Health Care Workers In India Research Articles

Psychosocial impact of COVID-19 pandemic on healthcare workers in India & their perceptions on the way forward - A qualitative study.

Background & objectives:The healthcare system across the world has been overburdened due to the COVID-19 pandemic impacting healthcare workers (HCWs) in different ways. The present study provides an insight into the psychosocial challenges faced by the HCWs related to their work, family and personal well-being and the associated stigmas. Additionally, the coping mechanisms adopted by them and their perceptions on the interventions to address these challenges were also explored.Methods:A qualitative study was conducted between September and December 2020 through in-depth telephonic interviews using an interview guide among 111 HCWs who were involved in COVID-19 management across 10 States in India.Results:HCWs report major changes in work-life environment that included excessive workload with erratic timings accentuated with the extended duration of inconvenient personal protection equipment usage, periods of quarantine and long durations of separation from family. Family-related issues were manifold; the main challenge being separated from family, the challenge of caregiving, especially for females with infants and children, and fears around infecting family. Stigma from the community and peers fuelled by the fear of infection was manifested through avoidance and rejection. Coping strategies included peer, family support and the positive experiences manifested as appreciation and recognition for their contribution during the pandemic.Interpretation & conclusions:The study demonstrates the psychological burden of HCWs engaged with COVID-19 care services. The study findings point to need-based psychosocial interventions at the organizational, societal and individual levels. This includes a conducive working environment involving periodic evaluation of the HCW problems, rotation of workforce by engaging more staff, debunking of false information, community and HCW involvement in COVID sensitization to allay fears and prevent stigma associated with COVID-19 infection/transmission and finally need-based psychological support for them and their families.

Review of Coveralls, Gowns, and their Use as Part of Personal Protective Equipment (PPE KIT) for Effective Protection of Healthcare Workers in India in COVID-19

Healthcare Workers (HCWs) and public health professionals are playing a pivotal role in containing COVID-19. Personal Protective Equipment (PPEs) are a critical component in the hierarchy of primary infection controls to ‘break the chain of infection’ to protect patients, HCW’s, and public. As SARS-CoV-2 is highly contagious, and vaccine and prophylactics not yet available, understanding correct PPE usage is imperative. This study aims to: understand purpose, use, and quality standards of body-coveralls and gowns and how to use PPE’s for effective protection in COVID 19 in India. Types of PPE’s in healthcare, their purposes, materials used, and properties were reviewed. Gowns and Body-coveralls classification and standards in Europe, USA and India were studied. While current stipulated test standards for coveralls in India are lower, as routine use of reusable gowns made of woven fabrics is more common in India, one could hypothesize that these coveralls provide a higher level of protection. As per current understanding of mode(s) of transmission of SARS-CoV-2 a properly fitted N95 respirator; goggles and splash resistant face shield; gloves; and single-use full body-coverall/gown preferably resistant to Synthetic Blood Penetration under pressure and made of non-woven Laminated SMS (Spunbond-Meltblown-Spunbond)_or Non Laminated SSMMS fabrics are advisable depending upon anticipated level of exposure. HCW’s should educated about transmission risks, correct principles of infection control, functional purpose of PPE’s and must be conscious that PPE’s alone will not protect them. They must follow good practices of how to wear (don) and how to remove (doff) and ensure that they do not inadvertently contaminate their clothing/skin and self-inoculate.

SARS-CoV-2 Sero-Prevalence among General Population and Healthcare Workers in India, December 2020 - January 2021

