same opportunity may not be possible after a COVID-related layoff, but workers should re-engage with work tasks gradually to allow re-adaptation to heavy loading. In addition, domestic pressures arising from the health or risk of ill-health in families can have a significant effect on workers’ wellbeing, sleep, and mental health, with possible increases in presenteeism and work absence. The most prevalent of all will be fears of novel coronavirus itself, ironically a consequence of the strong public messaging that underpinned the initial lockdown. This new fear of unseen infection hazards in the workplace, rather than hazards of work itself, will be difficult to manage using traditional safety training and disability management strategies. Workplace Factors The COVID-19 crisis has led to an unprecedented need for employers to provide flexibility and leeway so their workers can continue to work productively from home, adopt 13 different work habits, or work in a new or rapidly changing environment. From the occupational rehabilitation literature, we know that workers are highly variable in their need for job modification after injuries. Similarly, workers will have substantially different needs for job modification related to COVID-19. Supervisors will be an important resource for information and individual worker pr (...truncated)