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The burning building

BMJ 2020; 368 doi: (Published 19 March 2020) Cite this as: BMJ 2020;368:m1101

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Re: The burning building - Workforce redeployment to address economic and health threats from COVID-19

Dear Editor

The World Health Organisation declared COVID-19 a pandemic on 11 March 2020, reflecting the global health impact of over 130,000 confirmed cases and close to 5,000 deaths at that time. Since then, global case counts have more than doubled while deaths have nearly tripled. Aside from direct health impacts, the looming economic consequences of COVID-19 will also be substantial and will require a proactive approach to address.

The general economic impacts of COVID-19 have been well-covered by the media and are the subject of unprecedented government responses in most countries. Disruption to global supply chains and business cash flows, reductions in travel, and cancellations of events are just some examples of the impacts currently being faced. Frantic purchasing of necessities has stretched supermarkets to their limits, while also crowding-out disadvantaged groups such as the elderly and the vulnerable from accessing much needed supplies. Stock markets globally have experienced large declines in value. The Dow Jones Index in the USA declined 10% in a single day on 11 March 2020 and has declined markedly since then; the Index’s worst performance in three decades. Global economic integration means that shocks will reverberate across regions as economic contagion intensifies.[1]

That some individuals will experience severe economic impact due to the ramifications of COVID-19 is inescapable. Around one-quarter of Australia’s workforce is casualised, and around 35% of the casual workforce (or around 860,000 people) are in the badly affected sectors of hospitality and retail.[2] Many individuals in other countries will be similarly disadvantaged. Recent estimates for the UK, for instance, indicate that 1.4 million people are employed in temporary work.[3]

Governments across the world have had varying responses to the unfolding pandemic.[4] The USA and Australian governments have announced economic stimulus packages with financial support for businesses, households, and individuals on welfare schemes or the unemployed. Some governments, including those in the UK, China, Italy, Australia and Norway have imposed extensive quarantine and human control measures to stem virus transmission. Many governments have implemented border control measures, closure of non-essential services such as clubs and dine in facilities, closure of public facilities such as schools and universities, and deployed health measures including specialist COVID-19 clinics.

The loss of livelihoods from the current pandemic presents an immense economic and policy challenge. At the same time, COVID-19 has brought on capacity constraints in the health sector and elsewhere. Shortages of capacity to carry out diagnostic and treatment duties have arisen. An innovative policy solution could consider the redeployment of displaced workers. Options include call centre workers triaging callers to specialist COVID-19 clinics or to a regular general practitioner. Further, increasing the number of cleaners who continuously sanitise necessary public infrastructure, such as public transport and schools, could reduce transmission and minimise disruption of the wider workforce. Additional sanitary workers could also be deployed to critical private infrastructure, such as grocery stores and private health clinics. Public funding could also employ workers to deliver food and other essentials to higher risk people, including the elderly.

Facilitating such workforce redeployments would allocate economic resources to roles and individuals in greatest need. Without intervention, those in precarious employment potentially face destitution and other adverse consequences. Extraordinary times call for extraordinary solutions.

1. Ayittey FK, Ayittey MK, Chiwero NB, Kamasah JS, Dzuvor C. Economic impacts of Wuhan 2019‐nCoV on China and the world. J Med Virol. 2020; 1– 3.
2. Gilfillan G. Characteristics and use of casual employees in Australia. Canberra: Parliamentary Library, Research Paper Series 2017-18; 2018 [cited 2020 March 16]. Available from:
3. Office for National Statistics. United Kingdom: EMP07: Temporary Employees; 2020 [cited 2020 March 16]. Available from:
4. McCloskey B, Heymann DL. SARS to novel coronavirus – old lessons and new lessons. Epidemiol Infect. 2020;148, e22, 1–4.

Competing interests: No competing interests

24 March 2020
Ian W Li
Senior Lecturer
Devin C Bowles, Rory D Watts, David B Preen
School of Population and Global Health, The University of Western Australia
M431, 35 Stirling Highway, Crawley, WA 6009, Australia