Background: Repeated cross-sectional serosurveys in the same geographic area establish the trend of the evolving pandemic. We present the findings of the third round of a national serosurvey to estimate the seroprevalence of SARS-CoV-2 infection among the general population and health care workers of India. Methods: We conducted the third population-based serosurvey between Dec 18, 2020 and Jan 6, 2021 in the same 700 villages or wards from 70 districts in 21 states across India, which were selected for the first and second serosurveys. We enrolled from each district, at least 400 individuals aged ≥ 10 years from general population and 100 HCWs from sub-district level public health facilities. Serum samples from general population were tested for the presence of IgG antibodies against nucleocapsid (N) and spike protein (S1-RBD) of SARS-CoV-2 using the Abbott and Siemens assays respectively, whereas sera from HCWs were tested for anti-S1-RBD. For general population, sera positive for either of the antibodies were considered positive, while sera positive for anti-S1-RBD were considered as positive for HCW. Weighted seroprevalence estimates were adjusted for sensitivity and specificity of respective assays. Findings: Of the 28,598 sera from general population, 4585 (16%) had IgG antibodies against N, 6647 (23.2%) against S1-RBD and 7436 (26%) against either. The weighted and assay characteristic adjusted seroprevalence against either of the antibodies was 24.1 (95%CI: 23.0% to 25.3%). Seroprevalence was lower in rural areas (21.4%, 95% CI: 20.3% to 22.6%) compared to urban non-slum (29.4%, 95% CI: 26.9% - 32.1%) and slum areas (34.6%, 95% CI: 31.0% to 38.3%). Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI: 23.5% to 27.8%).Interpretation: Nearly one in four individuals aged 10 years or older from general population as well as HCWs were exposed to SARS-CoV-2 by December 2020 amounting to 271 million infections in India.

Utility of the Interferon-Gamma Release Assay for Latent Tuberculosis Infection Screening among Indian Health-Care Workers.

Background:The utility of interferon-gamma release assays (IGRAs) for latent tuberculosis infection (LTBI) screening among health-care workers (HCWs) in low- and middle-income countries (LMICs) remains unclear.Methods:This was a prospective cohort study among HCW trainees undergoing annual LTBI screening via tuberculin skin test (TST) and QuantiFERON® TB Gold Test-in-tube (QFT-GIT) in Pune, India. TST induration ≥ 10 mm and QFT-GIT ≥ 0.35 IU/ml were considered positive. Test concordance was evaluated at entry among the entire cohort and at 1 year among baseline TST-negative participants with follow-up testing. Overall test agreement was evaluated at both timepoints using the kappa statistic: fair (k < 0.40), good (0.41 ≥ k ≤0.60), or strong (k > 0.60).Results:Of 200 participants, prevalent LTBI was detected in 42 (21%) via TST and 45 (23%) via QFT-GIT; QFT-GIT was positive in 27/42 (64%) TST-positive and 18/158 (11%) TST-negative trainees. Annual TST conversion was 28% (40/142) and included 11 trainees with baseline TST-/IGRA+; QFT-GIT was positive in 17/40 (43%) TST-positive and 5/102 (5%) TST-negative trainees. Overall test concordance was 84% (k = 0.52; 95% confidence interval [CI]: 0.38–0.66) and 80% (k = 0.44; 95% CI: 0.29–0.59) at baseline and 12 months, respectively.Conclusions:We observed good overall agreement between TST and QFT-GIT, and QFT-GIT detected additional LTBI cases among TST-negative trainees with possible early detection of LTBI conversion. Overall, our results support the use of IGRA for annual LTBI screening among HCWs in a high burden LMIC setting.

Development and psychometric evaluation of COVID-19 Psychological Burden Scale for Indian Health Care Workers.

Background:It is beyond doubt that the health care systems across the globe have been experiencing burdens of unprecedented magnitude in the coronavirus disease (COVID-19) era. However, no psychometric tools were validated in India to assess the impact of COVID-19 on the psychological well-being exclusively among health care workers, given their obvious risk for exposure.Objectives:This study was conducted to develop the first of its kind psychometric tool that measures the psychological burden posed by COVID-19 on Indian health care workers.Materials and Methods:One hundred and sixty-nine health care workers attending COVID-19 duties in four different states of India took part in the study. The initial scale designed was tested for face and content validity. Exploratory factor analysis using direct oblimin rotation with Kaiser normalization was employed to determine the factor structure. Differential item functioning (DIF) analysis with ordinal regression based on the type of COVID-19 facility at which the participant is serving, educational background was done for identification of item bias.Results:COVID-19 Psychological Burden Scale for Indian Health Care Workers (CPBS-IHCW), with 17 items loaded on four components, demonstrated good internal consistency reliability (Cronbach's Alpha 0.873). DIF revealed no item bias based on type of facility and educational background. Significant differences in CPBS-IHCW scores were noted between health care workers serving at different COVID-19 facilities and belonging to different educational backgrounds.Conclusion:CPBS-IHCW is a 17-item, rapidly administrable scale, demonstrating good internal consistency reliability, and temporal stability, which can be used in the assessment of psychological burden among health care professionals catering to the needs of the COVID-19 affected.

