We need to protect our health workers and find a way to fix this serious gap in personal protection equipment in the UK.
The survey was open over the Easter Bank Holiday weekend – from Friday 10 April until Monday 13 April 2020.
Dr Nisreen Alwan tweets :
This language of heroism & self-sacrifice around healthcare workers who died of #COVID19 is not helpful & shifts responsibility. These people had a job to do that they couldn’t quit. They’re victims of an occupational hazard & should’ve been protected. They didn’t want to die
Text: 30% of COVID-19 nurses don’t have enough eye or face protection
another 28% are concerned for their next shift
Text: 4% of NHS nurses use home-made eye or face protection
7% use equipment they bought themselves
Text: 54% of NHS COVID19 nurses have had no training on how to don, doff and dispose of personal protection equipment.
If you are a nurse in the UK and haven’t had instruction, the WHO have online training materials on the Open WHO platform.
The platform is here: COVID-19
Nurses may be especially at risk because they are likely to have a higher initial viral load.
The WHO mentioned that - with Ebola and SARS severity depended on how much they were exposed to initially. This is an example for SARS. Research in progress for #COVID19
The red, green, yellow and blue curves corresponds to the amount of viral load when the patient is first admitted before any treatment, on average 3.9 days after onset of symptoms - the samples were taken from the nasopharynx (which connects the nose to the mouth).
For the red curve the amount was undetectable and none of them died. For a high initial load, 40% died.
I will add summaries in more direct form to help autistic readers.
ES My question is for Dr Tedros. You spoke about it a bit but I want to ask you for a further comment. In Bosnia-Herzegovina we lost one of the leading experts in this field, who passed away and he worked with WHO. That's a very hard situation. Dr Sefik Pasagic has passed away and we have conflicting information here on why he has passed. He was infected at home and that's a very hard situation and we hear from other medical doctors and nurses and workers around the world.
So what can they do to prevent situations like this in the future and also what can we do to increase money for research which is necessary at the moment? We know that many countries are talking about that. Thank you so much.
Summary: Bosnia-Herzegovina lost one of the leading epidemiologists to COVID-19 (Epidemiologist's COVID-19 Death Raises Concern in Bosnia). He was infected at home.
What can they do to prevent this in the future? Also what can we do to increase money for research?
MRI think it's always been true and it's more true than ever in this response that front-line health workers have always been unfortunately the mine-canaries in epidemic response, particularly in systems that don't have strong surveillance systems. The number of times in my career where the death of a health worker was actually the event that triggered the epidemic response; too many times in my career that has been the tragic stimulus to action.
We owe a huge debt to our front-line health workers and they ask for nothing more than the training and the protective gear to do their jobs. We need to ensure that they get that. We also need to ensure for the future that surveillance systems are in place, that we're able to prevent infection spreading in hospitals. Again, as we're dealing with the ongoing situation in Congo, at one point during the outbreak of Ebola in Benin in one of the most intense periods in the outbreak nearly 70% of the cases were actually being transmitted within the healthcare system.
Summary: Tragically front-line health workers have always unfortunately been the mine-canaries in epidemic response [the ones that get hit first]
They ask for nothing more than training and protective gear to do their jobs.
At one point with the Ebola outbreak in the Congo, nearly 70% of the cases were transmitted within the healthcare system.
So it shouldn't be a surprise to us with MERS, with SARS, with Ebola that the healthcare environment is an environment in which people can be saved and treated but it is also an environment in which viruses and other things are present and we need to protect patients and we need to protect those health workers.
With MARS, SERS and Ebola then the healthcare environment is one where people can be saved and teated, but also one where viruses and other things are present.
We need to protect those health workers
It takes a long time to build a health workforce and it should not be sacrificed to any virus and it should be protected and especially in countries that have invested precious development funds in building a health workforce which is central and vital to the health system. A health system is not bricks and mortar, a health system is not technology and infrastructure; that's part of it.
A health workforce should not be sacrificed to any virus. It takes a long time to build a health workforce and it should be protected. Especially, it should be protected in countries that have invested precious development funds to build it up.
A health workforce is central to a health system and vital to it. It is not bricks and mortar or technology and infrasructure, that’s parrt of it.
The heart of a health system is the health workers and everybody knows that. We do have a short-term objective now and that is to get the best possible protection for those workers and all of us have a responsibility in that but also for the long term we have to learn the lesson. We can no longer leave healthcare systems exposed to infectious disease and without the protection of the capacity to manage those and that's going to be a big discussion that needs to happen and, I believe, should happen before this epidemic ends.
This is a short term objective but also a long term one. We can no longer leave healthcare systems exposed to infectious disease.
This is a big discussion that needs to happen - and I believe this discussion needs to happen before this epidemic ends.
But the Director-General may have a comment to make on this because he's involved in much discussion on this with our G20 partners and others on how we strengthen the system and never let this happen again.
MK Just to add, in addition to the personal protective gear that we must provide to our front-line workers and masks, medical masks and respirators, gloves, gowns, we must train our healthcare workers. What we've seen from the recent studies that have been published on healthcare worker infections -we're very grateful to see evidence around this.
