Protecting Healthcare Heroes: Pandemic Preparedness

The 2025 Global Preparedness Monitoring Board (GPMB) report, The New Face of Pandemic Preparedness, arrives with a sobering message: five years after COVID-19 began, the world remains dangerously unprepared for the next pandemic. But perhaps nowhere is this vulnerability more acute than among healthcare workers and first responders—the very people we depend on when crisis strikes.

1. The Healthcare Worker Crisis We Can't Ignore

COVID-19 exposed a harsh reality: our healthcare systems were not designed to protect those doing the protecting. Healthcare workers faced inadequate personal protective equipment (PPE), overwhelming patient loads, and psychological trauma that continues to ripple through the workforce. The report notes that the health workforce has been "marginalized in pandemic preparedness and response decision-making" despite being critical to implementation.

This isn't just a healthcare problem—it's a workers' compensation crisis waiting to happen again.

2. The Hidden Costs: Workers' Compensation and Occupational Health

While the GPMB report focuses on mortality statistics and economic losses in the trillions, it gives less attention to the occupational health disaster that unfolded. Healthcare workers experienced:

• Elevated infection rates due to inadequate PPE and exposure protocols
• Physical injuries from extended shifts and improvised care conditions
• Mental health crises including PTSD, anxiety, and depression at rates far exceeding baseline
• Long COVID affecting workforce capacity for extended periods

These translate directly into workers' compensation claims, disability costs, workforce shortages, and liability exposure for employers. The report's finding that 17 million children had zero vaccine doses in 2020 occurred partly because healthcare workers were overwhelmed, unavailable, or had left the workforce entirely.

3. The GPMB Framework: CARE, MEASURE, COOPERATE

The report organizes its recommendations around three imperatives. Let's examine each through the lens of occupational health and safety:

CARE: Building Resilient Frontline Systems

The report calls for strengthening primary health care (PHC) as the first line of defense. For workers, this means:

What This Means for Worker Safety:

• Distributed care reduces concentration of exposure risk. When primary care facilities can manage the initial wave, hospital workers aren't immediately overwhelmed
• Community-level care keeps workers closer to home, reducing the transportation and displacement issues that complicated COVID-19 response
• Early detection and treatment means healthcare workers encounter patients earlier in disease progression, when they're less severely ill

Employer Action Items:

1. Invest in occupational health infrastructure that can quickly scale up for screening and monitoring workers
2. Create rotating stockpiles of PPE appropriate to different pathogen types (respiratory, vector-borne, etc.)
3. Develop rapid testing and treatment protocols for healthcare workers as a priority population
4. Establish clear exposure tracking systems to document occupational transmission for workers' compensation purposes

Insurance Company Role:

• Offer premium reductions for employers with documented PPE stockpiles and rotation protocols
• Develop pandemic-specific occupational health endorsements that clarify coverage
• Create preparedness assessment tools that help employers identify gaps before crisis hits
• Support research into occupational transmission patterns to improve risk modeling

MEASURE: Real-Time Monitoring of Healthcare System Strain

The report emphasizes the need for "dynamic metrics" that assess health system resilience in real time. Critically for workers, this includes:

What This Means for Worker Safety:

• Early warning systems can trigger surge staffing protocols before workers are dangerously overwhelmed
• Tracking workforce capacity (not just bed capacity) provides realistic pictures of system stress
• Monitoring PPE supply chains enables proactive reordering before shortages endanger workers

Employer Action Items:

1. Implement workforce monitoring dashboards tracking:

   • Staff-to-patient ratios in real time
   • PPE consumption rates and inventory levels
   • Worker absenteeism and exposure incidents
   • Mental health resource utilization

2. Establish clear surge protocols with defined triggers:

   • At what point are elective procedures postponed?
   • When are off-duty staff called in?
   • What are the maximum safe working hours?