Anxiety and Sleep Disturbances Among Health Care Workers During the COVID-19 Pandemic in India: Cross-Sectional Online Survey.

BackgroundThe COVID-19 pandemic caused by SARS-CoV-2 has become a serious concern among the global medical community and has resulted in an unprecedented psychological impact on health care workers, who were already working under stressful conditions.ObjectiveIn this study, we aimed to evaluate and measure the effects of the COVID-19 pandemic on the anxiety levels and sleep quality among health care workers in India, as well as to determine how the unavailability of personal protective equipment affects their willingness to provide patient-related care.MethodsWe conducted an online cross-sectional study using piloted, structured questionnaires with self-reported responses from 368 volunteer male and female health care workers in India. Study participants were identified through social networking platforms such as Facebook and WhatsApp. The survey evaluated the participants’ degree of signs and symptoms of anxiety and sleep quality based on the 7-item Generalized Anxiety Disorder (GAD-7) scale and single-item Sleep Quality Scale, respectively. Information on the availability of personal protective equipment was collected based on responses to relevant survey questions.ResultsThe majority of health care workers (126/368, 34.2%) were in the age group 45-60 years, and 52.2% (192/368) were doctors. Severe anxiety (ie, GAD-7 score >10) was observed among 7.3% (27/368) health care workers, whereas moderate, mild, and minimal anxiety was observed among 12.5% (46/368), 29.3% (108/368), and 50.8% (187/368) health care workers, respectively. Moreover, 31.5% (116/368) of the health care workers had poor-to-fair sleep quality (ie, scores <6). Univariate analysis showed female gender and inadequate availability of personal protective equipment was significantly associated with higher anxiety levels (P=.01 for both). Sleep disturbance was significantly associated with age <30 years (P=.04) and inadequate personal protective equipment (P<.001). Multivariable analysis showed that poorer quality of sleep was associated with higher anxiety levels (P<.001).ConclusionsThe COVID-19 pandemic has potentially caused significant levels of anxiety and sleep disturbances among health care workers, particularly associated with the female gender, younger age group, and inadequate availability of personal protective equipment. These factors put health care workers at constant risk of contracting the infection themselves or transmitting it to their families. Early identification of at-risk health care workers and implementation of situation-tailored mitigation measures could help alleviate the risk of long-term, serious psychological sequelae as well as reduce current anxiety levels among health care workers.

Perception and Psychological Help Seeking Behaviour Among Hematology Healthcare Workers during the COVID19 Pandemic in India

Introduction:The current pandemic of COVID 19 had come as guest this new year and has lingered on like an unwelcome rude guest. The greatest stress during this season is the fear of getting infected. Naturally, the ones facing the most stress are the frontline health care workers. India has been under lockdown since March'2020. Lockdown itself has also taken a toll on the mental health of people owing to inability to socialize and go the work.The main stress among the Hematology health care workers is the fear of infection, passing on the virus to family members and death.This study aims at assessing the perception and psychological help seeking behaviour among Hematology healthcare workers during the COVID19 pandemic in India. This study was conducted among 177 hematology related healthcare workers in India and it exposes a significant stress these people are undergoing in this pandemic. This area is one of the least talked during this pandemic but the impact it is going to have in future is humongous.Materials and Methods:We conducted a survey from the month of April'2020 till July 2020 among some of these hematology services related health care workers from different parts of India via electronic media [Survey Monkey]. A simple questionnaire of total thirteen questions was formulated. Questions were framed in simple english language for easy understanding of all participants. Social media was used for distributing this questionnaire. Our target population was hematology service related health care workers.Results and Discussion: We got a total of 177 responses and all the answers were analysed on per question basis. 60% of those who participated were doctors, followed by nurses (32%) and rest were lab personnel and other health care workers. 66% of participants belonged to the age group 31-45 years, followed by 22% belonging to 20-30 years, 11% belonged to 46-60 years and none were above 60 years of age.56% were males and rest were females. 73% were married and rest were single.Among all those who participated in this survey two thirds were not diverted to frontline Covid 19 patient care. Only one third (33.9%) were actually redirected to direct care of Covid 19 patients in their respective set-ups. On a scale of 1 to 10, where 1 being minimal to 10 being extremely high needing help, anxiety was scored. 48% of all scored themselves with an anxiety level of 4-6. 15% each scored for 1-3 and 7-9. 5% faced extreme anxiety needing help. 36% had moderate fear of infecting their family members. 30% and 18% had mild and severe fear, respectively.When enquired about the type of symptoms experienced by them, the most common reply was that they felt low and were depressed. Many experience sleep disturbances with increase in irritability, restlessness and health anxiety for Covid. Surprisingly, 40% denied any such symptoms at all. Adjustment and adaptability with the changing environment are a deciding factor on the mental well-being of everyone. Most popular method was avoiding frequent news updates (52.5%), followed by learning new skills and connecting with family and friends (47.5%). Least popular modality was resorting to healthy distraction (28%).17% of all participants felt a need for psychological consultation for themselves, 3.4% wanted consultation for their family members and 3.4% wanted such consultation for both themselves and their family members too. Among those who wanted professional help 58% preferred tele-consultation and rest aspired for personal consultation.Conclusion:The above responses show that work place stress has increased among hematology health care workers in the current pandemic situation which in broad terms is true for any specialty. A mental burnout and fatigue is setting among healthcare workers in this part of the country as COVID19 seems like a chronic story now. It is advisable to keep psychological help ready for all those involved in frontline Covid 19 health care. Its high time hospital administrators start taking notice this aspect of healthcare workers and start working on creating a positive work environment.FigureDisclosuresNo relevant conflicts of interest to declare.

