Covid-19: risks to healthcare workers and their families
BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m3944 (Published 28 October 2020) Cite this as: BMJ 2020;371:m3944Read our latest coverage of the coronavirus outbreak
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Risk of hospital admission with covid-19 in healthcare workers and their households
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Dear Editor
The UK is the only country in the world where PPE guidance for staff working with Covid patients is just a Fluid resistant surgical mask, visor, apron and gloves. These masks do not stop you from inhaling droplets and your bare arms would be covered with droplets. In most other countries the recommendations include level 3 PPE. It is not the availability of PPE that is an issue, it is the flawed guidance.
Perhaps, Public Health England is answerable for the additional mortality and morbidity.
It is November now, we are still not changing our practices.
Competing interests: No competing interests
Dear Editor
If I were a healthcare worker I would pay heed to the large and rapidly growing body of evidence that a hormonal deficiency underlies the severity of Covid-19. Routine, daily correction of that deficiency provides a marked reduction in testing PCR-positive and severity. Then, were I to experience symptoms of C19 I would immediately boost my supplementation of 4000 IU pd vitamin D3 with a one-off oral bolus of 50,000 IU. If that failed to keep me out of ICU I would demand an oral bolus of preactivated pro-hormone (25(OH)D) according to that used with great success in Cordoba (a 25-fold benefit). This recent review summarises the evidence, which goes a long way towards satisfying the criteria of causation according to Sir Austin Bradford Hill. https://www.mdpi.com/2072-6643/12/11/3361/htm
We read that D3-deficiency is a global issue and and appears to be exploited by SARS-Cov-2 . Our failure globally to correct that deficiency offers this virus an open door. In that respect D3 supplementation is much more than merely an alternative to dexamethasone and other drugs or vaccines. Health care workers might care to avail themselves of a cheap and safe supplement that has a 500 million year history of refining our innate and adaptive immune defences through evolution.
Competing interests: No competing interests
Dear Editor
Motivated by Editorials published in BMJ by Ulf Karlsson and Carl-Johan Fraenkel, Covid-19: risks to healthcare workers and their families; We want to publish our considerations on the risk that Covid-19 represents for health workers and their families.
Physical distancing is essential and the correct use of personal protective equipment (PPE) are vital prevention measures in vulnerable people.
However, although it is true that physical distance is very important to avoid contagion, it is also important to understand that it is not an emotional isolation with those or those around us. Today more than ever the call is to the family to keep us together and healthy from all points of view.
United not only in the hygienic measures of the home, but also in sharing the activities of the home and maintaining ongoing communication processes. Maintain the so-called social isolation, but not the psychological or spiritual.
Ensuring the safety and health of healthcare staff and support staff (eg laundry, cleaning and medical waste disposal staff) is of the utmost importance.
Information on disease transmission should be disseminated as widely and rapidly as possible to health workers, including information on the most up-to-date guidelines, measures to prevent contagion, and how to apply them. Dialogue between health workers and employers is crucial for the measures and procedures to be applied correctly.
It is crucial that they have personal protective equipment, and instructions and training on how to use it correctly. In addition, testing for Covid-19 infection should be as widely available as possible to preserve the health of staff and patient safety.
In emergency situations, health personnel have to work in irregular and sometimes atypical situations. As part of the response to the outbreak, many of these staff are facing an immense additional workload, long hours of work, and lack of rest periods.
ppropriate arrangements should be made regarding working hours, so that health workers can balance the demands of the health service with their domestic care responsibilities and their own well-being.
Covid-19 has exposed healthcare workers and their families to unprecedented levels of risk. Although not representative, data from many countries in all WHO regions indicate that the number of Covid-19 virus infections among healthcare workers is much higher than among the general population.
Although healthcare workers make up less than 3% of the population in the vast majority of countries and less than 2% in nearly all low- and middle-income countries, about 14% of Covid-19 cases reported to WHO correspond to health workers.
n addition to the physical risks, the pandemic has placed extraordinary levels of psychological stress on healthcare workers exposed to high-demand environments for long hours, who live in constant fear of being exposed to disease while separated from their families and they face social stigmatization.
References
1. Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., & Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain, behavior, and immunity, S0889-1591(20)30845-X. Publicación anticipada en línea. https://doi.org/10.1016/j.bbi.2020.05.026
2. Koh D. Occupational risks for COVID-19 infection. Occupational Medicine. 2020 [acceso: 30/10/2020];70(1):3. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7107962/
3. Baylina P, Barros C, Fonte C, Alves S, Rocha A. Healthcare Workers: Occupational Health Promotion and Patient Safety. Journal of Medical Systems 2018 [acceso: 30/10/2020];42:159. Disponible en: https://link.springer.com/article/10.1007/s10916-018-1013-7
4. Sim MR. The COVID-19 pandemic: major risks to healthcare and other workers on the front line. Occup Environ Med. 2020 [acceso: 30/10/2020];77(5):281-2. Disponible en: https://oem.bmj.com/content/77/5/281
5. Bowdle A, Munoz-Price S. Preventing infection of patients and healthcare workers should be the new normal in the era of novel coronavirus epidemics. Anesthesiology. 2020 [acceso: 30/10/2020]. Disponible en: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2763452
6. Zhang Z, Liu S, Xiang M, Li S, Zhao D, Huang C, et al. Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions. Front Med. 2020 [acceso: 30/10/2020]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7095352/
7. Burdorf A, Porru F, Rugulies R. The COVID-19 (Coronavirus) pandemic: consequences for occupational health. Scand J Work Environ Health Online. 2020 [acceso: 30/10/2020]. Disponible en: https://www.sjweh.fi/show_abstract.php?abstract_id=3893
8. Pimentel ASG, Silva MNRMO. Psychic Health in Times of Corona Virus. Research, Society and Development 2020 [acceso: 30/10/2020];9(7):e11973602. Disponible en: https://rsd.unifei.edu.br/index.php/rsd/article/view/3602/2807
9. Fisher D, Heymann D. Q&A: The novel coronavirus outbreak causing COVID-19. BMC Med. 2020 [acceso: 30/10/2020];18(1):57. Disponible en: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-020-01533-w https://doi.org/10.1186/s12916-020-01533-w
Competing interests: No competing interests
Re: Covid-19: risks to healthcare workers and their families
Dear Editor
Might I ask what are the responsibilities of health or social care workers and the companies which employ them, for ensuring that they all have been immunised? If they have not been immunised, and I catch the virus from, is either the individual or the company legally responsible and liable for damages and claims for compensation?
Yours faithfully
Brian E Dempsey 16th January 2021
Competing interests: No competing interests