Risk stratification

While most workers are staying at home, essential workers are continuing their job on site. Meanwhile, ”health care workers account for at least 11% of reported SARS-CoV-2 infections”. Indeed, few measures have been taken to stratify the risks of essential workers and protect the most vulnerable ones until now. The Centers for Disease Control and Prevention (CDC) have recently elaborated a framework for counseling the patients who are working during the pandemic, and classified them based on their risk factors and precautions needed for each group.

1. The following people should be advised about their high risk and consider to stop working:

  • High risk of death from SARS-CoV-2 AND contact with people known to have coronavirus
    • High risk = 65 years and older, living in a nursing home or long-term care facility, lung and heart diseases, immunocompromised, severe obesity, diabetes, dialysis, liver disease.

2. The following people should discuss with their primary care physician about their individual risks and opportunities to mitigate exposure or even consider to stop working. Precautions should be taken if they work.

  • Middle age OR younger age with high-risk of death from SARS-CoV and contact with people known to have coronavirus
  • High risk of death from SARS-CoV-2 and contact with people with uncertain coronavirus status

3. The following people should be instructed to wear a mask outside the home, practice hand hygiene and use personal protective equipment as recommended.

  • Younger age without high-risk condition regardless of the occupational risk of contracting SARS-CoV-2
  • People working from home or with strict physical distancing regardless of the risk of death from SARS-CoV-2
  • Middle age OR younger age with high-risk of death from SARS-CoV and contact with people with uncertain coronavirus status

The same framework could be applied to the soon-returning back to work people. Moreover, financial safety should be ensured by the government until we can provide these workers health safety measures at their workplace.

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