Psychological impact of COVID-19 pandemic on health-care professionals in India – A multicentric cross-sectional study

Objectives:The world is grappling with an ongoing COVID-19 pandemic that has shaken the mankind to the core and disrupted the lives of everyone. The aim of the study was to assess the presence of psychological distress, depression, anxiety, stress, and insomnia experienced by the Indian healthcare workers.Material and Methods:A cross-sectional study was conducted in India among 777 doctors to evaluate the mental health of doctors working in Corona wards from April 2020 to May 2020 using a pre-designed, pre-tested validated, semi-structured DASS-21 questionnaire, and the Insomnia Severity Index. Continuous variables between the groups were measured using the Mann–Whitney U-test and the Kruskal–Wallis H test.Results:Among the doctors working for the pandemic, around 55% of medical officers in the study reported having moderate levels of depression. With respect to anxiety, it was found that among men as many as 52% reported experiencing severe anxiety and 24% had moderate levels of anxiety whereas females reported as high as 68% and 48% of moderate and severe anxiety, respectively. In our study, around 30% and 44% of male doctors reported mild and moderate levels of stress, respectively, whereas 70% and 56% of female doctors reported mild and moderate levels of stress, respectively. It was also observed that among female doctors the rates of moderate insomnia were especially high (65%), whereas a high level of male participants reported sub-threshold insomnia (52%).Conclusion:Early screening targeting the medical workforce and the implementation of psychological interventions is essential for protecting and maintaining the functionality of the health-care system.

Prevalence, Clinical Characteristics, Virus Clearance and Treatment Outcomes of SARS-CoV-2 Infection in Healthcare Workers in India

Introduction: This aim of the study was to determine prevalence, associated factors, clinical characteristics, virus clearance and treatment outcomes of healthcare workers ( HCWs) with coronavirus disease 2019 (COVID-19) in a dedicated tertiary care COVID-19 hospital in India. Methods: The study included healthcare workers with laboratory confirmed COVID-19 from BYL Nair Hospital (NH), Mumbai, India. The data was captured from medical case records from 6th April to 31st August 2020. Epidemiological data was captured through interview of HCW. Duration of viral clearance amongst symptomatic and symptomatic HWCs was carried out using chi-square test.Results: The prevalence of SARS-CoV2 infection amongst HCWs was observed 11% during the first 5 months of COVID-19 pandemic. Majority of the HCWs with COVID-19 (85%) were symptomatic and 15% were asymptomatic. The frequency of SARS-CoV-2 infection was higher in Male HCWs (57%) as compared to female HCWs (43%). Hypertension and Diabetes Mellitus were the most common co-morbidities reported. More than 4% percent (18/413) of HCWs with COVID-19 were also positive for plasmodium vivax Malaria. 26% (107/413) of HCWs with COVID-19 were having symptoms suggestive of Severe Acute Respiratory Infection (SARI). Median duration for virus clearance was 11 (IQR, 7-15) days with maximum 40 days. Most of the asymptomatic cases cleared the virus within 15 days (93%) whilst most of the symptomatic cases cleared the virus between days 8 to 40 days (73%). Mean time to viral clearance was significantly higher in symptomatic compared to asymptomatic cases (8 days and 12 days, respectively, pConclusion: There is increased frequency of SARS-CoV-2 infection amongst frontline HCWs. We recommend universal testing of HCWs and double negative testing to label HCWs as fit to discharge to optimize staffing levels during this current pandemic. Testing should also be extended to family members and other close contacts. The HCWs are the most precious resource for every country.