3. Create "circuit breaker" policies that protect workers:

   • Automatic shift caps when staff-to-patient ratios deteriorate
   • Mandatory rest periods during extended responses
   • Mental health check-ins as standard protocol

Insurance Company Role:

• Develop real-time risk assessment tools that integrate with employer monitoring systems
• Offer crisis response consultation services when monitoring indicates system stress
• Create parametric insurance triggers based on workforce strain metrics (e.g., automatic additional coverage when staff-to-patient ratios exceed safe thresholds)

Worker/Labor Role:

• Participate in developing monitoring metrics to ensure they capture actual working conditions
• Establish clear reporting channels for safety concerns without fear of retaliation
• Negotiate contract language that ties staffing ratios to monitoring data

COOPERATE: Multisectoral Coordination for Worker Protection

The report stresses that pandemic response requires coordination across health, agriculture, finance, and security sectors. For workers, this means:

What This Means for Worker Safety:

• Supply chain coordination ensures PPE availability isn't disrupted by transport or manufacturing bottlenecks
• Cross-sector protocols mean emergency responders, healthcare workers, and essential workers operate with compatible safety standards
• International cooperation enables sharing of effective worker protection strategies

Employer Action Items:

1. Participate in regional preparedness networks to coordinate:

   • Shared PPE stockpiles and mutual aid agreements
   • Workforce surge capacity sharing
   • Coordinated procurement to avoid competition-driven shortages

2. Develop multisectoral safety protocols:

   • How do EMS, hospital, and public health workers coordinate safely?
   • What are handoff protocols that minimize exposure?
   • How are workers protected when responding to non-healthcare settings?

3. Engage workers in preparedness planning:

   • The report notes that "grassroots action is fastest and most trusted" but needs integration into formal systems
   • Workers know what actually works on the ground—involve them in protocol development

Insurance Company Role:

• Support industry-wide preparedness consortia that pool resources and share best practices
• Create incentives for mutual aid agreements through favorable policy terms
• Develop cross-border coverage solutions for workers deployed to outbreak hotspots
• Standardize reporting so occupational health data can be compared across regions and sectors

Worker/Labor Role:

• Demand seats at planning tables—the report explicitly criticizes the marginalization of healthcare workers in decision-making
• Share information across unions and professional organizations about what protective measures actually work
• Advocate for:
  • Presumptive workers' compensation coverage for communicable disease exposure during declared emergencies
  • Hazard pay structures tied to documented risk levels
  • Mental health support as a standard component of emergency response

4. The Critical First Months: When Worker Protection Matters Most

The GPMB report emphasizes that the first six to nine months of an outbreak are the most dangerous because:

• Uncertainty is highest
• Vaccines and specific treatments aren't yet available
• Health systems face the steepest surge

This is precisely when healthcare workers are most vulnerable. The report notes that rapid development of "broad-spectrum antivirals" and "pathogen-agnostic tools" could transform this critical period.

What This Means for Preparedness:

1. Don't wait for perfect information. The report advocates for "test-and-treat approaches" that reduce severity even with imperfect treatments. Apply this logic to worker protection:

   • Use the best available PPE and upgrade as better information emerges
   • Implement conservative exposure protocols initially, then adjust
   • Err on the side of over-protecting workers when uncertainty is high

2. Invest in flexible infrastructure. The report calls for "pathogen-agnostic" countermeasures. For worker safety, this means:

   • Negative pressure rooms that work for any airborne pathogen
   • PPE stockpiles that include options for multiple transmission routes
   • Decontamination and isolation protocols adaptable to different threats

3. Protect the workforce to maintain system capacity. The report notes the "increased gap in the size of the health workforce" post-COVID. Every worker lost to infection, burnout, or death permanently diminishes response capacity.

5. The Monitoring Framework: Tracking What Matters for Workers

The GPMB's Monitoring Framework includes 90 indicators across Risk, Prevention/Preparedness/Resilience, and Impact. Notably relevant for occupational health:

Current Gaps in the Framework:

The framework should be enhanced to explicitly track:

• Healthcare worker infection rates during outbreaks
• PPE availability per worker, not just aggregate stockpiles
• Staff-to-patient ratios during surge periods
• Workers' compensation claim rates for occupational exposure
• Healthcare workforce turnover and retention as resilience indicators
• Mental health resource availability specifically for healthcare workers

Figure 1: Major Infectious Threats in the 21st Century

This timeline from the report (pages 20-21) is the most important graph for conveying the occupational health message:

Why This Graph Matters for Workers:

1. Frequency is increasing. The report documents that acute public health events have grown from ~100/year in 2011 to ~200/year by 2024 (with a COVID-dip in 2020). More outbreaks mean more occupational exposure risk.

