Legally blocked: the right to health – GWC Mag

Are covid and long covid occupational diseases? The testimonies of health professionals who work long hours with inadequate protective equipment in poorly ventilated rooms are unequivocal (doi:10.1136/bmj.p1983).1 The data on covid in health workers are equally persuasive (doi:10.1136/bmj.m3582https://oem.bmj.com/content/78/5/307 doi:10.1136/bmj.m3944).234 The European Commission last year recommended that covid should be recognised as an occupational disease in certain sectors, such as health and social care (https://ec.europa.eu/social/main.jsp?langId=en&catId=89&furtherNews=yes&newsId=10463).5 Yet governments remain reluctant to accept the link.

Rachel Ali, a general practitioner whose life was “upended” by long covid, believes that the issue is one of legal liability, “to avoid being held responsible for the occupational illnesses of so many people, healthcare workers as well as other patient facing workers.” It’s hard to think of another adequate explanation, given the facts.

The UK’s Office for National Statistics estimates that about two million people are living with long covid, around 3% of the population. About 5% of the UK’s healthcare workers have acquired long covid. The World Health Organization calculated that 17 million people experienced long covid in Europe during the first two years of the pandemic (doi:10.1136/bmj.o2232).6 Research from Israel indicates that people with mild disease are “at risk for a small number of health outcomes, most of which are resolved within a year from diagnosis” (doi:10.1136/bmj-2022-072529).7 A Swiss study found, however, that 19% of people have persistent symptoms at one year, and that figure drops only to 17% by the end of year two (doi:10.1136/bmj.p932 doi:10.1136/bmj-2022-074425).89

Some people wonder why covid remains “news.” The emerging variants seem less troublesome than previous ones (doi:10.1136/bmj.p2097).10 There are other, bigger challenges—for example, the policy failures that contributed to high numbers of avoidable deaths (doi:10.1136/bmj.p2092),11 complex strategies on major conditions (doi:10.1136/bmj.p2122),12 and shortfalls in funding of science (doi:10.1136/bmj.p2068).13 The public is bored. We must move on.

Millions of people around the world can’t move on, mainly because of long covid. Many other vulnerable people remain concerned by the risks posed by new variants. And, if anything, the politically convenient information vacuum around covid, and a lack of surveillance and data, heighten people’s curiosity and interest. The “ban” on covid data are like any ban—it creates demand. The BMJ’s coverage of covid, now a minority of our output, remains some of our best read content.

If pertinent data remain in short supply, the law also persists in being an ass. Governments refuse legal liability for policy failures that led to deaths in social care and high infection rates among frontline workers during the pandemic and are now busy introducing new minimum service level agreements at the height of an uncomfortable dispute with doctors (doi:10.1136/bmj.p2142 doi:10.1136/bmj.p2126).1415 They hesitate over meaningful regulation of new patient facing roles (doi:10.1136/bmj.p1926 doi:10.1136/bmj-2022-073933) but will rush to game the membership of a supreme court to win an ideological war on women’s rights (doi:10.1136/bmj.o1575).161718

The right to health is an internationally recognised human right (www.who.int/news-room/fact-sheets/detail/human-rights-and-health).19 That’s the theory. Legal mechanisms are now lifelines in many health related scenarios, whether that is in attempts to ensure progress in global climate commitments (doi:10.1136/bmj.o1681),20 agreeing a pandemic treaty (doi:10.1136/bmj.p46),21 or for families to seek redress when they believe that a health system has brought them harm (doi:10.1136/bmj.p1931).22 In practice, and regrettably, the legal system has become an instrument to control and limit that human right to health. Instead of protecting citizens from the excesses of government and protecting the rights of an already stretched workforce (doi:10.1136/bmj.p2127),23 legal processes are at times manoeuvred to deny individuals’ rights and freedoms (doi:10.1136/bmj.p1954 doi:10.1136/bmj.p1935).2425 In the context of health, the failure to recognise long covid as an occupational disease is one of the most powerful examples.