Ergonomic mapping of work‐related musculoskeletal disorders and stress among Indian healthcare workers: An overview

Ergonomic mapping of work‐related musculoskeletal disorders and stress among Indian healthcare workers: An overview

Whole Genome Sequencing Confirmed SARS-CoV-2 Reinfections Among Healthcare Workers in India with Increased Severity in the Second Episode

Background: Frontline healthcare workers (HCWs) are exceedingly exposed to SARS-CoV-2 and reinfections are a possibility. A RT-PCR positive test does not confirm reinfection. Whole genome sequencing (WGS) of the viral isolates from the different episodes can confirm a reinfection. Methods: RNA was extracted from nasopharyngeal plus oropharyngeal samples from four HCWs who were SARS-CoV-2 RT-PCR positive in May/June and then again in July. Anti-NC antibody testing was performed after the second infection in three HCWs. The RNA was subjected to whole genome sequencing and comparative genome and protein-based functional annotation analyses were performed on the nucleotide and amino acid sequences. Findings: Whole genome sequencing of the eight SARS-CoV-2 viral samples generated a genome coverage ranging from 82.55 to 98.23%. Phylogenetic analysis revealed that sequences belonged to the L clade and within this major clade; they clustered into India-specific A2a and A4 clades. A total of 39 mutations were identified within the eight genomes, including 22 non-synonymous, 16 synonymous, and 1 stop-coding substitutions. Comparative genomic and protein-based annotation analyses revealed differences in the presence and absence of specific mutations in the virus sequences from the first and second episode in all four paired samples. Three HCWs were negative for anti-NC antibodies after the second infection.Interpretation: Genomic variations observed through whole genome sequencing coupled with clinical presentation confirm reinfections of SARS-CoV-2 in healthcare workers. Funding: Municipal Corporation of Greater Mumbai, ICGEB core funding, MLP-2005 and Fondation Botnar grants.Declaration of Interests: The authors declare no competing interests.Ethics Approval Statement: The study was approved by the Institutional Review Board of Kasturba Hospital of Infectious Diseases; IRB number 015/2020. The patients provided written informed consent.

Knowledge and attitude regarding COVID 19 among healthcare workers in India

Aim Covid-19 has engulfed the world and involved the healthcare workers (HCWs) worldwide. So, they should have the most updated knowledge and good attitude towards the disease. Hardly there is any study which evaluates the knowledge and attitude of healthcare professionals regarding Covid-19. This study assesses knowledge and attitude toward Covid-19 among HCWs across the country. Methods This was a multicentric cross-sectional study. It was performed from 10th-20th April, 2020. Convenient random sampling was used. Data was collected through self-administered questionnaire of knowledge and attitude of HCWs regarding Covid-19. Data was analysed to describe: demographic, mean knowledge and attitude score. Pearson correlation, Kruskal Wallis-H test and one way ANOVA were carried out to evaluate the relationship between study variables. Wherever required, post-hoc analysis was done using Tukey’s HSD method. Results Total 458 HCWs (56.8% were senior residents/postgraduate trainee) had mean knowledge score of 14.2±1.65 and mean attitude score of 3.80±0.52. 69.4% had sufficient knowledge but lack of knowledge was seen when Covid-19 infection rate and fatality rate was compared with seasonal flu. Nearly 85% didn’t know when to screen a patient and the components of Personal Protective Equipment. Significant difference in knowledge was seen between the junior residents/MBBS and senior resident/Postgraduate trainee, between nursing/allied sciences and consultants, and between nursing/allied sciences and senior resident/postgraduate (p-value <0.001). There was positive correlation between knowledge and attitude score (r =0.111, p =0.019). Conclusion Most HCWs had good knowledge and positive attitude but there were few lacunas. More frequent educational training programmes are required to overcome this chasm. Keywords Covid 19, Knowledge and attitude, Pandemic

