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

Matthew F Chersich,Fiona Scorgie,Helen Rees,Brian Allwood,Lee Fairlie,Rene English,Minh Duc Pham,Stanley Luchters,Susannah Mayhew,Marjan Mosalman Haghighi,Quentin Eichbaum,Glenda Gray,Greg Simpson

doi:10.1186/s12992-020-00574-3

Abstract

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.

Highlights

Sustaining safe and quality care in the SARS-CoV-2 pandemic hinges on the health and mental wellbeing of frontline healthcare workers
Inclusion and exclusion criteria Studies were included if they presented data or commentaries on the infection risks and mental wellbeing impacts that healthcare workers face during the COVID19 pandemic
In this review we describe the infection risks and mental health challenges that healthcare workers face in the COVID-19 pandemic and propose interventions to counter these in Africa

Summary

Methods for review of literature

Inclusion and exclusion criteria Studies were included if they presented data or commentaries on the infection risks and mental wellbeing impacts that healthcare workers face during the COVID19 pandemic. We included articles that covered the COVID-19 pandemic in Africa Iin general (these papers did not have to include infection risks and mental health). We excluded articles on infection control or mental health of COVID19 if they covered topics that were not relevant to Africa. In this review we describe the infection risks and mental health challenges that healthcare workers face in the COVID-19 pandemic and propose interventions to counter these in Africa. We searched Medline (Pubmed) on 24 March (see Additional File Fig. 1 for the search strategy and PRISMA flow chart) and located 1464 articles, of which 88 were on healthcare workers, and 32 considered relevant to this review. Search strategy The literature was identified in a search on Medline(Pubmed) up to 24 March and identified using the following search strategy: ((((((coronavirus) AND ("2020"[Date Create] : "3000"[Date - Create]))) OR SARS-CoV-2) OR 2019-nCoV) OR COVID)

Background

Conclusion