Hundreds of thousands of doctors, nurses and other frontline healthcare workers have contracted COVID-19 this year, and thousands have died, according to a survey of 37 countries. "The COVID-19 pandemic is a direct threat to humankind, and healthcare workers are the backbone of the struggle against the pandemic," said lead author Dr. Hakan Erdem, coordinator of the Infectious Diseases International Research Initiative in Ankara, Turkey. "We have seen healthcare workers face serious problems, and personal losses are common in all countries," he told Reuters Health by email. "No countries, even the most developed ones, were spared." In an article in the International Journal of Infectious Diseases, Dr. Erdem and co-author Dr. Daniel Lucey of Georgetown University Medical Center, in Washington, D.C., call on the World Health Organization to post detailed data on its website this month to better track worldwide COVID-19 infections and deaths among healthcare workers as the pandemic continues. The authors surveyed 37 countries that are members of the Infectious Diseases International Research Initiative to understand the number of COVID-19 infections and deaths among medical doctors, medical nurses, medical staff and overall healthcare workers through August 15. Overall, survey participants reported nearly 300,000 infections, which ranged broadly by country. Several countries reported few infections while others reported high numbers. The U.S. reported the highest number of infections, with more than 114,500 healthcare workers testing positive during the pandemic. In addition, Mexico reported 78,200 infections, followed by more than 30,000 in France and nearly 29,000 in Italy. The median number of healthcare worker deaths was 0.05 per 100,000 population, which also ranged broadly by country. Overall, more than 2,700 deaths were reported across the countries. Mexico reported the highest number of deaths, with 1,162 healthcare workers who have died from COVID-19. The U.S. reported 574 deaths, followed by 214 in Italy and 164 in Iran. The numbers are likely an undercount, the authors write. On September 2, the WHO Pan American Regional Office reported more than 570,000 infections and more than 2,500 deaths among healthcare workers. At that time, healthcare workers represented one in every seven COVID-19 cases in the U.S. and Mexico, which accounted for 85% of COVID-19 deaths among healthcare workers in the region. As of November 5, the U.S. Centers for Disease Control and Prevention has reported more than 205,000 COVID-19 cases and 789 deaths among healthcare workers in the U.S. However, nation-by-nation numbers continue to remain unclear, particularly in countries that don't provide data publicly. Drs. Erdem and Lucey called for the WHO to make nation-by-nation data available online in November to gain better understanding about infections and deaths. "Healthcare-worker deaths will ultimately cause stress, anxiety, depression, burnout and post-traumatic stress among healthcare workers, leading to potential shortages in medical service," Dr. Erdem said. "Optimization of staffing seems to be of utmost importance in this battle, and every measure to protect, support and encourage healthcare workers should be taken by medical leaders and decision makers." A limitation of the survey is that the data doesn't explain how or where healthcare workers contracted COVID-19, whether at their workplace or in the community. In addition, the data doesn't provide city-specific information or a timeline, which could indicate current hotspots or trends in infections and deaths over time. "Encouragingly, the data indicate that there has been a substantial decline in health-worker infections since the beginning of the outbreak," said Hedinn Halldorsson of the WHO Press Office. Halldorsson didn't indicate how or when the WHO may provide updated data about health care workers. Healthcare workers represent less than 3% of the population in many countries - and less than 2% in most low- and middle-income countries - yet about 14% of the COVID-19 cases reported to the WHO, Halldorsson said. In some countries, the proportion is as high as 35%. For many countries, the data is limited or difficult to obtain, he added. "Communities can play their part by adopting behaviors that reduce disease spread so that healthcare systems, and as result health workers, are not burdened," he told Reuters Health by email. "We all have a role to play." —Carolyn Crist Source