Combating the pandemic of COVID-19 in India: health care worker perspective

As the pandemic of COVID-19 intensifies there is a huge burden on the health care system of each country. As predicted by epidemic model, India with 1.3 billion population and only 0.76 doctors per thousand people will have 1 million people affected by COVID-19 needing ventilatory support. This situation focusses on the substantial thrust on health care workers in India while dealing with the pandemic and protection of the health care workers from COVID-19 infection is significant as they are the key-groups in health system to procure win-battle status against COVID-19. Henceforth, after meticulously comparing various countries’ strategies to protect their HCWs this brief study is being prepared and few recommendations has been suggested which may enable the protection of HCWs in India. Un-interrupted supply of appropriate PPE, phenomenon of presenteeism among HCWs, burn-outs among HCWs, front-line department protocol for protection of HCWs, need of constant psycho-analysis among HCWs, stigma in society for HCWs, prophylaxis for HCWs against COVID-19 and HCWs’ family concerns are some of the issues which are being highlighted in this paper.

Safety of Healthcare Workers in India

Health is one of our fundamental human rights and the role of workers in the healthcare system is inseparable. Health workers being the front line staff have more complicated situations to deal with especially in the wake of a pandemic like COVID- 19. WHO cautions that they are exposed to hazards that put them at risk of infection. Nevertheless, we are witnessing the relentless efforts put forth by health workers to reinstall the health care system in their respective countries. Amidst all this tension, another concern that derails the COVID-19 battle is the attacks happening against COVID-19 warriors around different parts of the country. This paper is a subjective personal introspection of the authors on the safety of health workers in India. The main objective of the study is to find out the different problems of safety faced by healthcare workers in India and measures to control them.

COVID-19: A ‘Violent’ pandemic for health care workers in India

Aims and Objectives: This study aims at detailed analysis of various incidents of violence to doctors during the time of COVID 19 pandemic all over India. Study Design: Cross sectional study. Study Duration: 3 months, First Patient of COVID 19 Pandemic reported in India to the Presidential Assent to The Epidemic Diseases (Amendment) Ordinance, 2020 -30 January, 2020 to 23 April, 2020. Inclusion Criteria: All Incidents of violence against health care workers in India reported by English media (print and online). Exclusion: Incidents of violence against health care workers in India reported by testimonies, hearsay, social media, organisations/ associations/professional bodies, feedback/complaints, government reports. Results: There were 49 incidents of violence after the COVID-19 pandemic and related to it. Majority of the incidents were in South India. The urban areas had more incidents about 88%. The violence happened mainly in community 67%. The health care team were the overall target of the violence which included doctors, nurses, nursing attenders and others including ambulance drivers. Doctors were targeted in majority (33%) and the team (33%) were affected in the violence. The incidents included verbal, physical, psychological, social and sexual violence. The majority were verbal (60%) and physical (50%) violence. The majority were the mob or community who were involved in the violence. Conclusion: The violence against doctors and other health workers is not uncommon, the incidence seems high and unprecedent in India during this COVID -19 pandemic. . It should also be confirmed that violence against doctors and health care workers is strongly dealt with to serve as a deterrent and reassure the medical fraternity. Keywords: COVID-19, Doctors, Violence.

Is there Diversity in our Diet? A Cross-sectional Study among Healthcare Workers in a Tertiary care Hospital in Tamil Nadu

Healthcare is a demanding profession and often, while performing their roles, healthcare workers face multiple occupational and personal stresses that may influence their ability to maintain positive dietary habits. Nutritional adequacy is the comparison between the nutrient requirement and the intake of a certain individual or population. Due to the limited availability of data on the dietary diversity of healthcare workers in India, an attempt was made to conduct an across-sectional study of the dietary diversity of healthcare workers working in a tertiary hospital. The sampling frame comprised of various hospital staff and healthcare workers who were working in the hospital and a total of 119 were examined. The study tool was prepared based on the FAO dietary diversity questionnaire Details about age, gender, and details regarding their jobs, such as shift work, were collected. A score of &gt;11 was considered as the operational definition for a diverse diet. The socio-demographic variables of study participants, when analyzed show than early 90% (107) of the study population, were aged below thirty (30) years. Amongst the 119 subjects, 19 (16%) were male and 100 (84%) were female. Almost two thirds (58.8%) of the population involved worked in shifts. A majority of the subjects 18 (26.8%) opted for taste as the major determinant, followed by Stress at 15 (22.3%) and Cost with 12 (17.9%) subjects. When compared, dietary diversity in males was found to be much better. In conclusion, there is a significant absence of dietary diversity and the presence of nutrient inadequacy among the hospital staff and health care workers. This inadequacy is present primarily due to the ignorance and lifestyle choices of the subjects involved.

