Before an effective COVID-19 vaccine becomes widely available, countries must find a way to safeguard their economies and the welfare of their populations, while continuously mitigating the impact of COVID-19 through the implementation of public health and social measures.
This cross-country analysis provides an overview of public health and social measures implemented within non-health care related workplace settings, in response to localized COVID-19 outbreaks in the WHO European Region. Information was collected from open sources including government and media websites by the Incident Management Support Team (IMST) of the WHO Regional Office for Europe and COVID-19 Health Systems Response Monitor (HSRM) (up to 30 November). Selected country examples are provided for Andorra, Austria, Denmark, France, Germany, Iceland, Ireland, Israel, Italy, Kazakhstan, Luxembourg, Netherlands, Poland, Russian Federation, Slovenia, Spain, United Kingdom.
This analysis can support countries by providing information on common approaches and innovative solutions across the European Region with regards to measures in workplace settings, implemented to manage risks and mitigate the impact of COVID-19 via public health and social response measures.
Following workplace closures earlier in 2020, many countries implemented subnational strategies on workplace measures based on local epidemiological criteria during autumn
Throughout the Region, a majority of countries implemented partial or full closure of non-essential businesses in the initial phase of the COVID-19 response. While most non-essential businesses had reopened throughout the Region by August 2020 following their initial closure, a number of countries have re-imposed measures since then affecting workplace settings, in response to local COVID-19 outbreaks. In response to the resurgence in case numbers in the European Region at the start of autumn, many Member States are responding by ordering the full or partial closure of non-essential businesses.
As of 30 November, 32 Member States in the European Region require closing (or work from home) for some sectors or categories of workers at either the national or subnational level. An additional 12 Member States require closing (or work from home) for all-but-essential services. All Member States have implemented precautionary adaptation measures targeting workplaces and workplace settings.
Figure 1. Public health and social measures affecting workplace settings implemented by WHO Member States in the European Region (as of 30 November 2020)
The approaches for implementing preventive measures in workplace settings vary across Member States
Registration of customers for contact tracing purposes
In order to support contact tracing efforts, several Member States including Austria and Andorra, have required or recommended registration of customers entering establishments in the hospitality sector and other workplace settings where workers are in close contact with customers (such as beauty salons, hairdressers, and tattoo shops) in the event that a customers or staff member tests positive for COVID-19.
On 19 October, the Russian Federation implemented a QR code system within nightclubs in Moscow. All persons were required to register their phone number upon entry and were contacted if a visitor later tests positive for COVID-19 who was also present on the same night. Visitors will be denied entrance unless they register a valid phone number.
In the Netherlands, preceding the partial lockdown implemented in mid-October including the closure of establishments in the hospitality sector, a targeted approach was employed where leisure establishments such as cafés, theatres and museums could be ordered to close for up to 14 days in the event of a COVID-19 outbreak being traced back to the premises.
Mandatory wearing of face masks and capacity requirements for businesses and institutions welcoming guests are being implemented in an attempt to keep business operations running
In order to mitigate the risk of transmission of COVID-19 while keeping businesses operational, most countries in the European Region have introduced the mandatory wearing of face masks and other personal protective equipment (PPE), according to a risk-based approach in workplace settings where customer contact is required, and physical distancing cannot be maintained.
When Iceland lifted the mandatory closure of businesses offering personalized services that requires closer contact than two meters, the wearing of face masks was added as a requirement and a 10-person limit was set as the total number of customers allowed at the same time within the premises of such businesses.
In addition, several Member States have tightened restrictions on capacity and gatherings, such as the number of guests allowed in indoor spaces, seating requirements and limitations on the maximum number of people allowed to gather around a table. Preceding the closure of all restaurants, bars and cafes to the public in Luxembourg on 26 November restaurants were required to not seat more than four persons around a table in order to reduce the risk of transmission between individuals from different households.
Limiting of business hours and banning the sale of alcohol to further reduce the number of gatherings, and their duration, in public spaces
In response to the resurgence of COVID-19 cases, many Member States limited the business hours for establishments in the hospitality sector, aiming to reduce the number and duration of gatherings and interactions of people from different households. Several countries combined limiting of business hours with a ban on the sale of alcohol within the hospitality sector after a certain time at night, while others included other businesses such as supermarkets and petrol stations. When the Oslo City Government in Norway implemented a ‘social lockdown’ on 9 November in response to the increasing cases, a complete ban on the sale of alcohol in restaurants and bars was enforced.
Full or partial closure of non-essential businesses at subnational level preceded nationwide closure of non-essential businesses
In an attempt to protect the population by suppressing transmission in higher risk areas while supporting the operation of businesses in areas with less risk, several countries responded to the resurgence in case numbers from the start of autumn by applying a targeted approach and implementing measures at the subnational level.
Several Member states, including Ireland, Slovenia and Poland, implemented systems where subnational areas are subject to different public health and social measures depending on the local epidemiological situation and other relevant criteria. In Poland, these levels include requirements of limitations in business hours for establishments serving food and drinks, the closure of workplace settings where close proximity is required, limited seating availability in large cultural venues (cinema, theatre, etc.) and strict adherence to sanitary guidelines.
