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Author: Brian May
Romelia is shown here being comforted by a nurse Michele. Romelia is sitting at her dying husband's bedside.
Source: Jae C. Hong, 2020, Associated Press via Atlantic
As of December 2nd, 2020, at least 1,425 healthcare workers in the U.S. have died in the fight against COVID-19
As of December 2nd, 2020, at least 1,425 healthcare workers in the U.S. have died in the fight against COVID-19
Source: The Guardian, 2020
Introduction
Introduction
All workers have a right to a safe and healthy work environment. For the individuals that work in health care settings, occupational health is kept to a high standard. Our health care system must follow strict regulations to ensure the health and safety of both themselves and the communities they serve. Reducing the spread of infectious disease is a vital component of occupational health, especially within health care environments. Given that COVID-19 has disrupted almost every aspect of our daily lives, the occupational experience of our health care providers is no exception.
Since the beginning of the COVID-19 pandemic, health care providers are experiencing unforeseen rates of both illness and death.
Confirmed Deaths - State
Source: The Guardian, 2020
As of December 2nd, 2020, at least 1,425 healthcare workers in the U.S. have died in the fight against COVID-19.
As of December 2nd, 2020, at least 1,425 healthcare workers in the U.S. have died in the fight against COVID-19.
The figures to the left and directly below are from The Guardian's profiling of 278 individuals that have lost their lives to COVID-19.
The figures to the left and directly below are from The Guardian's profiling of 278 individuals that have lost their lives to COVID-19.
As of December 2nd, 2020:
172 of 278, or 62%, were people of color
32% reported that they were concerned about insufficient personal protective equipment (PPE)
35% were nurses
Almost 30% were from outside the United States
Source: The Guardian, 2020
Confirmed Deaths - Occupation
Source: The Guardian, 2020
Confirmed Deaths - Race & Ethnicity
Source: The Guardian, 2020
Health care workers are at a higher risk of contracting COVID-19. Barrett et al. (2020) observed at least a 7% greater risk for health care workers when compared to non-health care workers.
Health care workers are at a higher risk of contracting COVID-19. Barrett et al. (2020) observed at least a 7% greater risk for health care workers when compared to non-health care workers.
When comparing health care providers working in COVID-19 wards to providers in other settings, it has been found that the former experience higher rates of both depressive symptoms and post-traumatic stress symptoms (Tella et al., 2020).
When comparing health care providers working in COVID-19 wards to providers in other settings, it has been found that the former experience higher rates of both depressive symptoms and post-traumatic stress symptoms (Tella et al., 2020).
In an open-ended survey of 455 nurses on experienced stress, 6 major themes emerged. New COVID-19-related stressors included:
The workplace - 51%
Illness and death of others - 39%
Exposure to or infection with COVID-19 - 30%
Associated unknowns of the pandemic - 23%
Lack of enough or appropriate PPE - 22%
The politicization and perceived administrative failures regarding COVID-19 - 10%
Source: Arnetz et al., 2020
Source: Pixabay
Transmission
Transmission
Source: Pixabay
There is also evidence of the virus spreading to surfaces via air transmission. Surfaces out of reach by both patients and health workers in a COVID-19 ward unit tested positive for the virus after 72 hours (Orenes-Piñero et al., 2021).
Even though there is current debate about the specific manner in which COVID-19 is transmitted through the air, there is evidence of COVID-19 presenting on surfaces and in the air.
Even though there is current debate about the specific manner in which COVID-19 is transmitted through the air, there is evidence of COVID-19 presenting on surfaces and in the air.
Surface and air samples tested positive for SARS-CoV-2 in both fully contaminated and semi-contaminated COVID-19 wards. The contamination rates of various measured surfaces are:
Hand sanitizer dispensers - 100%
Touch screens on medical equipment - 50%
Medical equipment itself - 50%
Medical equipment shelves - 40%
Bed rails - 33.3%
Door handles - 25%
Source: Razzini et al., 2020
It has been found recently that COVID-19 transmission to health care workers is associated with medical procedures that are considered lower-risk and exposures in the community (Lentz et al., 2020).
It has been found recently that COVID-19 transmission to health care workers is associated with medical procedures that are considered lower-risk and exposures in the community (Lentz et al., 2020).
Current and Future Solutions
Current and Future Solutions
PPE
PPE
There is evident need for proper PPE to reduce the transmission of COVID-19 from infected persons to their providers.
There is evident need for proper PPE to reduce the transmission of COVID-19 from infected persons to their providers.
However, in a survey of 2,711 health care workers, it was found that 52% of the sample was missing at least one piece of the standard PPE set and that 30% reused a single-use item (Tabah et al., 2020).
However, in a survey of 2,711 health care workers, it was found that 52% of the sample was missing at least one piece of the standard PPE set and that 30% reused a single-use item (Tabah et al., 2020).
Source: Pixabay
During the treatment of patients with COVID-19, it is important that health care providers wear a full PPE set during both aerosol-generating and "lower risk" non-aerosol-generating procedures.
A proper PPE set includes:
At least a N95/FFP3 mask with or without a surgical mask
Eye protection (goggles, face shield, etc.)
