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Since the coronavirus (COVID-19) outbreak, standard precautionary measures have been taken to lower the risk of virus transmission from both recognised and unrecognised sources.
The precautionary measures are the basic level of infection control precautions which are used in the care of all suspected or confirmed COVID-19 patients in any healthcare facility. Standard precautions include hand and respiratory hygiene, use of personal equipment (gloves, masks and gowns), needle safety, safely handling contaminated equipment or surfaces, and disposal of body fluids and other clinical wastes properly .
The healthcare workers (HCWs) are at the forefront selflessly taking care of COVID-19 patients. They are at the occupational risk of getting exposed to the virus during their routine work in the wards, intensive care units, emergency or trauma triage and so on.
In this article, we will talk about the importance of healthcare workers at this crucial time and how they can protect themselves from getting infected.
Importance of health care workers
According to the World Health Organization (WHO), healthcare workers play a central and vital role in improving access and quality healthcare for the people by promoting health, preventing diseases and delivering healthcare services to individuals, families and communities based on the primary healthcare approach.
Healthcare workers include doctors, nurses, helpers, laboratory technicians or even medical waste handlers. Recognising the important role played by every healthcare worker, they are called "the most valuable resource for health" .
What poses health risks for healthcare workers?
A study published in the journal The Lancet, over 3300 healthcare workers were infected with coronavirus in China as of early March and around 22 have died. Italy, the country with the highest number of coronavirus cases have 20 per cent infected healthcare workers and some even died from it.
Healthcare workers are at a higher risk of exposure mainly due to physical and mental exhaustion, the torment of difficult triage decisions, the pain of losing patients and colleagues, longer working hours, minimal hand hygiene, pathogen exposure and shortage of personal protective equipment (PPE) , .
How should healthcare workers protect themselves?
A healthcare worker should be prepared and trained on precautions that need to be taken while handling patients, conducting tests and also taking care of themselves to prevent contracting the infection.
The WHO has listed down the steps for the protection of healthcare workers:
- Follow established occupational safety and health procedures and participate in employer-provided occupational safety and health training.
- Use provided protocols to assess, triage, and treat patients.
- Use, put on, take off and dispose of personal protective equipment (PPE)
- Provide or reinforce accurate IPC and public health information, including to concerned people who have neither symptoms nor risk.
- Maintain appropriate working hours with breaks.
- Consult with healthcare workers on occupational safety and health aspects of their work and notify the labour inspectorate of cases of occupational diseases.
- Healthcare workers should be advised on self-assessment, symptom reporting, and staying home when ill.
- Healthcare workers should self-monitor for signs of illness and self-isolate and report the illness to managers if it occurs.
- Healthcare workers should talk to the management if they are experiencing signs of undue stress or mental health challenges that require supportive interventions.
- Assessing the risk factors in a healthcare facility to prevent the transmission of pathogens.
- Perform good hand hygiene and ensure availability of hand-washing facilities with clean running water.
- Practice good hand hygiene after contact with respiratory secretions.
- Select PPE based on the assessment of risk factors which includes cleaning non-sterile gloves, cleaning non-sterile fluid-resistant gown, and wearing mask and goggles.
- Wash hands before and after direct patient contact, during patient care, immediately after gloves are removed, after touching blood, body fluids, secretions and contaminated items, even if gloves are worn.
- Wear gloves when touching blood, body fluids, secretions and contaminated items.
- Change gloves between tasks and procedures on the same patient after contact with infectious material.
- Dispose of used gloves before touching non-contaminated items.
- Wear a gown to protect skin and remove the soiled gown as soon as possible and wash your hands properly.
- Discard single use items properly.
- The hospital floors should be cleaned properly with phenolic disinfectants and cleaning of surfaces should be done with sodium hypochlorite solution.
In Hong Kong, the hospitals implemented precautionary measures such as good hand hygiene, wearing surgical masks and using PPE during patient care to control the infection. In this way, the virus transmission within the hospitals was less and the healthcare workers were protected due to the standard practices of infection control .
Healthcare workers are every country's most valuable resource and their safety is of utmost importance. To ensure healthcare workers are safe, the first step would be adequate provision of PPE. Other measures must be considered including cancelling non-essential events to prioritise resources, distribution of food, adequate rest, family support and psychological support.