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Healthcare worker infections and deaths due to COVID-19: A survey from 37 nations and a call for WHO to post national data on their website

Open AccessPublished:October 29, 2020DOI:https://doi.org/10.1016/j.ijid.2020.10.064

      Highlights

      • Healthcare workers (HCW) are part of the frontline in the struggle against the pandemic.
      • Many HCWs have been infected with SARS-CoV-2 and have ldied worldwide during the pandemic.
      • We performed an international survey and requested the total numbers of HCW deaths and infections.
      • Data were obtained from 37 countries, where HCWs have lost their lives in substantial numbers.
      • We call on the WHO Director-General to highlight this tragedy at the WHO COVID-19 website regularly.

      Keywords

      The coronavirus disease-2019 (COVID-19) pandemic is an ongoing devastating threat to human lives and livelihoods around the world. Healthcare workers (HCW) are part of the frontline in the struggle against the pandemic. Many HCWs have been infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and have lost their lives worldwide during the pandemic. Recently, the World Health Organization (WHO) African Regional Office in Brazzaville reported that over 10,000 HCW in Africa were infected with this coronavirus (
      • African Regional Office (AFRO)/World Health Organization (WHO/OMS)
      Over 10,000 Health Workers in Africa Infected with COVID-19.
      ). On September 2, the WHO Pan American Regional Office in Washington, DC, reported that 570,000 HCW were infected and 2500 were dead due to COVID-19 (
      • PanAmerican Health Organization (PAHO)/World Health Organization (WHO)
      COVID-19 has Infected Some 570.000 Health Workers and Killed 2,500 in the Americas.
      ). The WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, emphasized during the announcement of the WHO Health Worker Safety Charter September 17, 2020 that “thousands of health workers infected with COVID-19 have lost their lives worldwide” (
      • WHO Geneva
      Keep Health Workers Safe to Keep Patients Safe.
      ).
      The nation-by-nation number of HCW infections and deaths is unclear, however, because some countries do not make the data publicly available. Moreover, the WHO headquarters in Geneva does not currently post on their COVID-19 website the number of HCW infections and deaths by country. We call on the WHO Director-General to make this information available nation-by-nation on their COVID-19 website beginning from November 2020 to focus attention on this ongoing tragedy and the steps to be taken to stop it.
      To help catalyze this nation-by-nation data sharing, we performed a survey among members of the ID-IRI (Infectious Diseases International Research Initiative; https://infectdisiri.com/). We asked members to complete a brief survey that requested the number of deaths and number of infected in four categories: medical doctors, medical nurses, other medical staff as well as the total number of HCWs (see Table 1). The data were reported through Google Drive to one of the authors (HE). The sources of information for each country are provided by the collaborators as listed below the Table 1. The updated population of the countries were obtained from ). Data were obtained between July 22 and August 15, 2020. As a limitation of the study, we could not provide data where HCWs contracted the disease–during work with patients or from the community. We found that although there were differences among the countries that joined the survey, the median of the HCW deaths in 100,000 per population of the country was 0.05.
      Table 1Healthcare workers’ losses due to Covid-19 in 37 countries.
      CountryMedical DoctorsMedical NursesOther Medical StaffHCWs (total)PopulationHCW Mortality per 100,000
      diedinfecteddiedinfecteddiedinfecteddiedinfected
      Afghanistan??????26?38,928,3460.07
      Albania26015062272,877,7970.07
      Azerbaijan18?12?15?45?10,139,1770.44
      Bangladesh692447091792042805827044164,689,3830.05
      Botswana000100012,351,6270
      Bulgaria42131212218876136,948,4450,10
      Colombia146027173810131531365550,882,8910,06
      Croatia01270167011204064,105,2670
      Czech Republic0211248704212111910,708,9810,02
      Denmark0−54310−513440−56050−1523805,792,2020,17 ∼
      Egypt3537510751130056750102,334,4040,05
      France52906086261118,5001630,03265,273,5110.02
      Hong Kong000302057,496,9810
      India10810732144?9611013131,380,004,3850.01
      Iran913000317000422000164>12,00083,992,9490.20
      Italy17417,0001612,0002489621428,89660,461,8260.35
      Jordan050230102610,203,1340
      Kosovo4174034106545801,810,3660.22
      Lebanon1651122022024166,825,4450.03
      Mexico20513,80027418,40068346,000116278,200128,932,7530.90
      Nepal023030135016129,136,8080
      N. Macedonia32406302231092,083,3740.14
      Oman119205080486111865,106,6260.02
      Pakistan42327515718131374705367220,892,3400.02
      Palestine Gaza00000000?0
      Peru702062??????32,971,854?
      Poland1660416592857240437,846,611?
      Portugal151601180019851368110,196,7090.01
      Romania85759173411159528390719,237,6910.14
      Sierra Leone34111013551497,976,9830.06
      Slovakia040000045,459,6420
      Spain7652,7466?????46,754,778?
      Syria341080335217,500,6580.02
      Tunisia0?0?0?014511,818,6190
      UK19?35?52?106?67,886,0110,16
      USA??????574114,529331,002,6510.17
      Uzbekistan6???????33,469,203?
      UK: The United Kingdom and USA: The United States of America.
      Data sources (provided by the collaborators).
      1) Afghanistan (data provided by the collaborator).
      2) Albania (data provided by the collaborator).
      3) Azerbaijan (data provided by the collaborator).
      4) Bangladesh (Bangladesh Medical Association website daily update).
      5) Botswana (Ministerial data).
      6) Bulgaria (Official informational portal for COVID-19 in Bulgaria: https://coronavirus.bg).
      8) Croatia (Ministerial data).
      9) Czech Republic ("Czech Medical Association official magazine, online at https://www.lkcr.cz/doc/tempus_file/tm-07_08_20-166.pdf, page 13").
      11) Egypt (data provided by the collaborator).
      13) Hong Kong (CHP Hong Kong).
      15) Iran (irimc.org Iranian Medical Council).
      17) Jordan (MOH, Jordan. Department of Communicable disease. https://corona.moh.gov.jo/en).
      18) Kosovo (data provided by the collaborator).
      19) Lebanon (Ministerial data).
      22) N. Macedonia (www.iph.mk).
      23) Oman (Ministry of Health; Disease Surveillance and Control).
      24) Pakistan (National health services regulations and coordination. NHSR&C Pakistan).
      25) Palestine Gaza (http://www.moh.gov.ps/portal/).
      28) Portugal (Data from the Portuguese health minister conference in the end of June).
      30) Sierra Leone (Ministry of Information and Ministry of Health and Sanitation).
      31) Slovakia (Ministerial data).
      33) Syria (Ssnsy.org).
      37) Uzbekistan (data provided by the collaborator).
      COVID-19 HCW infections and deaths are tragedies for the individuals, their families, colleagues, and an existential crisis for HCWs and for local and national healthcare infrastructures. China reported that 3387 HCW were infected with this novel coronavirus. Of this number, 23 died, including 21 who were physicians and surgeons, one nurse, and one technician (
      • Zhan M.
      • Qin Y.
      • Xue X.
      • Zhu S.
      Death from Covid-19 of 23 Health Care Workers in China.
      ). A 34-year-old ophthalmologist in Wuhan Central Hospital, Dr. Li Wengliang, died due to COVID-19 on February 7, 2020 in Wuhan. He was recognized in this journal by Petersen et al. as “a face to the frontline healthcare worker. The first doctor to notify the emergence of the SARS-CoV-2, (COVID-19), outbreak” (
      • Petersen E.
      • Hui D.
      • Hamer D.H.
      • Blumberg L.
      • Madoff L.C.
      • Pollack M.
      • et al.
      Li Wenliang, a face to the frontline healthcare worker. The first doctor to notify the emergence of the SARS-CoV-2, (COVID-19), outbreak.
      ).
      This ongoing tragedy will continue as long as most nations lack safe and effective vaccines, drugs, and antibodies. Most immediately important, however, is to make available enough highly effective COVID-19 personal protective equipment, training, and donning and doffing protocols (
      • World Health Organization
      Personal Protective Equipment for COVID-19.
      ).
      We add these data on infections and deaths due to COVID-19 from 37 nations to emphasize this continuing and preventable tragedy involving healthcare workers. We also call on the WHO Director-General to highlight this tragedy and the need to stop it by posting nation-by-nation data on the WHO COVID-19 website beginning from November 2020.

