COVID-19: The politics of economics and adjustment
Sustainable pandemic workforces and changing job demand
Rory Watts explores the relationship between COVID-19, changing job demand, and the importance of sustaining a pandemic workforce.
COVID-19 has had a profound impact on the world, especially through its effects on health and livelihood. At the time of writing, there are run-on predictions of 30% unemployment in the United States due to the pandemic, an order of magnitude larger than pre-pandemic predictions, 21% unemployment in the UK, 11% in Australia, and 10% in New Zealand and Canada. These are predictions amid much uncertainty, but job loss for many people is likely. For Australia, despite having successfully flattened the curve thus far, ministerial briefings suggest that a stepping down of restrictions is still many weeks away, and a return to pre-virus life is well beyond that.
For the employers and employees who are still in work, there are likely to be substantial changes. They may be as simple as additional duties related to hygiene and protective equipment (such as additional protocols when working with the elderly), or may be as drastic as the complete repurposing of a business (e.g. distilleries producing hand sanitiser). For some businesses, changes in people's lives may mean a great surge in demand which requires both internal reallocation and external hiring. For example, Woolworths is hiring for 20,000 new positions, and Tesco (a grocer in the UK) 35,000 people.
Where employees are at-risk of losing their jobs, many countries are focusing on maintaining employer-employee relationships through wage subsidies, which in effect is an effort to retain composition of the economy pre-lockdown, referred to by some as a 'freeze-in-place' strategy. This strategy is important, because we assume for the most part that business will return to usual after this episode, but decision makers should be confident this is the case. The economy during COVID-19 so far has created a very uneven economic impact, in terms of both scale and composition. For example, whilst the fitness industry has seen a 95% decrease in consumption, home improvement has seen a 64% increase. It is likely that much of this will revert once constraints are relaxed, but it is foreseeable that changes in some sectors will be longer lived than others, especially changes to sectors that need to be sustained.
Healthcare is one such sector which will need to see a continued increased demand, in order to ensure a return to normal work for other sectors. In fact, the return to normal life for other sectors relies on effective scaling up of public health interventions, such as mass testing and contact tracing, and this can only be performed by a large and sustained workforce. Even in a scenario where the virus is eliminated in Australia, a sustained public health response is essential to reducing a second wave which might be introduced as international travel resumes.
We have been examining the composition and demand of this workforce by looking at advertised jobs on online job boards (places like SEEK and Indeed). The preliminary results (from the beginning of March to the beginning of April) paint the following picture: a surge of jobs advertised for nurses, some doctors and some scientific health positions (e.g. laboratory technicians). The demand is for people who can operate phone centres, take temperatures, screen people, and care for patients. Many contracts are for a number of months. This is the picture in Australia as well as other countries we have looked at (New Zealand, Canada, United Kingdom, United States). Although it is too early to tell yet, it is unlikely that we will see the demand for this 'pandemic workforce' change earlier than other sectors.
However, the supply of the pandemic workforce has vulnerabilities which are important to qualify, namely salary, security and credentials. If there are temporary COVID-19 positions competing with longer-term non-COVID-19 positions, or if increasing demand in other sectors means non-COVID-19 jobs are more competitive in salary, sustainability may be compromised. If it is unclear how temporary COVID-19 nursing positions will help a young nurse’s career, they may opt out when a better offer becomes available. If a migrant who worked as a nurse in their country of origin cannot find a role that utilises their skillset, then this is an under-utilisation of labour.
We are not the only country to be concerned with the sustainability of this workforce. Academics from the US have published an article about how regulations may be relaxed to sustain a pandemic workforce. Such skills-substitution is a useful consideration for the Australian context too. Other suggestions in the US relate to mobilising low-risk prison population, or drawing on retirees. In Australia, there are recruitment pools which seek applications from those not currently employed in the public health system, but also second- and third- year nursing students. Elsewhere, medical students are being considered to assist for routine duties, but why stop here?
What can be improved to sustain the pandemic workforce?
Estimates suggest that the current mortality in the United States could have been reduced by 90% if measures had been put in place two weeks earlier. We have been lucky in Australia: our mortality has been low, and our case rate has been decreasing. However, it is also unlikely that a great majority of Australians has been infected already, and so absent of technology or elimination, a second wave could occur. If it does, timing of public health interventions is crucial, and these rely on a workforce that is ready to go.
Many unemployed persons in Australia could serve as a pool of workers to carry out essential public health activities, such as screening or low-risk care work, and if there are current soft restrictions preventing this, these should be interrogated. This would involve creating roles that consist of essential low-skill tasks and duties which could be implemented by the Work for the Dole program. For workers whose vocation is health care, this would create opportunities for future caring roles (e.g. aged care work), but for those whose vocation lies elsewhere, there should be appropriate help given after their duties are done. For those who can fill this workforce, they should be incentivised to do so, and these incentives should be reviewed when business-as-usual sectors become competitive alternatives. However, incentives must be carefully considered due to the inherent risks of the work and the existing vulnerabilities of workers.
For those who are looking online for these jobs, advertisements should be made easy to find. Currently, if one searches 'COVID' in an attempt to participate in this workforce, they are likely to find false-positive results at a rate 3:1 (e.g. a job advertisement which has in its description ‘due to COVID, we are temporarily suspending hiring’). Making pandemic workforce jobs easier to find would be a simple matter of a check-box which advertisers could fill to flag their job as part of the response.
The other important piece of the puzzle is to have a solid plan of attack. At the time of writing, the current Australian COVID-19 health-system response plan is vague about what will need to be done during the ‘stand-down’ and ‘preparedness’ phases. There needs to be a clear way forward, which estimates how many workers will be needed, and errs on the side of generosity lest we are underprepared.
Rory Watts is a PhD candidate with the School of Population and Global Health at UWA. He thanks his supervisors Dr Ian Li, Dr Devin Bowles and Professor Colleen Fisher for their continued support. Views in this piece are his own.