We must provide personal protection gear, masks, medical masks and respirators, gloves, gowns
We must also train our healthcare workers
I first should say sorry for the loss that you mentioned. What we must do is we must train our healthcare workers for respiratory diseases, for infectious diseases because what we've seen in some initial cases of healthcare worker infections they've been infected in different wards where they're not used to infectious diseases.
We must train our healthcare workers for respiratory diseases and infectious diseases.
We have seen cases of healthcare workers where they have been infected becaue they’re not used to infectious diseases and working in a different ward.
They may be long-term care wards for older individua ls and so they just don't have the training and right now with COVID-19 circling the globe all healthcare workers must know about this virus. They must know how this is transmitted and they must know how to protect themselves. We have trainings that we put up on our Open WHO platform which are interactive which can teach healthcare workers about what this virus is, how it's transmitted and how they can protect themselves and not only what needs to be worn but how to put the materials on, how to put the PPE on, how to take the PPE off safely.
For COVID19, our workers must know about this disease, how it is transmitted, and how to protect themselves, and not only what needs to be worn but how to put the PPE on and take it off safely [Personal Protection Equipment].
We have training materials on the Open WHO platform.
The platform is here: COVID-19
We must also find ways in which we can provide psychosocial support to our healthcare workers and our front-line workers because this is a very difficult position that all of them are put in now or will be put in in countries that have not yet seen large numbers of cases. We need to find ways in which we can provide some rest periods for them so that they don't have very long or too-long extended shifts and they have ample time to rest because when fatigue sets in it's possible that maybe the personal protective equipment isn't taken off properly and that's not to blame the healthcare worker
We must also provide psychosocial support.
We need to find ways to provide rest periods, make sure they don’t have extended shifts that are too long, and have ample time to rest.
When fatigue sets in that’s when it is possible they don’t take the personal protective equipment off poperly. That’s not to blame the health worker.
So there are things that we can put in place and right now we have tools available to train every healthcare worker on the planet and that is something that we look forward to working with all of our member states through our regional offices... to do this training so that they can be better prepared to protect themselves against infection and provide the best care that they can for all patients with COVID-19.
So these are things we can do right now.
We have tools available to train every healthcare worker on the planet.
TAG Just one thing I would like to say; countries who relatively have the strongest health systems have been actually surprised by this pandemic. It shows that any system could have gaps and we should have the humility to see to what extent our system is prepared and where are the gaps and how can we improve it for the future.
Countries with the strongest healthcare systems have been surprised by this pandemic.
We should have the humility to see to what extent our system is prepared and where the gaps are and how to improve it for the future.
I think from this pandemic we have to try to learn, focus on learning what the gaps are. This is not a message only for the developing world. This is a message even for the developed countries. Across the board you see lack of preparedness of the public health system and of course the whole health system and that's why WHO has been advocating for universal health coverage, health for all, strong health systems and with a strong foundation of primary healthcare and within that strong preparedness, especially in public health to prevent outbreaks.
It’s not a message only for the developing world. Across the board you see a lack of preparedness of the public health system and the whole health system.
That’s why WHO has been advocating for universal health coverage, strong health systems and a strong foundation of primary healthcare.
Within that we need to have strong preparedness especially in public health to prevent outbreaks.
That's the best option and if it happens, to diagnose early and respond quickly and arrest it as quickly as possible. But we can see now through this pandemic there is a serious challenge or vulnerability even in countries who claim to have the strongest health systems. I think this should bring humility to all our countries to see and assess the situation carefully, understand the gaps carefully and understand the importance of health for all.
We can see a serious challenge or vulnerability even in countries who claim to have the strongest health systems.
This should bring humility to all countries, to see and assess the situation carefully and understand the gaps and importance of health for all.
We should not go into the cycle of panic and neglect. As you all know, we're now in a phase of panic because there is this dangerous, invisible virus which is wreaking havoc and there is panic and there is concern but that should actually lead into asking questions on what to do to strengthen our system and to improve or reduce the vulnerabilities that we have.
We are now in a phase of panic, but this should lead into asking questions on what to do to strengthen our system and improve or reduce vulnerabilities.
So the risk which is coming to our health professionals is because of weak health systems. The reason why we're not detecting or preventing the outbreak easily or quickly is because of weak health systems, because of serious vulnerabilities and from what we have seen now, no country is immune, no country can claim that it has a strong public health system or a strong health system.
The reason we have risk to our health professionals is because we have weak health systems.
The reason we are not detecting or preventing the outbreak easily or quickly is again because of weak health systems.
So we have to really be honest and assess and address this problem to provide better services to our people but at the same time to protect our health profession.
So we have to be honest and address this problem, both to provide better services to our people and to protect our health profession.
WHO COVID-19 10th April - welcome slowing down in some European countries, Africa of concern - care easing lockdown - infected health workers - and World Food Program shipments of medical equipment and supplies