Gloves
Gown
Source: Pandian et al., 2020
Source: Pixabay
The Responsibilities of our Health Care Leaders
The Responsibilities of our Health Care Leaders
Resource limitations need to be addressed on multiple levels:
Resource limitations need to be addressed on multiple levels:
Planning for the challenges associated with a crisis and reaching capacity
Acquiring enough PPE and establishing other protective measures
Addressing any new barriers to delivery of care as they arise
Source: Butler et al., 2020
For an example of the challenges at one institution, in an article on November 24th, 2020, Ian Kullgren (2020) stated that over 100 physician assistants, doctors, and nurses walked out of their jobs in Washington state that week. They accuse their employer of declining to lessen 12-hour shift times or providing PPE.
For an example of the challenges at one institution, in an article on November 24th, 2020, Ian Kullgren (2020) stated that over 100 physician assistants, doctors, and nurses walked out of their jobs in Washington state that week. They accuse their employer of declining to lessen 12-hour shift times or providing PPE.
In addition to PPE, there are additional steps that may help protect our health care workers
In addition to PPE, there are additional steps that may help protect our health care workers
Health care environments adhering to strict guidelines for the continuous sanitation of all surfaces and attaining excellent levels of air filtration and ventilation.
Staying home as much as possible and exercising social distancing to help reduce the community spread of COVID-19.
Providing mental health support services, at little or no cost, to address the new emotional burden and stressors that COVID-19 has placed upon our health care providers.
It is time for our leaders and society to step up to the plate and protect the individuals that dedicate their lives to saving ours.
It is time for our leaders and society to step up to the plate and protect the individuals that dedicate their lives to saving ours.
Video Summary
Video Summary
4:51m video; Script
Disclaimer: The Guardian regularly updates its data on this topic. Please follow the link in the References section for the latest.
References
References
Arnetz, J. E., Goetz, C. M., Arnetz, B. B., & Arble, E. (2020). Nurse Reports of Stressful Situations during the COVID-19 Pandemic:
Qualitative Analysis of Survey Responses. International Journal of Environmental Research and Public Health, 17(21), 8126.
doi:10.3390/ijerph17218126
Barrett, E. S., Horton, D. B., Roy, J., Gennaro, M. L., Brooks, A., Tischfield, J., . . . Panettieri, R. A. (2020). Prevalence of SARS-CoV-2
infection in previously undiagnosed health care workers in New Jersey, at the onset of the U.S. COVID-19 pandemic. BMC Infectious
Diseases, 20(1). doi:10.1186/s12879-020-05587-2
Butler, C. R., Wong, S. P., Wightman, A. G., & O’Hare, A. M. (2020). US Clinicians’ Experiences and Perspectives on Resource Limitation
and Patient Care During the COVID-19 Pandemic. JAMA Network Open, 3(11). doi:10.1001/jamanetworkopen.2020.27315
Kullgren, I. (2020, November 24). Health-Care Workers Turning to Strikes as Covid-19 Surges Again. Bloomberg Law: Daily Labor Report.
Retrieved from https://news.bloomberglaw.com/daily-labor-report/health-care-workers-turning-to-strikes-as-covid-19-surges-again
Lentz, R. J., Colt, H., Chen, H., Cordovilla, R., Popevic, S., Tahura, S., . . . Maldonado, F. (2020). Assessing coronavirus disease 2019
(COVID-19) transmission to healthcare personnel: The global ACT-HCP case-control study. Infection Control & Hospital Epidemiology,
1-7. doi:10.1017/ice.2020.455
Orenes-Piñero, E., Baño, F., Navas-Carrillo, D., Moreno-Docón, A., Marín, J. M., Misiego, R., & Ramírez, P. (2021). Evidences of SARS-CoV-2
virus air transmission indoors using several untouched surfaces: A pilot study. Science of The Total Environment, 751, 142317.
doi:10.1016/j.scitotenv.2020.142317
Pandian, V., Morris, L. L., Brodsky, M. B., Lynch, J., Walsh, B., Rushton, C., . . . Brenner, M. J. (2020). Critical Care Guidance for
Tracheostomy Care During the COVID-19 Pandemic: A Global, Multidisciplinary Approach. American Journal of Critical Care, 29(6).
doi:10.4037/ajcc2020561
Razzini, K., Castrica, M., Menchetti, L., Maggi, L., Negroni, L., Orfeo, N. V., . . . Balzaretti, C. M. (2020). SARS-CoV-2 RNA detection in the air
and on surfaces in the COVID-19 ward of a hospital in Milan, Italy. Science of The Total Environment, 742, 140540.
doi:10.1016/j.scitotenv.2020.140540
Tabah, A., Ramanan, M., Laupland, K. B., Buetti, N., Cortegiani, A., Mellinghoff, J., . . . Waele, J. J. (2020). Personal protective equipment
and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey. Journal of Critical Care, 59,
70-75. doi:10.1016/j.jcrc.2020.06.005
Tella, M. D., Romeo, A., Benfante, A., & Castelli, L. (2020). Mental health of healthcare workers during the COVID ‐19 pandemic in Italy.
Journal of Evaluation in Clinical Practice, 26(6), 1583-1587. doi:10.1111/jep.13444
The Guardian. (2020, November 20). Lost on the frontline: US healthcare workers who died fighting Covid-19. Retrieved December 6,
2020, from https://www.theguardian.com/us-news/ng-interactive/2020/aug/11/lost-on-the-frontline-covid-19-coronavirus-us-healthcare-workers-deaths-database
Brian May
MPH 2022 Health Promotion, OHSU-PSU School of Public Health
Page last updated on Dec. 6th, 2020
MPH 2022 Health Promotion, OHSU-PSU School of Public Health
Page last updated on Dec. 6th, 2020
Page updated
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