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 Table of Contents  
REVIEW ARTICLE
Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 75-77

COVID-19 infection risk in pakistani health-care workers: The cost-effective safety measures for developing countries


1 Department of Genetics, VA Hospital Stanford University, Palo Alto, CA, United States
2 Department of Public Health and Informatics, Jahangirnagar University; Undergraduate Research Organization, Dhaka, Bangladesh
3 Undergraduate Research Organization, Dhaka, Bangladesh; Department of Internal Medicine, Kabir Medical College, Gandhara University, Peshawar, Pakistan

Date of Submission13-May-2020
Date of Decision14-Jun-2020
Date of Acceptance20-Jun-2020
Date of Web Publication27-Jul-2020

Correspondence Address:
Mohammed A Mamun
Undergraduate Research Organization, Gerua Road, Savar, Dhaka 1342
Bangladesh
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/SHB.SHB_26_20

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  Abstract 


To combat the massive COVID-19 infection rates, the health-care workers (HCWs) are likely to work for long hours under substantial pressures, along with the infection risk. The consequence is that the HCWs become progressively hesitant to their works and psychologically impaired. In developing countries such as Pakistan, the health-care facilities are limited; hence, the HCWs safety measures are a great concern. Thus, these country needs a cost-effective strategy focusing on sympathetic discussions, that can be beneficial to reduce the psychological sufferings by ensuring the protection of the HCWs to facilitate proper services in combating with the COVID-19 crisis– which is provided in this commentary.

Keywords: Coronavirus, COVID-19, healthcare, health-care professionals, safety guidelines, safety measures


How to cite this article:
Usman N, Mamun MA, Ullah I. COVID-19 infection risk in pakistani health-care workers: The cost-effective safety measures for developing countries. Soc Health Behav 2020;3:75-7

How to cite this URL:
Usman N, Mamun MA, Ullah I. COVID-19 infection risk in pakistani health-care workers: The cost-effective safety measures for developing countries. Soc Health Behav [serial online] 2020 [cited 2020 Nov 24];3:75-7. Available from: https://www.shbonweb.com/text.asp?2020/3/3/75/290975




  Introduction Top


On December 31, 2019, the Novel Coronavirus (also known as 2019nCoV) was first introduced in the Wuhan City Hubei Province, China.[1] Its' infection (known as COVID-19) as was initially rumored to be associated with the seafood exposures even though, recent epidemiologic data specify 2019-nCoV person-to-person transmission, and it was transmitted throughout the entire world within a month of the first documentation.[1],[2] As of May 12, 2020, the virus affected more than 210 countries and territories around the world, with a total of 4,088,848 cases and 283,153 deaths.[3] In February 2020, the first COVID-19 case was confirmed in Pakistan and as per May 12, 2020, the total number of confirmed cases is 34,336 and 737 deaths.[4]

The COVID-19 pandemic disrupted all aspects of human life (i.e., social, physical, and psychological), even though it led to suicide completions.[5],[6],[7],[8],[9] With the massive transmission rates, the healthcare systems are drained worldwide. To combat with COVID-19, the health-care workers (HCWs) are likely to work for long hours under substantial pressures. Besides, HCWs are at risk, both to disease infection and vulnerable to rumors and wrong information that is responsible for elevating their psychological issues such as anxiety, fear, depression, and stress.[10] Their exposures to infected patients by close contact caring, is concerned for their family transmission, especially among these who are immunosuppressed, elderly, and have chronic medical situations.[11] It will take months for the development of a vaccine and research to find out the proper medical treatment for COVID-19 patients. Meanwhile, HCWs are under extreme psychological pressures that were likely reported in the previous pandemics too (for instance, that were peaked in SARS 2002 in response to cases of HCWs dying or falling ill[12]). The consequence is that the HCWs become progressively hesitant to their works and psychologically impaired.


