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COVID-19: Protecting Healthcare Workers is a priority

Published online by Cambridge University Press:  17 April 2020

Francesco Chirico*
Affiliation:
School of Occupational Medicine, Università Cattolica del Sacro Cuore, Rome, Italy Health Service Department, State Police, Ministry of Interior, Milan, Italy
Gabriella Nucera
Affiliation:
University of Milan, Milan, Italy ASST Fatebenefratelli Sacco, FatebeneFratelli Hospital, Milan, Italy
Nicola Magnavita
Affiliation:
School of Occupational Medicine, Università Cattolica del Sacro Cuore, Rome, Italy Department of Woman/Child and Public Health, Fondazione Policlinico “A.Gemelli” IRCCS, Rome, Italy
*
Author for correspondence: Prof Francesco Chirico, E-mail: medlavchirico@gmail.com
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Abstract

Type
Letter to the Editor
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© 2020 by The Society for Healthcare Epidemiology of America. All rights reserved.

To the Editor—We very much appreciated the letter by Zhou et alReference Zhou, Huang, Xiao, Huang and Fan1 regarding the protection of Chinese healthcare workers (HCWs) while fighting the COVID-19 pandemic. The authors recognized that the lack of awareness and training, the shortage of personal protective equipment (PPE), and the lack of point-of-care diagnostic tests for were the most important sources of viral spread. In Italy, more infections among HCWs have been recorded than in China. As of April 5, 2020, 12,252 HCWs in Italy had tested positive for SARS-CoV-2, comprising 10% of Italy’s COVID-19 cases2; furthermore, 80 medical doctors and 25 nurses had died. Notably, official figures probably underestimate the real impact of COVID-19 on Italian HCWs because many have not been tested and a large majority of coronavirus infections do not result in symptoms or remain paucisymptomatic.Reference Day3 In Italy, HCWs are facing the same issues that Zhou highlighted in Chinese hospitals. SARS-CoV-2 has a high transmissibility rate in indoor environments and, therefore, asymptomatic patients admitted to hospitals without respiratory symptoms have probably spread the virus to unaware and unprotected HCWs. These HCWs have, in turn, infected other patients, visitors, and staff, further amplifying viral transmission. It is well-known that a hospital may amplify an epidemic and that epidemics may overwhelm a hospital’s capacity to deliver healthcare services.4 Therefore, in addition to general lockdown and social distancing measures, protecting HCWs is a priority in alleviating the burden on the hospitals. However, in the absence of effective therapies or a vaccination, before the onset of further COVID-19 waves, it is important to relocate the public health emergency response from the hospitals to other locations by integrating the hospital into an overall epidemic response.4 In this regard, communication and mass-media information campaigns for the public are crucial.

Acknowledgments

Financial support

No financial support was provided relevant to this article.

Conflicts of interest

All authors report no conflicts of interest relevant to this article.

References

Zhou, P, Huang, Z, Xiao, Y, Huang, X, Fan, XG. Protecting Chinese healthcare workers while combating the 2019 novel coronavirus. Infect Control Hosp Epidemiol 2020 Mar 5 [Epub ahead of print]. doi: 10.1017/ice.2020.60.CrossRefGoogle ScholarPubMed
Istituto Superiore di Sanità. Sorveglianza integrata COVID 19 in Italia. Epicentro website. https://www.epicentro.iss.it/coronavirus/sars-cov-2-sorveglianza-dati. Published April 5, 2020. Accessed April 5, 2020.Google Scholar
Day, M.COVID-19: four-fifths of cases are asymptomatic, China figures indicate. BMJ 2020;369:m1375. doi: 10.1136/bmj.m1375.CrossRefGoogle ScholarPubMed
World Health Organization. Hospital Preparadness for Epidemics. Geneva: WHO; 2014.Google Scholar
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