      Conflict of interest

      None to declare.

      Funding source

      We did not receive a fund of any kind.

      Ethical approval

      Not applicable.

      Collaborators

      Bilal A. Rahimi (Afghanistan), Edmond Puca (Albania), Raksana Jalilova (Azerbaijan), Rezaul Karim Ripon and Abu Hena Mostafa Kamal (Bangladesh), Sajini Souda (Botswana), Michael M. Petrov (Bulgaria), Alfonso J. Rodriguez-Morales (Colombia, Peru), Gaspar Del Rio and Julio Benavides, (Colombia), Rok Civljak (Croatia), Matúš Mihalčin (Czech Republic), Signe Maj Sørensen (Denmark), Ashraf Wegdan (Egypt), Pierre Tattevin (France), Ivan Hung (Hong Kong), Hema Prakash Kumari Pilli (India), Masoud Mardani (Iran), Antonio Cascio (Italy), Jamal Wadi Al Ramahi (Jordan), Sadie Namani (Kosovo), Abdul Rahman Bizri (Lebanon), Leonel Lagunes (Mexico), Ranjit Sah (Nepal), Marija Dimzova (North Macedonia), Nenad Pandak (Oman), Altaf Ahmad (Pakistan), Rami H. Alabadla (Palestine Gaza), Joanna Zajkowska (Poland), Lurdes Santos (Portugal), Roxana Cernat, Viorel Rotila, Egidia Miftode (Romania), Haurace Nyandemoh (Sierra Leone), Anna Liskova (Slovakia), Jordi Rello (Spain), Anas Jouhar (Syria), Amel Letaief (Tunisia), Effrossyni Gkrania-Klotsas and Sylviane Defres (United Kingdom), Daniel Lucey (USA), and Uktanjom Suvankulov (Uzbekistan).

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