  Using the Us Data to Interpret Pakistan's Health-Care Worker Difficulties Top


Based on the US data (February 12–April 9, 2020), about 9282 HCWs have been confirmed with COVID-19 infection; About 73% were females, the median age was 42 years [Table 1].[13] This first world country scenario resembles the fact, i.e., protection and safety of the HCWs in developing countries such as Pakistan are arguably life-threatening. Because, the developing countries have a hard time in buying safety equipment as of lockdown-related economic crisis and fallout, and COVID19 cases increasement opposing to the limited health-care resources. However, at present, Pakistan is also facing a shortage of masks, gloves, and gowns which are bringing challenges for those who are working on the frontlines to combat with COVID-19. Few days before the first COVID-19 case was reported in the country, the drug regulatory authority, a legal frame that controls drugs, and medical equipment permitted the exportation of personal protective equipment (PPE), including 10,000 N-95 masks with a PKR 2.98 million (USD 18,500) profits,[14] which clearly figures the worst situation for the Pakistani HCWs. Thus, the country needs a cost-effective strategy focusing on sympathetic discussions, that can be beneficial to reduce the psychological sufferings by ensuring the protection of the HCWs to facilitate proper services in combating with the COVID-19 crisis.[15]
Table 1: Hospitalizations, intensive care unit admissions, and deaths of the health-care workers with COVID-19 - United States, February 12-April 9, 2020[13]

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  Potential Strategies for Health-Care Worker Top


First, the precedence assurance in receiving a vaccination, testing, and treatment by the HCWs family members while these are available is urgent. This will enhance HCWs availability and confidence in service, but the priority of family advisability is not yet determined. Hence, ensuring front-line caregivers about the worries of the virus transmitting to family members, should be addressed as soon as possible.[11] Second, the point of discussion might be focused on safety arrangements for their homes such as separate bathrooms and a living area, and when it should be applied and instructions to follow after arriving home from hospital with the benefits of taking off shoes, removing and washing clothing, and straight showering. These are all safety protocols, but the evidence is uncertain, but they may be functional, other protocol includes changing clothing to hospital supplied scrubs and before leaving the hospital changing back to personal clothes before going home. The emphasis should be on clear management when recommendations happen, efforts to diminish misinformation, efforts to minimize anxiety, and sympathetic conversations.[16] Third, both the Centres for Disease Control and Prevention (CDC) and the World Health Organization (WHO) rules equally in highlighting the importance of firm hand hygiene in restricting of COVID-19 transmission. It is suggested to use at least surgical masks wherever they are caring for the suspected (or nonsuspected) COVID19 patients who have traveled (or not) to a high-risk area and while HCWs performing aerosol creating procedures such as non-invasive ventilation or bronchoscopy they should use N-95 respirator.[17] Besides with N-95 filtering facepiece respirator, other PPEs such as gloves, shoe covers, head covers, eye protection, face shields, goggles, and gowns, etc. in the healthcare settings to protect the HCWs from possible infection is mandatory.[18] Fourth, along with HCWs, the patients must follow standard handwashing methods, i.e., washing hands with water and soap for a minimum of 20 s when it seems to have touch with suspected objects; or using an alcohol-based sanitizer with at least 60% alcohol, after blowing the nose, before and after eating; sneezing or coughing, etc.[19] FIFTH, health-care service providers, and clinicians should arrange emergency and urgent visits and procedures now. These arrangements can reserve patient care supplies and staff PPE, should warrant for patient and staff safety, and increase existing hospital capacity. Delay all elective in and outpatient visits, delay elective inpatient and outpatient surgeries. Reschedule nonurgent admissions—Delay inpatient and outpatient elective surgical and procedural cases.[20] Sixth, HCWs should be provided with the latest and authentic information concerning COVID-19 patients caring and treating, and it is recommended not to collect the information from unauthentic sources such as social media rather than assessing the WHO, CDC, etc.[10] Finally, individuals with suspicious interactions and close contacts to COVID-19 patients need to be on an observation time frame for 14 days and immediate medical attention, prioritizing private transport over the public, wearing N95 masks, cleaning the vehicle with 500 mg/L chlorine-disinfectant to reduce possible infection among others and these individuals are highly forbidden in rush visit (instead of telemedicine care) to any of the HCWs who are not veiled with safety measures.[21]


  Conclusions Top


The demand for HCWs increases during the COVID-19 outbreak so does their anxiety and reluctant to work. The COVID-19 transmission trend in Pakistan seems more concerns as the country has limited resources in providing the proper safety supports to the HCWs in caring for the large infected patients.[22] Thus, the cos-effective guideline should be supported and make available by the health authorities, that will facilitate in creating a comfortable caring environment for the HCWs.