However, as the surge in COVID-19 cases continued to increase, all subnational regions in the above-mentioned countries transitioned into high-risk zones starting from the latter half of October, causing many measures to be stricter and implemented nationwide. In Ireland, all counties were declared at the highest alert level (level 5) on 21 October, as of 1 December transition to alert level 3, including re-opening of certain businesses and institutions. In France, the tiered system was overruled by a nationwide lockdown that came into place on 30 October, including closure of shops, bars, restaurants and other non-essential establishments. On 28 November some shops were allowed to reopen but restaurants and bars are at the time of writing ordered to be closed over Christmas.
Member States reimplemented national lockdowns and targeted closures of certain sectors following efforts of adaptation measures
In Israel closure of all non-essential businesses was reimplemented following the reinstitution of their national lockdown in mid-September. In Kazakhstan, weekend curfews including mandatory closure of all non-essential businesses were implemented in mid-August. While both above mentioned Member States have eased their lockdown restrictions and non-essential businesses have gradually resumed, several countries in the western part of the region have responded to resurgence in COVID-19 cases by implementing full or partial closure of non-essential businesses at the national or at subnational level.
Countries are taking a targeted approach in workplace settings that are more vulnerable to outbreaks
Mink farms: Drastic approaches taken to eradicate the source of infections from mink
The Netherlands was one of the first countries in the Region to report SARS-CoV-2 infections at mink farms in both mink and human mink-farm workers. As of 21 November, 70 mink farms were confirmed infected in the country and as a result, more than one million animals have been culled and a shutdown of the entire mink farming industry has been moved forward to early 2021.
In Denmark, as of 1 December, authorities reported that SARS-CoV-2 had been identified at 289 mink farms and a total of five identified virus variants related to farmed mink in 349 human COVID-19 cases. The majority of the human cases, as well as infected mink farms, were reported from the North Jutland area. One of the virus variants, the so called ‘Cluster 5’, was found in 12 human cases in North Jutland. Appropriate studies are still required to fully understand the impact such SARS-CoV-2 variants will have on virus transmissibility, clinical presentation and effectiveness of diagnostics, therapeutics and vaccines.
As a result, Danish authorities urged citizens of the seven most affected municipalities in North Jutland to refrain from moving outside of their municipal borders, suspended public transport and closed catering establishments to break chains of transmission. In addition, a population-wide mass testing was initiated for the approximately 270 000 people residing in the area, including increased sequencing of SARS-CoV-2 infections in both human and mink. At the time of writing, approximately 11 million animals have been culled, and a ban on farming of mink in the country until January 2022 is about to be enforced.
COVID-19 outbreaks in agricultural and plant farms have called for testing and isolation of the workforce
COVID-19 outbreaks were also reported in both animal and plant farms in the European Region, from mushroom farms in Ireland, to cattle farms in Spain. With 53 positive cases (as of 24 August), inhabitants of the La Barquilla farm in Spain were ordered to isolate for 14 days. In Italy, all newly hired workers were swabbed at the Francescon farm in Rodigo after 130 cases were confirmed in August. An outbreak of 170 cases in a vegetable farm in the United Kingdom resulted in 75% of the workforce self-isolating.
Comprehensive guideline development and implementation after outbreaks in slaughter houses and meat processing plants
The working environment in slaughter houses increases the risk for disease transmission due to the confined, cold and damp nature, with noisy machinery that people need to shout over in order to understand one another. Outbreaks have been reported in Germany, the Netherlands, France, the United Kingdom and more. Besides closure of the plant sites, in the United Kingdom, the government and British Meat Processors Association issued new guidelines on working safely in food manufacturing, with areas on disinfection, isolation of symptomatic staff, additional personal protective equipment (PPE), contact tracing and testing. Where required, mobile testing units have been deployed to ensure large workforces are tested promptly.
Conclusions: managing of outbreaks in workplace settings requires a timely and flexible approach focusing on vulnerable workplace settings for transmission of COVID-19
Throughout the European Region, Member States aim to keep businesses operational to minimize the negative impacts of the COVID-19 pandemic and public health response on the economy. In countries where strict public health and social measures have broken the chain of transmission and easing of so called ‘lockdown’ measures may begin, continuous monitoring of transmission at local level is required to maintain the suppression of the virus.
Measures shall be targeted, tailored, time-bound and regularly re-assessed according to the local situation
To ensure continued operation of essential businesses and services during ongoing community transmission of COVID-19, Member States must carefully monitor the epidemiological situation and the pressure on hospital capacities at subnational level to enable targeted implementation of adequate response measures. Where community transmission occurs, partial or full closure of non-essential businesses in affected areas may be required to curb the spread of disease. However, measures should be timebound and regularly re-assessed according to the local situation.
Targeted response measures to localized outbreaks in workplace settings, including enhanced testing of workers, quarantining of close contacts and strengthened sanitary measures, should be encouraged in response to outbreaks in specific workplace settings. Adaptation measures such as enhanced sanitary practices should be implemented at all workplaces and the workforce must be kept updated with the workplace risk-assessments and policies in place in the event of a detected outbreak. In addition, teleworking should continue to be encouraged in areas where there is a risk of community transmission beyond clusters.
Sandra Lindmark, Calvin Cheng, Lauren MacDonald, Tanja Schmidt
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All URLs accessed on 15 December 2020.