A day (nearly) like any other: healthcare work in an influenza pandemic

Abstract

The World Health Organization has long anticipated an outbreak of a highly pathogenic influenza. Fear of a highly virulent influenza has been compounded by the 2003 outbreak of Severe Acute Respiratory Syndrome (SARS) where some health workers refused to work. In light of this, the question has been asked whether healthcare workers would continue to work during an influenza pandemic. Worryingly, surveys suggest that many would not. The thesis explores past experience of some ‘new’ infectious diseases and how these impacted on the health workforce. It considers evidence from the 1918 influenza pandemic, where (for the most part) nurses were not over-represented in the death statistics. It is argued that all infectious disease is not the same and a one-size approach by way of either compulsion or incentives to work should not be adopted. In situations where a healthcare worker faces a higher risk of infection and serious illness than the general population and attending at work could expose their family to additional risk (as was the case in SARS) consideration may need to be given to incentives to encourage work performance rather than any form of compulsion. However, the thesis argues that the health workforce would not be at greater risk during an influenza pandemic and the common law contract of employment sufficiently compels work performance, with public sector employees having a greater obligation to work than might their private sector counterparts. During an influenza pandemic workloads may increase but it will be a day (nearly) like any other.