2. International collaboration has improved (shown by the bottom portion of the timeline), but these frameworks focus primarily on surveillance and countermeasure development—not explicit worker protection.

3. The gap between threats and protections persists. Each epidemic line represents a period when workers were on the front line, often before adequate protective measures were in place.

4. Pattern recognition enables preparation. For employers and insurers, this timeline shows we're not talking about rare "black swan" events—we're talking about regular, predictable occupational hazards that demand standing protocols.

6. Practical Preparedness Checklist

For Employers (Healthcare Facilities, Emergency Services, Essential Services):

Immediate Actions (Next 90 Days):

• [ ] Conduct inventory of PPE stockpiles by pathogen type (respiratory, contact, vector-borne)
• [ ] Establish PPE rotation schedules to maintain fresh stocks
• [ ] Review workers' compensation policies for pandemic coverage gaps
• [ ] Create workforce monitoring dashboard (even if simple Excel-based initially)
• [ ] Identify mental health resources available to workers
• [ ] Review and update exposure reporting protocols

Short-Term Actions (Next 6-12 Months):

• [ ] Conduct tabletop exercises with frontline workers participating in design
• [ ] Establish mutual aid agreements with peer organizations
• [ ] Develop surge staffing protocols with clear worker protection triggers
• [ ] Create communication channels for rapid policy updates to workers
• [ ] Invest in engineering controls (negative pressure, HVAC upgrades, etc.)
• [ ] Negotiate presumptive coverage language with workers' compensation carriers

Long-Term Actions (Next 1-3 Years):

• [ ] Integrate pandemic preparedness into standard occupational safety programs
• [ ] Participate in regional/national preparedness networks
• [ ] Invest in flexible infrastructure (spaces that can convert to isolation areas, etc.)
• [ ] Develop career pathways that retain experienced workers
• [ ] Create financial reserves or insurance mechanisms to fund surge response
• [ ] Establish research partnerships to evaluate worker protection interventions

For Insurance Companies:

Product Development:

• [ ] Create pandemic-specific occupational health endorsements with clear coverage language
• [ ] Develop parametric triggers based on public health declarations or system strain metrics
• [ ] Offer business interruption coverage that includes pandemic scenarios
• [ ] Design premium incentives for demonstrated preparedness (PPE stocks, training, etc.)

Risk Management Services:

• [ ] Develop preparedness assessment tools for policyholders
• [ ] Create pandemic playbooks tailored to different industries
• [ ] Offer real-time consultation services during emerging outbreaks
• [ ] Support research into occupational transmission patterns

Claims Management:

• [ ] Establish rapid response teams for mass exposure events
• [ ] Create streamlined claims processes for occupational disease during declared emergencies
• [ ] Develop clear guidance on causation standards for pandemic-related claims
• [ ] Train adjusters on communicable disease occupational health issues

For Workers and Labor Organizations:

Immediate Actions:

• [ ] Survey members on current PPE access and concerns
• [ ] Document baseline working conditions (staffing ratios, safety protocols, etc.)
• [ ] Establish rapid communication channels for safety concerns
• [ ] Review existing contract language on occupational health and safety

Advocacy Priorities:

• [ ] Demand meaningful participation in preparedness planning
• [ ] Negotiate presumptive workers' compensation coverage for pandemic exposure
• [ ] Advocate for hazard pay structures tied to documented risk
• [ ] Push for enforceable staffing ratio standards with pandemic surge protocols
• [ ] Require mental health support as standard emergency response component

Knowledge Sharing:

• [ ] Create cross-union networks to share effective protective practices
• [ ] Document what actually worked (and didn't) during COVID-19 from worker perspective
• [ ] Participate in research on occupational health interventions
• [ ] Contribute to development of national/international worker protection standards

7. The Business Case for Preparedness

The GPMB report notes there is an estimated $10.5 billion annual gap in pandemic preparedness funding globally. Employers might view this as someone else's problem, but consider:

. Costs of Unpreparedness (from COVID-19 experience):

•  Workers' compensation claims for occupational exposure
• .Disability costs for long COVID
• Life insurance and death benefits
• Recruitment and training costs from workforce turnover
• Productivity losses from staff shortages
• Liability exposure from inadequate protection
• Reputational damage affecting recruitment

Returns on Preparedness Investment:

• Reduced workers' compensation costs through fewer occupational exposures
• Lower turnover from demonstrated commitment to worker safety
• Maintained operational capacity during surge periods
• Reduced business interruption from adequate staffing
• Enhanced reputation as employer of choice in healthcare sector
• Lower insurance premiums through demonstrated risk management
• Avoided regulatory penalties for safety violations

The report frames pandemic preparedness as "an insurance policy for the global future." For individual employers, it's also an insurance policy against catastrophic workers' compensation losses and workforce collapse.

8. What the WHO Pandemic Agreement Means for Workers

The report highlights the May 2025 adoption of the WHO Pandemic Agreement as a "beacon of hope." Key provisions relevant to occupational health include:

Pathogen Access and Benefit-Sharing (PABS):

• Countries share pathogen samples and data
• 20% of real-time production of vaccines, diagnostics, and treatments reserved for global distribution (10% donations, 10% affordable prices)

For Workers, This Means:

• Earlier access to diagnostic tests for screening healthcare workers
• More equitable distribution of vaccines so frontline workers globally are prioritized
• Availability of treatments even in first months of outbreak

However, the Agreement has gaps from a worker protection perspective:

• No explicit provisions on PPE prioritization for healthcare workers
• Limited focus on occupational health surveillance
• Unclear mechanisms for international deployment of healthcare workers with adequate protection

Advocacy Opportunity: Workers' organizations should engage with the Conference of the Parties (COP) established under the Agreement to ensure occupational health is explicitly addressed in implementation.

9. The Inequity Dimension: Safety as Social Justice

The GPMB report repeatedly emphasizes that "inequities are the cracks through which viruses spread." This applies within healthcare systems too:

Occupational Health Inequities:

• Lower-wage healthcare workers (CNAs, janitorial staff, food service) often had least access to quality PPE during COVID-19
• Workers in under-resourced facilities faced greater exposure risks
• Community health workers operating in informal settings had minimal protection
• Women comprise ~70% of the healthcare workforce globally and bore disproportionate exposure and burden

Preparedness Must Address:

• Ensuring PPE and protective measures reach all worker categories, not just physicians
• Addressing language and literacy barriers in safety training
• Providing paid sick leave so workers can actually isolate when exposed
• Including informal healthcare workers (traditional healers, community health workers) in preparedness planning

The report notes that "grassroots action is fastest and most trusted" but "needs to be integrated into formal preparedness architectures." Apply this insight to occupational health: the workers who delivered creative community responses during COVID-19 must have formal roles in preparedness planning, with adequate resources and protection.

10. Mental Health: The Invisible Occupational Hazard

The GPMB report documents that COVID-19 triggered a 25% increase in anxiety and depression globally, with effects likely persisting through 2030. For healthcare workers, the burden was exponentially higher:

• Moral injury from having to make impossible triage decisions
• PTSD from exposure to mass death and suffering
• Burnout from sustained overwork
• Grief from loss of colleagues
• Ongoing anxiety about future exposures

This Is a Workers' Compensation Issue:

• Mental health injuries from occupational exposure are compensable in many jurisdictions
• But claims are often difficult to prove and face higher denial rates
• Stigma prevents many workers from filing claims

Preparedness Must Include:

• Proactive mental health support as standard component of emergency response, not afterthought
• Peer support programs that connect workers with shared experiences
• Clear protocols for when workers should step back from high-stress assignments
• Presumptive coverage for mental health conditions developing during/after declared emergencies
• Long-term support recognizing that psychological impacts may not emerge immediately

Insurance Implications: The report's projection of persistent elevated mental health burden through 2030 suggests insurers should expect long-tail claims from COVID-19 exposure continuing for years. This should inform:

• Reserve setting for pandemic-related claims
• Policy language clarifying mental health coverage
• Investment in early intervention programs that might reduce claim severity

11. The Ticking Clock: Why Preparedness Can't Wait

The GPMB report cautions that "if a new pandemic were to occur soon, the world could be even more vulnerable than it was in 2019" because:

• Healthcare systems are still in recovery
• Workforce gaps persist
• Lessons of COVID-19 are being forgotten as attention shifts
• Trust in institutions has eroded
• Geopolitical tensions complicate cooperation

For occupational health, this means:

We're in a dangerous window. The healthcare workforce is smaller, more burned out, and more skeptical than in 2019. A major outbreak now would hit an already compromised system.

