Healthcare workers infected by COVID-19 globally, they are more exposed then you are! Show some respect, stay at home!
Healthcare workers who treat COVID-19 coronavirus-infected patients are at great risk of contracting the disease themselves due to constant exposure and proximity to these patients. Out of all the patients, 10-15% of them are healthcare workers.
Globally, the coronavirus cases have exceeded 3.97M with more than 276K deaths. The United States has been the worst-hit country with 1.32M cases, followed by Spain, Italy, UK, Russia, France, and Germany.
The number of coronavirus cases is expected to increase among healthcare workers. Although this is partly due to more communities experiencing widespread transmission, the nature of healthcare work contributes understandably to the risk: about 45 percent of workers who have tested positive have lived in households or communities where the virus was present, meaning they risk exposure on two fronts, both within and outside a healthcare setting.
The International Council of Nurses (ICN) said that 90,000 health workers worldwide are Covid-19 contaminated. More than 260 nurses worldwide are infected by a coronavirus. The estimate of 90,000 is based on information gathered from thirty countries.
The COVID-19 risk to healthcare workers
There are several reasons why health care workers catch COVID-19. One of the most significant is how much virus the individual is exposed to. So, the body has mechanisms for natural defence. And if you’re exposed to a small amount of virus, you’re more likely to fight off that infection. Healthcare workers may have contracted the infection from three sources-
- Positive co-workers
- Individuals (doctors/personnel) who have travelled abroad.
In general, healthier health care staff, particularly younger ones, should not get sick at these levels. However, they are around really sick people, actually coughing in their faces in so many situations. And they are getting inoculants repeatedly. For instance, I could get a high inoculant from person A, a medium from person B, another high one from person C.
I may have had 10 inoculants by the end of the day. So I’m dealing with something that’s far different from the casual visitor in the grocery store, who might have wiped an apple and caught some virus off that apple because somebody coughed on it 2 days ago. It is a whole different ball of wax. And so the amount of virus I get as a health-care worker will put me at a much higher risk.
Need for personal protective equipment
Undoubtedly we need to lower the exposure, the number of exposures to the virus that health care providers have and this is where PPE gets on board. Healthcare professionals are demanding more Personal Protective Equipment (PPE).
According to the World Health Organization (WHO), PPE is comprised of garments worn to prevent health workers or someone else from getting contaminated. These include gloves, medical masks, goggles or a face shield, and gowns, as well as respirators (i.e., regular or equivalent of N95 or FFP2) and aprons for different procedures.
There has been a lot of discussion about Personal Protective Equipment in the media and the big questions are: What kind of masks should we be wearing? And what do we do with these shortages that we’re seeing?
It’s so heartbreaking to see health care providers that aren’t properly equipped especially seeing nurses in New York wearing garbage bags. So if you have health care workers out there because their hospital said: “Go out there and use this one mask for the week or for the month”, and that’s all they have.
They do wear them. There could be a crack, or the thing is beginning to break down. Maybe it’s stained or ripped up, it doesn’t work even well. And yet they are compelled to wear it day by day. It’s not like they are just getting these high inoculants, they are getting them on top of not having the right, adequate protection.
A discussion has been going on about whether we need surgical masks or N95 masks. And this all comes down to whether we think that droplet or aerosolized procedure transmits the Coronavirus. Let me explain that! The difference between aerosols and droplets is just about the size. Thus droplets become larger and then fall out of the air quicker.
In contrast, aerosols are small and can remain suspended in the air. So surgical masks were originally designed to prevent surgeons from contaminating patients and reducing wound infections.
But now we’re using the surgical mask to protect ourselves. And that’s something that we actually haven’t studied that much but overall we know that it stops bigger particles. On the other hand, N95s are designed to stop 95% of particles in the air and that includes the small particles.
Science tells us that infections, like droplets or aerosols, can easily be put into boxes. It is possibly a mix of both, somewhere in between. From some research, we learn that Coronavirus is present in the air around people who are ill. What we do not know is: Will those viruses found in the air. Are they able to infect people? We don’t know if they’re still feasible and that’s why we need more research.
This is why health agencies such as the CDC (Center for Disease Control and Prevention) or the World Health Organization have generated a list of the most likely medical procedures to produce such tiny particles. Even in those scenarios, we are using N95 masks, because they’re such a scarce resource.
For me, I think that right now, often what’s seen at the hospital is that you wear a surgical mask and if there’s no aerosolizing procedure, then you’re putting on an N95 mask. Sometimes I can’t help but wonder if a patient has just coughed or sneezed when I am walking into a room. It could have been seconds before. And if you go in, how would this not be an aerosolized procedure? Or do you think coughing and sneezing are aerosolized?
Obviously Yes, of course. Put it like this, it makes no sense to think: ‘Oh, an N95 is necessary for intubation,’ but if someone is coughing and sneezing a minute before you go in. You might not even know it! In fact, they have been coughing and sneezing for the last hour.
As well as 10 other patients in that room had been coughing and sneezing before they were in that room. You can walk in there and think if necessary, of a surgical mask. Absolutely not. That is a joke. And therefore I think that for health care professionals working with COVID-19 patients, we absolutely need N95 masks at all times.
In case you don’t know what does intubation mean? Intubation is a procedure that is used when you are unable to breathe on your own. This process uses the tube which is inserted through your mouth down into the trachea (windpipe) to make it easier to get air into and out of your lungs.
Another way the virus is probably spreading is through asymptomatic carriers. So people who have the virus, but who have no symptoms and have no idea. I mean, it could be me. I wouldn’t know. In turn, you can spread it asymptomatically. In fact, one of the things that have become very evident with COVID-19 is that you can spread it through conversation.
You don’t need anybody to cough, you can just talk to someone. And this is passing into your airways and coming out into space. We also know that if you’re touching your nose and mouth and it’s there, I’m touching things now, I’m getting it on objects. You know I’m not coughing, I’m actually getting it there with my hands.
This is possibly why many hospitals are moving towards compulsory masking so that everyone wears a surgical mask. There are some interesting reports about surgical masks and Coronavirus. They took Coronavirus patients who were sick and they just made them lie down there and breathe.
They weren’t coughing and they didn’t talk. And therefore it turned out they scattered droplets and aerosols all around them. They took the same patients, put on a surgical mask and those patients did not spread the virus but again, they weren’t coughing.
Another study investigated patients wearing surgical masks, and yet they coughed. Indeed it turns out the virus had penetrated the mask and somehow got into the air. So that’s why physical distancing is really important to still do, even though people wear masks.
Social distancing is a non-pharmaceutical infection prevention and control technique introduced to prevent/decrease interaction between those infected with a pathogen-causing disease and those not infected, in order to avoid or slow down the rate and duration of transmission of disease in a population. This eventually leads to diminishing disease spread, morbidity, and mortality.
Okay, we do know it works. We’re seeing that the curve is flattening in many parts of the world. Yet in the hospital, it is very difficult to do. I wanna say like even in hospitals it’s hard to have social distancing. I don’t know if you have had the same experience. But you know, you’re at a nursing station, and for things, you have to reach out.
That is nearly impossible. You’re trying to wait for your turn but you’re never going to get anything done. And people have to converse with each other, consult each other. In the last couple of weeks, it has been a real struggle for the people out there. I totally agree that social distancing is a joke i.e. it isn’t real. It’s just not happening.
This article will get us to start thinking about how to better protect our health care providers. We know there will be pandemics in the future, so will we be better prepared next time? I think we should start thinking about it now.
Healthcare workers infected by COVID-19 globally
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