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Since the onset of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which causes Covid-19, frontline healthcare workers around the world have been at high risk of infection.

As the pandemic continues, they remain at the frontline, risking their lives to keep us safe, write Dr Patrick Osewe, Chief of Health Sector Group, Asian Development Bank and Dr Kieran Walsh, BMJ Clinical Director.

BMJ in partnership with the Asian Development Bank

Healthcare workers are unsung heroes

And the challenges they face have not gone away.

As Covid-19 continues to paralyze our society, they continue to work in sometimes overwhelmed health systems. The scale and uncertainty of the public health crisis⎯along with the strain of responding to it⎯have resulted in burnout and exhaustion among healthcare workers worldwide.

Over 37 million patients have been diagnosed with Covid-19 globally, with approximately 1 081 000 deaths. The countries of Asia have also been severely affected. In India alone, there have been over 7 million confirmed cases and over 100 000 deaths. And at least 7,000 health workers have died around the world after contracting Covid-19.

As the first line of defence in the Covid-19 pandemic, frontline healthcare workers play a critical role in preventing the spread of disease. Under difficult conditions, they have also been responsible for continuing to provide a service for patients with other illnesses.

As the bridge between scientific information and patients, health professionals have a vital role to play in communicating evidence-based information to patients, carers, and the general public which can help dispel myths and misinformation about the pandemic. So it is vital that they receive updated, evidence-based and trusted medical information and guidance about the virus. 

From shortages of personal protective equipment to delays in testing, the pandemic has exposed the vulnerability and fragility of our health systems. One of the biggest challenges for healthcare workers is working in an uncertain environment where there is limited knowledge about the virus. Under the best of conditions, it can take up to 17 years for evidence to become routine clinical practice.

The scientific evidence on Covid-19 has changed every week for the past nine months and healthcare workers, especially those with little or no prior infectious disease expertise, are finding it challenging to keep up with the latest guidance in a sea of information, misinformation and disinformation.

 

The challenge of comorbidities

The World Health Organisation has called on all countries to accelerate and fund Covid-19 research to tackle the outbreak, leading to great advances in our knowledge of the virus over the past nine months.

These have extended to knowledge of epidemiology, diagnosis, differential diagnosis, investigations, management and prognosis. 

One issue that has become clear is that certain groups of patients with Covid-19 will become seriously ill. These are largely patients with comorbidities.

The comorbidities that have the greatest adverse effects are chronic non-communicable diseases (such as hypertension, diabetes, heart disease, and kidney disease). These make the management of the virus more challenging and complex.

With many countries experiencing further waves of infection, there is an urgent need to educate large numbers of healthcare professionals on how to diagnose, manage, and prevent infections. Traditional methods of providing education to healthcare professionals will not work in these new circumstances.

The pace of change of scientific knowledge means that information on epidemiology, testing and prevention become out of date within days if not weeks.

Digital tools such as evidence-based clinical decision support at the point of care and e-learning are proven means of providing the education needed. They can help health professionals and community health workers manage patients with Covid-19, its relevant differential diagnoses, and common comorbidities in real-time, at the point of care.

Health professionals are often guided by their institution or local health authority on which resource to follow, however, there is no guarantee that all guidelines are updated regularly. Many also rely on public sources of information; a simple Google search of “Covid-19 resources for healthcare professionals” yields hundreds of options. And of course, this search result will vary from country to country. So how does a health professional confidently choose which one to view?  

Coronavirus Information Centre

In response to these many challenges, BMJ in partnership with the Asian Development Bank (ADB) has launched a new Coronavirus Information Centre for all healthcare workers in ADB’s 49 member countries in the Asia Pacific region. 

The online Information Centre provides free access to BMJ’s clinical decision support resources via BMJ Best Practice, e-learning modules via BMJ Learning, as well as patient information leaflets and procedural videos.

The Coronavirus Information Centre draws upon BMJ’s experience from the Clinical Decision Support Training Initiative, a pandemic preparedness programme that supported healthcare professionals in the Caucasus, Middle East and South East Asia.

Over 18,000 doctors have benefited from the Initiative. BMJ’s resources left a long-term positive impact on health professionals’ knowledge and skills with 95% reporting that BMJ’s resources helped them improve patient care.

BMJ also had an impact on strengthening health systems within the countries – through establishing online accredited continuous professional development, integration of e-learning into curricula, and driving healthcare quality improvement initiatives.

In 2018, the Initiative won the Prize for Innovation in Global Security from the Geneva Centre for Security Policy due to its positive, and sustainable impact on pandemic preparedness and health systems strengthening. 

We are delighted to put what we have learned from this Initiative into our planning for the new Coronavirus Information Centre with ADB.

ACCESS THE CORONAVIRUS INFORMATION CENTRE
  • BMJ Best Practice offers continually updated, evidence based and practical guidance for the point of care, giving healthcare professionals immediate answers to their Covid-19 clinical questions without interruption to their workflow.

     

  • BMJ Learning offers interactive and multimedia learning modules for healthcare professionals. They are essential to patient safety and also the safety of healthcare professionals. 

  • BMJ’s Covid-19 patient information leaflets can be used to help dispel myths about the virus that are being spread by word of mouth and on social media. 

Dr Patrick Osewe, Chief of Health Sector Group, Asian Development Bank provides leadership on policy, technical, and operational matters. In close collaboration with the Sector Committee, he is leading the application of new and innovative approaches to address priority and emerging health issues in the Asia and Pacific region. 

Prior to his time at ADB, Patrick worked as the World Bank’s Global Lead of Healthy Societies, providing technical and operational guidance to countries, World Bank teams, and the global health community to address public health challenges.

These include strategies for achieving universal health coverage (UHC), combatting the emerging threat of non-communicable diseases, addressing health security as both an economic issue, and as a major challenge to achieving UHC.  

Get in touch

For partnership queries or anything else, please contact us.
Dr Kieran Walsh
BMJ Clinical Director