KARACHI: Given the fact that a large number of healthcare workers are forced to perform their duties at hospitals without personal protective equipment (PPE), it is important that the government get them tested for coronavirus, doctors associated with Pakistan Medical Association (PMA) stated on Friday.

Infected health workers, if not isolated, could have a devastating effect on the already fragile health system and increase the number of coronavirus patients multiple times, they said.

“We continue to receive complaints from doctors from Sindh and Punjab that they are forced to work in risky conditions as the government hasn’t provided them with PPE,” said Dr Qaiser Sajjad representing the PMA, adding that testing of health workers should be done phase-wise gradually with the first priority given to those working in emergency sections.

“We understand that there is a shortage of diagnostic kits, but there should be a plan for testing healthcare workers for coronavirus. This would help raise their confidence level. We know that there are cases in which families of young female doctors are reluctant to let their loved ones perform their duties.”

Doctors condemn misuse of PPE by irrelevant people

It is important to mention here that though there have been several individual reports on healthcare staff getting infected with coronavirus, no consolidated data has either been provided by the federal health ministry or the provincial health department.

PPE for all

Dr Abdul Ghafoor Shoro, also representing the PMA, pointed out that the government must understand that PPE needed to be provided to all healthcare workers handling either Covid-19 or non-Covid-19 patients.

“This is because we don’t know whether a patient reporting with health complaints other than coronavirus is a virus carrier or not. The way the government is responding is nothing but unfortunate,” he said, adding that while outpatient departments were closed at most public and private sector hospitals, doctors and other medical staff were very much attending their duties in the emergency sections and wards.

According to experts, apart from the risks associated with an environment where healthcare workers know that they would be handling Covid-19 patients, some medical specialists are at a higher risk of contracting the virus, such as dentists, eye specialists and ear-nose-throat doctors who need to get close to the patient for various procedures/examination.

In such conditions, doctors, they said, should demonstrate extreme caution.

They urged that the federal health ministry and the provincial health department must separately notify healthcare workers testing positive for the virus and said confirmation of such cases from the government was critical to address lapses in the system and ensure proper care to affected staff.

Misuse of PPE

Dr Sunil Kumar Dodani, infectious diseases expert at the Sindh Institute of Urology and Transplantation, underscored the need for training healthcare workers in using PPE.

“It’s easy to wear them but there is a high risk of infection if the equipment is not properly taken off,” he said.

Asked about the problems staff has been facing, Dr Dodani said one important thing was unnecessary referrals that SIUT received from other health facilities.

“Patients are referred to us from other hospitals with a request that we provide them with a certificate that they are free from coronavirus, which means additional work,” he said, adding that these hospitals should develop a system to evaluate patient risk for Covid-19 under government guidelines as [is] being done at designated centres for coronavirus testing and treatment.

Experts also complained about the misuse of PPE and said that it was important that healthcare workers received the required equipment instead of law enforcement agencies, politicians or government officials.

“We have seen personnel of law enforcement agencies and politicians wearing N-95 masks, which should be used solely by the medical staff handling high-risk patients. If we don’t stop this kind of misuse of PPE, we may start losing the limited workforce we have to battle this epidemic,” a doctor said.

Published in Dawn, April 4th, 2020