June 24, 2020—As health care workers of the world risk their lives on the frontlines of the COVID-19 response, their consistently elevated rates of infection suggest that countries are not doing enough to limit their risk. In “Assessing and Reducing Risk to Health Care Workers in Outbreaks,” a new paper published in the journal Health Security, a team of global health researchers and practitioners cite alarming evidence of insufficient protections for health care workers— in the early stages of the COVID-19 pandemic in the United States, health care workers accounted for nearly one in five reported cases—and identify three practical steps countries can take now to improve health care worker safety. They include: prioritizing health care worker protection in global assessments of epidemic preparedness, developing protocols to rapidly evaluate protections in health facilities, and prioritizing access to personal protective equipment and treatment.
“Without health care workers, there is no health care,” said Amanda McClelland, registered nurse and Senior Vice President of the Prevent Epidemics program at Resolve to Save Lives, an initiative of Vital Strategies. “COVID-19 has confirmed that health care workers, who are on the front lines when it comes to stopping epidemics, are still among the most vulnerable. This jeopardizes global health security and weakens our ability to respond to future epidemics.”
Health care workers are put at elevated risk by deficiencies in health facility infrastructure (e.g. a lack of running water and electricity, or acceptable isolation wards); supplies (e.g. personal protective equipment and cleaning supplies); training; and preparedness measures.
“Governments and international organizations should treat health care workers like the scarce resource they are,” said Colby Wilkason, a Technical Advisor at Resolve to Save Lives and the paper’s lead author. “Losing health care workers should not be accepted as a tragic inevitability when investment in basic protections can save their lives as well as the people they care for.”
In studies of recent outbreaks of Ebola and Middle Eastern Respiratory Syndrome, a significant number of total cases were acquired in hospitals or other health care settings. Another concern is that infections among health care workers can lead to superspreading events in health facilities. One study of COVID-19 showed that up to 41% of patients in a hospital were infected due to transmission that occurred within the facility.
To better protect health care workers from infection and strengthen global capacity to respond to COVID-19 and future outbreaks, the paper’s authors recommend:
- Grading countries on their standards for the safe delivery of health care by integrating it into the way their epidemic preparedness is evaluated
- Developing protocols for countries to rapidly evaluate the preparedness of individual health facilities
- Prioritizing health care workers’ access to personal protective equipment and other preventive and treatments as they become available
Health care worker risk also has a ripple effect on population health. Fewer health care workers on the job due to illness or death, especially in places where they are already scarce, also deters patients from seeking care. One study estimated that the loss of health care workers to Ebola in West Africa in 2014-15 resulted in an additional 4,022 women dying in childbirth each subsequent year in the three most affected countries.
Erin Sykes, Resolve to Save Lives: [email protected]; +1.646.612.0001
Christina Honeysett, Vital Strategies: [email protected]; +1.914.424.3356
About Resolve to Save Lives
Resolve to Save Lives, an initiative of the global health organization, Vital Strategies, is a five-year, $225 million initiative funded by Bloomberg Philanthropies, the Bill & Melinda Gates Foundation, and Gates Philanthropy Partners, which is funded with support from the Chan Zuckerberg Foundation. Resolve received additional funding from Bloomberg Philanthropies, the CDC Foundation and the Stavros Niarchos Foundation for the COVID-19 response. It is led by Dr. Tom Frieden, former director of the US Centers for Disease Control and Prevention, To find out more visit: https://www.resolvetosavelives.org or Twitter @ResolveTSL
Resolve to Save Lives created a website called PreventEpidemics.org that shows how prepared each country is for an epidemic. This site is also a resource for current coronavirus statistics and resources.
About Vital Strategies
Vital Strategies is a global health organization that believes every person should be protected by a strong public health system. We work with governments and civil society in more than 70 countries to design and implement evidence-based strategies that tackle their most pressing public health problems. Our goal is to see governments adopt promising interventions at scale as rapidly as possible. To find out more, please visit www.vitalstrategies.org or Twitter @VitalStrat.