South African healthcare workers and COVID-19 : a shared responsibility to protect a precious and limited resource

Dramowski, Angela ; Zunza, Moleen ; Dube, Kopano ; Parker, Mohammed ; Slogrove, Amy L. (2020)

CITATION: Dramowski, A. et al. 2020. South African healthcare workers and COVID-19 : a shared responsibility to protect a precious and limited resource. South African Medical Journal, doi:10.7196/SAMJ.2020.v110i7.14903.

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Healthcare workers (HCWs) in African countries face high risks of occupational exposure to many pathogens, including tuberculosis, measles, HIV and Ebola.[1,2] The novel coronavirus SARSCoV- 2 poses an arguably greater threat to African HCWs than any other infectious agent to date. Data from countries with established epidemics show that HCWs experience high rates of COVID-19 infection, morbidity and mortality. In the USA, 19% of COVID-19 cases whose occupational status was known were HCWs (9 282/49 000),[3] and >90 000 HCW COVID-19 infections were documented in 30 countries, with 260 deaths in nurses, by early May 2020.[4] In South Africa (SA), on 6 May, Minister Zweli Mkhize reported that 511 HCWs had tested positive for SARS-CoV-2 (7% of the national total), with nurses accounting for 53% of total HCW cases.[5] The unprecedented risk posed to HCWs by COVID-19 is clearly acknowledged by all levels of the SA government. Nationally there have been commitments, both financially and administratively, to ensure procurement and local production of personal protective equipment (PPE) and transparent reporting of HCW COVID-19 infections. To varying degrees, administrative and engineering interventions to prevent COVID-19 infections and outbreaks have been implemented in SA healthcare facilities (Table 1). Despite the early phase of the pandemic and general availability of PPE, SA is already facing high rates of HCW COVID-19 infections and exposure events. This is a concerning development reflecting both widespread community transmission (with HCW infections) and the need to strengthen ‘universal’ prevention measures in healthcare facilities, e.g. physical distancing, mask-wearing, hand hygiene, and increased cleaning/ disinfection of surfaces and equipment.

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