OzSAGE working group: Dr David Allen, Prof Nancy Baxter, Kate Cole OAM , Anna Davidson, Prof Geoff Hanmer, Prof Deborah Lupton , Prof Raina MacIntyre, Prof Lisa Maher, Dr Alan McLean, Dr Andrew Miller, Dr Suzi Nou, Dr Karina Powers (Chair)
Australian pandemic border controls have been relaxed in recent months, and in many cases employees and contractors are now travelling for work purposes. However, in many settings there remains widespread community transmission of disease, potentially exposing employees to significant acute and chronic health complications, including death.
OzSAGE previously provided pandemic control advice for businesses in October 2021 with the document, “Creating safe workplaces during the Covid-19 pandemic” and updated mask advice for the community in January 2022 with “We urgently need better masks (respirators)”. Employers have both an ethical and legal responsibility for workplace health and safety, no matter where employees work.
To assist employers in providing a safe workplace, OzSAGE recommends layering in practical protections for work-related travel to protect staff from contracting COVID-19, as part of a Vaccine-PLUS strategy:
- Online attendance at events should be preferred over face-to-face attendance while there is widespread community transmission.
- Staff who are travelling should be up to date with all recommended COVID vaccinations. Travel medicine consultations provide any relevant protective vaccines and treatments. Occupational physicians can advise on fitness for work-related travel and travel precautions.
- Employees should be covered by travel insurance policy for medical care and transport delays from all causes. Employers should ensure that all travelling staff members are covered for and have access to testing and COVID-related medical care while on trips. Prior planning for repatriation of staff due to high-risk situations such as emergence of new variants or closing of borders is advised.
- Employers should have prior arrangements in place to support staff with simple and quick access to extended periods of stay in hotel accommodation if they are forced to quarantine or are unable to travel home due to sickness or testing COVID positive while on their trip.
- Safer air ventilation:
- Where possible, accommodation such that staff can access their room directly from the outside should be chosen. Motels are generally configured in this way and for that reason are to be preferred.
- Preferentially select accommodation where ventilation and filtration have been reviewed and optimised to create safe indoor air. Asking a simple question of, “How have you maximised fresh air intake and minimised the recirculation of air in your accommodation?” for example, can help staff make safer choices. Again, motel rooms with individual room ventilation/air-conditioning are preferred.
- Separate rooms, that is, one room per one staff member, should be used to protect staff from cross-infection.
- Employees/employers should ask for a copy of the COVID safe plan for accommodation, alternate workplace and any event attended as per any government guidelines. COVID safe plans need to include safe indoor air ventilation. If the plans do not include ventilation, consideration of safer air has likely not been made. OzSAGE has provided safer indoor air ventilation advice.
- Where large gatherings are organised (e.g., a conference or a dinner), check if measures to achieve safe indoor air have been implemented. This may include a ventilation assessment of the indoor space to understand the maximum number of guests, layout and spacing of tables for use, and the use of supplementary air cleaning devices (e.g., portable HEPA air purifiers) for example.
- Portable carbon dioxide (CO2) monitors are a useful tool for travellers to understand when their risk of airborne transmission to COVID-19 is high. Employers should consider providing low-cost CO2 monitors to staff, along with training in their use. This enables travellers to understand when to leave an area and/or use N95/P2 respirators to reduce their risk of infection.
- Employers should provide travelling staff with Rapid Antigen Tests (RATs) and encourage them to test prior to travel (ideally each day in the two days or so before and on the day of travel), on a regular basis whilst away and on return in the ensuing ten days (to cover the viral incubation period).
- Staff should be provided with and wear N95/P2 respirators at airports and during aeroplane travel and in shared spaces (e.g., lifts, vehicles, taxis, buses, and other ground travel). Travellers should request in advance that windows be at least partly open on both sides of vehicles prior to arrival, the driver be in a mask, vehicle air-conditioning should be set to fresh air intake and Recirculation should not be used, and consider opening windows for cross ventilation in vehicles when weather permits.
- If travellers need to interact with others in close proximity (e.g., a staff member needs to access a hotel room), the traveller should wear a N95/P2 respirator (ideally, fitted).
- When eating or drinking with others, travellers should utilise venues open to the air or outdoor venues whenever possible.
- A variety of nasal sprays are available based on active principles including Carrageenan, Nitrous Oxide etc., with claimed efficacy for prevention of SARS-CoV-2 infection and/or reduction of viral load and severity for those infected, but overwhelming body of definitive clinical trial evidence for this efficacy is not yet available. The regular use of such nasal sprays may be helpful to provide an added layer of protection, but employers should ensure that staff understand that the use of these products should not reduce their adherence to the proven approaches of vaccines, masks and good indoor ventilation.
- Employers should consider provision of small portable HEPA air purifiers that may be suitable for some circumstances, such as when people gather: e.g., small meetings.
- Employers should document a back-up plan for sudden staff absence or the inability to attend in circumstances where business travellers test positive or are ill.
- Employers should consider checking if event organisers have a system for attendees to report positive RAT results and notification of persons who may be close contacts.
- Employers should consider checking if refunds or credit are available for event registrants who are unable to attend due to COVID symptoms, COVID positive or being a close contact. Event organisers should have COVID safety information readily accessible on their website and at the event.
- Employers should provide training to staff on COVID risk identification and how to reduce their risk. For example, employees should be advised that social events with dancing and singing indoors are of increased risk and best avoided.
Cognitive Dissonance during transition to long term COVID-19 control
OzSAGE recognises that large parts of the community will at this time find scientifically-based public health advice contrary to a prevailing narrative of “return to normal”.
This situation causes cognitive dissonance for individuals, and can create a risk of conflict between staff and organisations, where the aim of decreasing COVID-19 transmission and all of the problems of ongoing infection is mutually exclusive to the desire to remove all public health measures surrounding business travel, no matter the consequences.
Therefore, compromise is required in order to function, and difficult decisions will need to be made by individuals who may face repercussions for seeking to protect themselves and others from disease. Respectful discussion will hopefully, in most instances, enable the policy objectives of, for example, commerce, education, healthcare, or tourism, to be achieved without counter-productive infectious disease burden through lack of simple precautions.
This position statement has been written with the best evidence available at time of writing and was last updated on 9 June 2022. OzSAGE strongly recommends continuous quality assurance activities and ongoing adaptation for individual circumstances. OzSAGE is not liable for the implementation of the advice contained herein, or for resulting outcomes.