As if risking exposure to the COVID-19 coronavirus during the global pandemic wasn't enough, healthcare workers face another risk: burnout due to overstress in an increasingly burdened healthcare system.
Dr. James Adams of Northwestern University's Feinberg School of Medicine, and Dr. Ron Walls of Harvard Medical School, write in a new paper that the combination of stress and possible exposure puts healthcare professionals, from physicians, to nurses, to specialists, at greater risk of contracting COVID-19 and potentially spreading it to others.
It's the classic rock-and-a-hard-place scenario – healthcare workers and caregivers are desperately needed during the global response to the outbreak, but represent one of the most vulnerable populations in terms of contracting the highly virulent disease.
Adams and Walls used recent history as their guide. In China, where the novel coronavirus began, more than 3,000 healthcare workers have become infected; as of the paper's publication on March 12, 22 of those workers have died. Anecdotal evidence suggests these workers may have spread the virus to family members, even when they were asymptomatic, though hard data on that last point has yet to emerge.
WHAT'S THE IMPACT?
When it comes to transmission, the primary concern is surfaces that may be carrying the virus due to droplets or contact. Common-sense measures have so far been the most effective at limiting the risk this poses to healthcare workers, such as the use of personal protective equipment – gowns, gloves, N95 respirators with face shields or goggles, and air purifying respirators.
But this poses its own set of problems. As has been the case with testing kits in the U.S., personal protective equipment for health personnel has been in short supply, in some cases leading to price spikes for such items.
There are some workarounds, however. Adams and Walls cite a report that finds medical masks worn by both the patient and the caregiver provide roughly the same level of efficacy as N95 masks, although that study examined influenza specifically, not the coronavirus.
As ever, handwashing and environmental hygiene are critical and effective strategies for ameliorating the spread.
Because healthcare facilities can often be hectic, fast-paced environments, Adams and Walls suggest healthcare workers be quick to isolate any patient who exhibits symptoms of a respiratory illness, whether it's COVID-19 or not, and immediately put facemasks on patients upon their arrival. Providing hand hygiene and reminding the public of proper coughing etiquette can also be effective preventive measures.
Since those working in healthcare are at elevated risk of exposure, so too are their families, and to alleviate some of that fear and trepidation – and to reduce feelings of stress and burnout – Adams and Walls suggest that healthcare systems and facilities could provide such employees and their families priority access to testing, as well as treatment and vaccination whenever they become available. Providing adequate time off for personnel to care for their loved ones is another strategy they said could help to rebuild a sense of trust and control as the pandemic runs its course.
THE LARGER TREND
As of Monday morning, a Johns Hopkins University coronavirus tracker places the number of confirmed cases of COVID-19 in the U.S. at 3,813. That places the U.S. at 8th on the list of most-affected countries, behind China, Italy, Iran, Spain, South Korea, Germany and France.
Worldwide, there are close to 175,000 confirmed cases. Globally, there have been 6,705 deaths, while 77,657 people have made full recoveries.
On Friday, President Donald Trump declared the coronavirus a national emergency, freeing billions in funding for states and relaxing rules for providers and hospitals. In addition, He also announced a public and private partnership with retailers and labs to get more testing up and running to overcome shortages of test kits, and for individuals to get drive-up testing in the parking lots of Walmart and elsewhere.
Other retailers working with the Administration include Walgreens, CVS Health and Target.