Financial support

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.  Back to cited text no. 2
    
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COVID-19 Health Advisory Platform by Ministry of National Health Services Regulations and Coordination; 2020. Available from: http://covid.gov.pk/. [Last retrieved on 2020 May 13].  Back to cited text no. 4
    
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Mamun MA, Griffiths MD. First COVID-19 suicide case in Bangladesh due to fear of COVID-19 and xenophobia: Possible suicide prevention strategies. Asian J Psychiatr 2020;51:102073.  Back to cited text no. 5
    
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Bhuiyan AKMI, Sakib N, Pakpour AH, Griffiths MD, Mamun MA. COVID-19-related suicides in Bangladesh due to lockdown and economic factors: case study evidence from media reports. Int J Mental Health Addict 2020; Epub ahead of print.  Back to cited text no. 6
    
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Sakib N, Bhuiyan AKMI, Hossain S, Al Mamun F, Hosen I, Abdullah AH, et al. Psychometric validation of the Bangla Fear of COVID-19 Scale: Confirmatory factor analysis and Rasch analysis. Int J Mental Health Addict 2020; Epub ahead of print.  Back to cited text no. 7
    
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Mamun MA, Ullah I. COVID-19 suicides in Pakistan, dying off not COVID-19 fear but poverty? - The forthcoming economic challenges for a developing country. Brain Behav Immun 2020; Epub ahead of print.  Back to cited text no. 8
    
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Lin CY. Social reaction toward the 2019 novel coronavirus (COVID-19). Soc Health Behav 2020;3:1-2.  Back to cited text no. 9
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10.
Su TP, Lien TC, Yang CY, Su YL, Wang JH, Tsai SL, et al. Prevalence of psychiatric morbidity and psychological adaptation of the nurses in a structured SARS caring unit during outbreak: A prospective and periodic assessment study in Taiwan. J Psychiatr Res 2007;41:119-30.  Back to cited text no. 10
    
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Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: Exposure, risk perception, and altruistic acceptance of risk. Canadian J Psychiatry 2009;54:302-11.  Back to cited text no. 12
    
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CDC - COVID-19 Response Team. Characteristics of Health care Personnel with COVID-19-United States, February 12-9 April, 2020. Available from: https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e6.htm?s_cid=mm6915e6_x. [Last retrieved on 2020 May 13].  Back to cited text no. 13
    
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Adams JG, Walls RM. Supporting the health care workforce during the COVID-19 global epidemic. JAMA 2020;323:1439-40.  Back to cited text no. 15
    
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Chen Q, Liang M, Li Y, Guo J, Fei D, Wang L, et al. Mental health care for medical staff in China during the COVID-19 outbreak. Lancet Psychiatry 2020;7:e15-e16.  Back to cited text no. 16
    
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Alhazzani W, Møller MH, Arabi YM, Loeb M, Gong MN, Fan E, et al. Surviving sepsis campaign: Guidelines on the management of critically ill adults with Coronavirus Disease 2019 (COVID-19). Intensive Care Med 2020;48:e440-69.  Back to cited text no. 17
    
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CDC - Pandemic Planning – Respiratory Protection - NIOSH Workplace Safety and Health Topic; 2020. Available from: https://www.cdc.gov/niosh/topics/hcwcontrols/pandemic-planning.htm. [Last retrieved on 2020 May 13].  Back to cited text no. 18
    
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Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Mil Med Res 2020;7:4.  Back to cited text no. 19
    
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    Tables

  [Table 1]


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