COVID-19 in Africa: care and protection for frontline healthcare workers

• Published in: Globalization and health Vol. 16; no. 1; pp. 46 - 6
• Main Authors: Chersich, Matthew F., Gray, Glenda, Fairlie, Lee, Eichbaum, Quentin, Mayhew, Susannah, Allwood, Brian, English, Rene, Scorgie, Fiona, Luchters, Stanley, Simpson, Greg, Haghighi, Marjan Mosalman, Pham, Minh Duc, Rees, Helen
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.05.2020; BioMed Central; BMC
• Subjects: Africa; Betacoronavirus; Clinical Laboratory Techniques; Community health care; Coronavirus Infections - diagnosis; Coronavirus Infections - epidemiology; Coronavirus Infections - prevention & control; Coronavirus Infections - transmission; Coronaviruses; Cost control; Cough; COVID-19; COVID-19 Testing; Critical care; Disease control; Disease Outbreaks - prevention & control; Disease transmission; Ebola virus; Employee motivation; Epidemics; Exhaustion; Health aspects; Health care; Health Personnel - psychology; Health risks; Healthcare workers; HIV; Hospitals; Human immunodeficiency virus; Human resources; Human resources for health; Humans; Infection Control; Infection control, mental health; Infections; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Medical personnel; Medical supplies; Mental Health; Morale; Motivation; Occupational Exposure - prevention & control; Pandemics; Pandemics - prevention & control; Patients; Personal protective equipment; Personal Protective Equipment - supply & distribution; Pneumonia, Viral - epidemiology; Pneumonia, Viral - prevention & control; Pneumonia, Viral - transmission; Protective equipment; Psychological stress; Public health; Review; Risk management; Safety equipment; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Stress (Psychology); Telemedicine; United Kingdom; Ventilators; Viral diseases; Water supply; Workers; United Kingdom; China; Africa; COVID-19; Human resources for health; SARS-Cov-2; Healthcare workers; Infection control, mental health; Africa
• ISSN: 1744-8603; 1744-8603
• DOI: 10.1186/s12992-020-00574-3

Medical staff caring for COVID-19 patients face mental stress, physical exhaustion, separation from families, stigma, and the pain of losing patients and colleagues. Many of them have acquired SARS-CoV-2 and some have died. In Africa, where the pandemic is escalating, there are major gaps in response capacity, especially in human resources and protective equipment. We examine these challenges and propose interventions to protect healthcare workers on the continent, drawing on articles identified on Medline (Pubmed) in a search on 24 March 2020. Global jostling means that supplies of personal protective equipment are limited in Africa. Even low-cost interventions such as facemasks for patients with a cough and water supplies for handwashing may be challenging, as is ‘physical distancing’ in overcrowded primary health care clinics. Without adequate protection, COVID-19 mortality may be high among healthcare workers and their family in Africa given limited critical care beds and difficulties in transporting ill healthcare workers from rural to urban care centres. Much can be done to protect healthcare workers, however. The continent has learnt invaluable lessons from Ebola and HIV control. HIV counselors and community healthcare workers are key resources, and could promote social distancing and related interventions, dispel myths, support healthcare workers, perform symptom screening and trace contacts. Staff motivation and retention may be enhanced through carefully managed risk ‘allowances’ or compensation. International support with personnel and protective equipment, especially from China, could turn the pandemic’s trajectory in Africa around. Telemedicine holds promise as it rationalises human resources and reduces patient contact and thus infection risks. Importantly, healthcare workers, using their authoritative voice, can promote effective COVID-19 policies and prioritization of their safety. Prioritizing healthcare workers for SARS-CoV-2 testing, hospital beds and targeted research, as well as ensuring that public figures and the population acknowledge the commitment of healthcare workers may help to maintain morale. Clearly there are multiple ways that international support and national commitment could help safeguard healthcare workers in Africa, essential for limiting the pandemic’s potentially devastating heath, socio-economic and security impacts on the continent.