Impact of Covid-19 Pandemic on Mental Health of Healthcare Workers in India: A Questionnaire Based Study

Introduction: Healthcare workers across the globe are working tirelessly to keep the severity under control. The long working hours wearing PPE, the self-quarantine periods, staying away from family, and various other factors does influence the mental wellbeing of an individual. In a country like India, mental health is still a poorly recognised issue even among healthcare professionals. Objectives: To assess the stress, anxiety and depression among healthcare professionals at the time of Coronavirus pandemic and estimating the same in Anaesthesiology Cohort.Material &amp; Methods: The study was conducted using a self-reporting questionnaire. The questionnaire was made using Google forms and the link for participation was sent using various digital mediums e.g., email, WhatsApp, Facebook. The questionnaire was sent to a total of 886 doctors and there was a total of 256 responses were received. The questionnaire was submitted anonymously and no personal data was collected. The respondents were allowed to submit only once to prevent duplicity of responses. We used the DASS 21 scale as the assessment tool. Data was collected using google forms and the collected data were transferred to a Microsoft Excel sheet for analysis.Results: Our study on 256 doctors 40.75% of doctors were found to be suffering from Depression, 38.29% from anxiety &amp; 32.4% from stress in the current pandemic situation. Anaesthesiologists were found to have 30.29% depression; Anxiety was found among 42.56% and stress was found among 37.24%.Conclusion: Stressors, like grueling shifts, risk of infections, non-availability of protective kits, health risk to family and friends, etc, are many and respite seems to be far. We need to address and acknowledge the mental health of healthcare workers and people working in critical care consideration and find solutions to the underlying causes so that the current and future of healthcare can be saved from mental health crises.

Unmasking N95 for COVID-19 health-care workers in India.

A general term N95 Mask has been widely used by all including the health care personnel. It has been use incorrectly by all and it should be replaced with the term filtering facepiece respirator. There are two types of respirators being used in the world. One is the industrial type whereas the other one is the medical surgical one. The medical surgical masks are an intermediate product between the industrial and the triple layer medical mask. Many other equivalent products like KN95 masks are also available in the market. There is an urgent need of certification because this is the only way quality face masks can be provided to the public in these difficult times of COVID-19. This is essential because of the entry of many counterfeit and uncertified respirators have entered the market.

Risk factors and outcome among COVID-19 exposed and quarantined healthcare workers: A study on the status of existing practices of standard precautions.

Context:Health care workers (HCWs) are at high risk of COVID-19 infection but data on the risk factors for exposure and infection rate among Indian HCWs are limited.Aims:Our study aims to identify the risk factors and behavior of HCWs which make them high risk for COVID-19 infection and the infection rate among them.Settings and Design:This is a retrospective study conducted at All India Institute of Medical Sciences, New Delhi.Methods and Material:Fifty HCWs quarantined at our institute in April and May 2020 following exposure to confirmed or suspected COVID-19 cases, or due to development of Influenza-Like Illness (ILI) were included. Data was collected from medical records in a predesigned proforma and analyzed.Results:Thirty-eight (76%) of the 50 quarantined HCWs had high-risk exposure and there was a significant breach in personal protective measures. N-95 masks were worn by 59.6%, gloves by 61.7%, and goggles or face shields by 2%. Exposures were more common in non-COVID areas of the hospital. Hydroxychloroquine pre-exposure prophylaxis was taken by 7 (14%). 3 (6%) were confirmed to be COVID-19 positive during the quarantine period.Conclusions:Our study has shown leniency among HCWs in adhering to infection control and personal protective measures resulting in an increased quarantine and infection rate and loss of manpower. The safety of our HCWs must be given paramount importance during this pandemic and should be ensured by educating them about infection control, and persistently reinforcing and strictly adhering to standard precautions.

Proctoring Hydroxychloroquine Consumption for Health-care Workers in India As Per The Revised National Guidelines.

Proctoring Hydroxychloroquine Consumption for Health-care Workers in India As Per The Revised National Guidelines.