The next pandemic will be different. The report emphasizes preparing for a "range of pandemic threats," not just respiratory viruses. This demands:

• PPE strategies for various transmission routes
• Training in proper use of different protective equipment
• Flexibility in protocols

Complacency is the enemy. The report warns against "eager to move on, sometimes at the cost of ignoring hard-earned lessons." For employers:

• Don't dismantle preparedness infrastructure built during COVID-19
• Don't assume workers will accept dangerous conditions again
• Don't treat pandemic planning as one-time compliance exercise

12. Key Takeaways

• Healthcare workers bore the brunt of COVID-19, with inadequate protection contributing to burnout, infections, and deaths
• Strengthening primary care creates safer working environments and reduces surge demands on hospitals
• Investment in PPE stockpiles and pathogen-agnostic tools protects frontline workers during the critical first months
• Real-time health system monitoring can identify workforce strain before it becomes critical
• Multisectoral planning must include occupational health and safety protocols for all response workers
• Employers must integrate pandemic preparedness into workplace safety programs now, not during crises
• Insurance companies should incentivize preparedness through premium structures that reward readiness investments
• Workers and unions must be involved in preparedness planning to ensure protocols are practical and protective

13. Conclusion: Protection as Preparedness

The GPMB report's organizing framework—CARE, MEASURE, COOPERATE—provides a roadmap not just for global health security, but for protecting the workers on whom that security depends.

CARE means investing in systems that don't overwhelm frontline workers. It means treating occupational health infrastructure as essential, not optional.

MEASURE means monitoring workforce strain in real time and acting on data. It means tracking not just disease spread but worker protection and system capacity.

COOPERATE means bringing workers to the table as full partners in preparedness planning. It means employers, insurers, and labor organizations working together before crisis strikes.

The report concludes that "building strong care systems, measuring the full spectrum of pandemic impacts and strengthening cooperation across sectors and borders will determine whether the next outbreak becomes a manageable event or a repeat of recent global upheaval."

Add to that list: Protecting the workforce will determine whether we have anyone left to manage the response.

The healthcare heroes who carried us through COVID-19 deserve better than to be left marginalized in preparedness planning. They deserve employers who invest in their protection, insurers who fairly cover their occupational risks, and systems that value their expertise.

The next pandemic is not a question of if, but when. The question for employers, insurers, and society is: will we protect those who protect us?

The 2025 GPMB report provides the framework. Now comes the hard work of implementation—with healthcare workers and first responders not as an afterthought, but as the foundation of pandemic preparedness.

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For more information:

• Full GPMB report: www.gpmb.org
• GPMB Monitoring Framework: Technical framework and methodology
• WHO Pandemic Agreement: WHA78.1

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This analysis is based on "The New Face of Pandemic Preparedness: 2025 GPMB Report" published by the Global Preparedness Monitoring Board. All data and quotes are from that source unless otherwise noted.

Recommended Citation: Gelman, Jon,  The Healthcare Worker Crisis We Can't Ignore (10/15/2025) https://workers-compensation.blogspot.com/2025/10/protecting-healthcare-heroes-pandemic.html

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*Jon L. Gelman of Wayne, NJ, is the author of NJ Workers' Compensation Law (West-Thomson-Reuters) and co-author of the national treatise Modern Workers' Compensation Law (West-Thomson-Reuters).

Blog: Workers' Compensation

LinkedIn: JonGelman

LinkedIn Group: Injured Workers Law & Advocacy Group

Author: "Workers' Compensation Law" West-Thomson-Reuters

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© 2025 Jon L Gelman. All rights reserved.

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