Covid-19: BMA calls for rapid testing and appropriate protective equipment for doctorsBMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1099 (Published 17 March 2020) Cite this as: BMJ 2020;368:m1099
All rapid responses
Whilst the health select committee made mention yesterday of the importance of supplying the staff at the frontline of this terrible pandemic with effective and correctly fitted PPE, might I suggest that a valuable role for retired medical practitioners might be to campaign for the improvement of general pastoral care of these young doctors.
I think that there are some simple measures which could add considerably to the safety and morale of the hospital staff.
I believe that every hospital should be providing lockers for storage of doctors’ personal possessions so they don't have to bring potentially contaminated equipment such as stethoscopes home. Importantly, no hospital doctor should, at this time, be wearing “civilian clothes” in the hospital. They should all be issued with a fresh pair of scrubs to work in. A hot soapy shower at the end of the shift would help protect us all as they often travel home on public transport or in taxis, and more importantly help protect their own partners, children and unborn children.
We know that fatigue and stress have a detrimental effect on the immune system. There should be quiet rest areas and hot food available, especially during night shifts. The last thing they should be worrying about is having to remember to pack a picnic supper.
Lastly I believe our hospital doctors are going to be facing the deaths of very significant numbers of patients in their care. The emotional impact will be huge. They need help with setting up peer support possibly overseen by psychologists re-tasked away from psychiatric outpatient clinics.
If each retired doctor lobbied their local MP and local hospital medical director we could achieve something really important.
I’m old enough to remember that in the 1970s at UCH /St Pancras Hospital we were given a free bottle of beer or cider with our supper, a silver service cooked breakfast the morning after a night on call and of course an on-call bedroom, to rest when we could.
I, like many retired GPs have a vested interest in campaigning for the frontline doctors, not just because they may be called upon to look after my health should I become infected myself but also because I have 2 daughters currently working at the coal face. One who has apparently graduated 5 months early , her final exams having been cancelled!
Lis Hawthorne (retired GP Didcot Health Centre)
Competing interests: No competing interests
RE: The important statement “We are also concerned about the need for healthcare workers to be protected from exposure so that we are able to work as safely and effectively as possible throughout the duration of this crisis.”
It is inevitable that many frontline healthcare workers will be exposed to COVID-19 during the coming weeks and months, with particular risk afforded to prolonged contact with patients . The principal concern is not only protection again exposure, but the degree of viral load that the individual may be exposed to. Thus, even previously healthy individuals can be affected deleteriously by COVID-19. A higher viral load detected in the upper respiratory tract makes it more infectious than previous SARS-CoV and MERS-CoV diseases . The transmission of COVID-19, as with other coronaviruses, occurs via droplets . Providing a sealed face mask (with eye protection if necessary) would prevent minimise exposure to these droplets, and prevent hand to mouth transmission. However, compliance is important, and these do need to be fitted correctly.
Protection of healthcare workers is paramount, even more so in such a challenging time. Reducing the amount of viral load if and when exposure happens needs to be a priority for healthcare providers.
1. Ran L et al. Risk Factors of Healthcare Workers with Corona Virus Disease 2019: A Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clin Infect Dis. 2020 Mar 17
2. Holshue et al. First Case of 2019 Novel Coronavirus in the United States. N Engl J Med 2020; 382:929-936 DOI: 10.1056/NEJMoa2001191
3. Yu P et al. . A familial cluster of infection associated with the 2019 novel coronavirus indicating potential person-to-person transmission during the incubation period. The Journal of Infectious Diseases 2020.
4. Siegel JD et al. . 2007 guideline for isolation precautions: preventing transmission of infectious agents in health care settings. Am J Infect Control 2007;35: S65-164.
Competing interests: No competing interests