Why healthcare workers should be our last line of defence against COVID-19, not first

Everyone must have understood by now how the deadly novel coronavirus (SARS-CoV-2) originated, spread in Wuhan and then to the rest of the world.

Apart from the economic impact and the humanitarian crisis unleashed by this pandemic, the other important problem that it has given rise to is the risk it poses to frontline health workers, now often described as ‘corona warriors’.

The lay person gets the disease through fomite transmission, (where a patient touches the surface and another person comes in contact with it) or through droplet spread, where the viral load is comparatively less. However, when a treating health care worker (HCW) gets the disease, he or she stands to get it directly from a COVID-19 patient. Here the initial viral load is so high that the severity of the disease and fatality rates are much higher than those among the general population. There are many reasons why a HCW could get infected – lack of adequate Personal Protective Equipment (PPE), treating undetected, asymptomatic people who may have reported for an unrelated illness and the use of equipment that is way beyond its usage limit among others.

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Let us look at the number of cases in other countries (where the numbers are quite reliable) as far as HCWs go. The latest figures show that healthcare workers make up about 9 per cent of Italy’s COVID-19 cases. In Spain, reports peg between 12-14 per cent of infected cases as those of HCWs. They might not make up a huge chunk of the general population, but the number of cases and the fatalities among HCWs paints a grim picture.

Let us understand one thing: It’s not just HCWs, but lay people who are or should be the frontline warriors in the fight against COVID-19. The onus is on them to avoid contracting the infection and spreading it to others. If common people treat themselves as the frontline defence, then not only do they help themselves and others but also the health system, including HCWs, making sure that those in need actually get the treatment.
Read: Coronavirus India update: State-wise total number of confirmed cases, deaths

Here is why common people need to think of HCWs not as the first line of defense, but as the last one. If any HCW gets exposed to the virus they need to be quarantined till they test negative for the disease (fourteen days). In case they are infected, in any case, they will be out of circulation for the period of time it takes for treatment. That means till they return the workforce in health units stands depleted. For instance an anesthetist, intensivist and ICU staff are basically irreplaceable, as these are the people who can take a sick person out of his or her deathbed. Even if there are ICUs and ventilators and patients on them, there will be no one to handle them. It is like an army, which can afford to lose an aircraft but not a pilot.

Moreover, every time a HCW gets affected, the workload on the already tired staff mounts. On top of all this, in India we also have a special problem – handling of unruly attenders i.e. those who accompany patients. India cannot afford to let this happen especially now when we need every hand on the deck to tackle the health emergency facing us all.

A HCW is always ready to work again after the quarantine/ illness gets over. But if an infected HCW continues to work they may be the reason for the spread of the infection to other people, including their loved ones. If they happen to infect an elderly person in the family, the virus can wreak havoc in that family, both in terms of emotion and health.

What needs to be done is to get more and more of personal protection kits to healthcare professionals – doctors, nurses, lab technicians, housekeeping staff and those who take care of biomedical waste. This is key because there should be no fear of infection among them while working.

Let's not take this pandemic lightly. Here is what is incumbent on each citizen: Follow practices such as social distancing, hand hygiene, staying at home; don’t hide travel history; and report to the nearest facility where a sick person can be handled in case of symptoms. By practicing all this, common people automatically become frontline warriors, helping everyone in winning the war against coronavirus.

(Dr Manjunath Sharma is a Bengaluru-based paediatrician)

The views expressed above are the author’s own. They do not necessarily reflect the views of DH.