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Covid-19: How can we keep the world’s doctors safe?

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1100 (Published 29 April 2021) Cite this as: BMJ 2021;373:n1100

Read our latest coverage of the coronavirus pandemic

  1. Fiona Godlee, executive editor
  1. The BMJ
  1. fgodlee{at}bmj.com
    Follow Fiona on Twitter @fgodlee

The world’s doctors have been at the forefront of the pandemic response. Already overstretched by workforce shortages, they have carried exhaustion, uncertainty, and risk, redeploying to unfamiliar specialties, learning at speed, and adopting different ways of working and new technology,1 while all the time fearing for their patients, their families, and themselves. For many there has been the added burden of betrayal by governments, whose decisions have caused avoidable harm through waste, corruption, and incompetence and through policies driven by ideology rather than evidence.23

Nothing shows this more starkly than the events unfolding in Myanmar and India. Doctors who have joined peaceful protests against the military regime in Myanmar are being assaulted, shot at, and arbitrarily arrested.4 Reports of patients voluntarily leaving hospital in support of striking medical staff reflect the extent of the public’s despair.5

In India, pictures of exhausted doctors and nurses tell a different but equally dreadful tale, with shortages of oxygen and other essential supplies,6 as the official but almost certainly underestimated death toll heads towards 200 000.

Countries and colleagues around the world are at last responding. Medical organisations have condemned the targeting of doctors in Myanmar.7 And desperately needed supplies are arriving in India, although not yet the US’s unused stockpile of the Oxford-AstraZeneca vaccine.8 Meanwhile senior UK doctors of Indian origin have proposed a plan to tackle the healthcare crisis, including a call for a ban on mass gatherings and postponement of the forthcoming elections.9

The role of mass gatherings in the spread of covid 19 remains a subject for debate, and with it the question of whether people should be encouraged or even required to wear masks outside.1011 As for indoor transmission, official guidance has yet to reflect the growing evidence on airborne spread,12 but the UK government’s advisers seem to be heading towards recommending what many think is long overdue: higher grade face masks for all staff who care for patients with suspected or confirmed covid-19.13 Mandatory vaccination for healthcare workers is not, however, being considered.14

As the pandemic continues, how can we properly look after doctors so they can look after their patients and communities? We need to focus on the big ticket items on which a better future for all of us depends: good governance, equitable healthcare, universal health coverage, and action on climate change.15 But there are other, no less important acts that will help protect doctors, not least providing proper personal protective equipment (https://www.bmj.com/wellbeing) and enabling and encouraging mutual support.16

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