The COVID 19 crisis is challenging social workers world-wide as they continue to carry out their professional roles. Even under situations of lock-down many professionals consider or are required to meet with clients in the community, in offices, or working in close proximity to clients in other types of settings such as schools and hospitals. In the context of a shortage of resources and in many places a lack of safety equipment, social workers are having to make difficult decisions about in-person contacts with their clients. Our ethical principles can serve as a compass to guide their deliberations.
It is important to note Ethical Principle 3.4: Social workers must be aware of situations that might threaten their own safety and security, and they must make judicious choices in such circumstances. Social workers are not compelled to act when it would put themselves at risk. At this time, both the World Health Organization (WHO) and Center for Disease Control (CDC) have indicated that COVID-19 is highly contagious but preventative practices can reduce your chances of getting it and also protect those around you.
Social workers can reduce their chances of being infected or spreading COVID-19 by taking some simple precautions as recommended by the WHO:
- Regularly and thoroughly clean your hands with an alcohol-based hand rub or wash them with soap and water.
Why? Washing your hands with soap and water or using alcohol-based hand rub kills viruses that may be on your hands.
- Maintain at least 2 meters (6 feet) distance between yourself and others and more distance if anyone is coughing or sneezing.
Why? When someone coughs or sneezes they spray small liquid droplets from their nose or mouth which may contain the virus. If you are too close, you can breathe in the droplets, including the COVID-19 virus if the person coughing has the disease.
- Avoid touching eyes, nose and mouth.
Why? Hands touch many surfaces and can pick up the virus. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.
- Make sure you, and the people around you, follow good respiratory hygiene. This means covering your mouth and nose with your bent elbow or tissue when you cough or sneeze. Dispose of the used tissue immediately.
Why? Droplets spread viruses (or the virus). By following good respiratory hygiene, you protect the people around you from viruses such as cold, flu and COVID-19.
- Stay home if you feel unwell. If you have a fever, cough and difficulty breathing, seek medical attention and call in advance. Follow the directions of your local health authority.
Why? National and local authorities will have the most up to date information on the situation in your area. Calling in advance will allow your health care provider to quickly direct you to the right health facility. This will also protect you and help prevent spread of viruses and other infections.
- Keep up to date on the latest COVID-19 hotspots (cities or local areas where COVID-19 is spreading widely).
Why? You have a higher chance of catching COVID-19.
(Downloaded from WHO website, April 1, 2020.)
In facing the decision of whether or not to have face-to-face contact with clients, social workers should be guided by how to keep all people as safe as possible. When social workers meet with clients, it is not only themselves and their clients being placed at risk, there is also a risk of the infecting many other people as both the social worker and the client likely will have contact with many other people
The following questions might helpful in guiding social workers through resolving the dilemma of balancing public health directives and guidelines and ethical obligations to clients.
- Is there an agency policy that has been developed to help determine how to practice safely during this time of the COVID-19 pandemic? (If not consider advocating for the development of such a policy. No professional should have to individually make a decision on risk. Give consideration how to best articulate your needs in a professional and ethical manner.)
- If client-to-worker contact is deemed to be necessary by you and your team, what can you do to reduce the possibility of contracting or spreading the virus?
- Do you have access to the protective measures you would need to make the in-person contact as safely as possible (e.g. appropriate mask, gloves, hand washing/sanitizing capability, ability to disinfect office space, or car.)
- In situations where there is no PPE available, is there another way to accomplish social work intervention without client-to-worker contact?
- In addition to the protective measures to be taken, what further risks may exist? With regard to transportation whether by public transport or travel by car, what safety protocols has your agency or team put into place for situations when social workers are working within 2 meters of each other? (Please note that there is a general consensus that a mask should be worn when working in such close proximity).
In the event that your employing organization insists that you must see your clients in-person no matter what, you have the right to articulate the IFSW Ethical Principles, in particular, Principle 3.4 Challenging Unjust Policies and Practice that states, Social workers work to bring to the attention of their employers, policymakers, politicians, and the public situations in which policies and resources are inadequate or in which policies and practices are oppressive, unfair, or harmful. In doing so, social workers must not be penalized.
Social workers must be aware of situations that might threaten their own safety and security, and they must make judicious choices in such circumstances. Social workers are not compelled to act when it would put themselves at risk. Your decision-making strategy should also include incorporating your national code of ethics as well as seeking ethical, clinical, legal and other consultations as appropriate.
If, after carefully thinking through your decisions and organizational circumstances related to serving your clients, you have determined that it is necessary to have the in-person contact with your client, be sure that you are doing all that you can to follow guidelines that are appropriate to the in-person contact you are planning to have.
A final note for consideration relates to principle 9.6 Social workers have a duty to take the necessary steps to care for themselves professionally and personally in the workplace, in their private lives and in society.
To learn how other social workers in the world are responding to the COVID-19 virus, please visit the IFSW website.
Prepared by Kathryn Conley Wehrmann, Ph.D. LCSW
IFSW Corona Virus Information Officer