Covid-19’s assault on doctors, nurses carries greater threat

Large-scale infection of healthcare professionals can worsen the current situation of the Coronavirus outbreak in Bangladesh, as the country suffers from an acute shortage of such workers, compounded by their maldistribution, reports UNB.

The number of infected health workers has increased manifold alongside the surging overall caseload in Bangladesh. Around 100 healthcare professionals, including 54 doctors, tested positive for Covid-19 in the country as of April 14, according to Bangladesh Doctors' Foundation (BDF). This number has likely increased further since then.

BDF founder and Chief Administrator Dr Nirupam Das said two doctors are undergoing treatment in ICUs while one has died so far. Most of the doctors infected were in Dhaka and Narayanganj-two major clusters of community transmission of the SARS-CoV-2 coronavirus, which causes Covid-19.
Dr Nirupam also said more than 300 healthcare professionals are currently in home-quarantine.

The figures on April 14 marked a threefold rise in the number of infected healthcare professionals in just a few days. There are an estimated 3.05 physicians per 10,000 population and 1.07 nurses per 10,000 population (estimates based on MoHFW HRD 2011). There is a severe gap between sanctioned and filled health worker positions: 36 percent of sanctioned health worker positions lie vacant.

Meanwhile, less than a third of healthcare facilities (32 percent) have three-fourths or more of the sanctioned staff working in the facilities (World Bank, 2009). The danger of being infected has been a persistent concern within the community of healthcare workers, particularly doctors and nurses. They are daunted by the alarming rate of infection and increasing trend, that may have to be tackled with many doctors waylaid.

Doctors and nurses working in public hospitals shared their anxieties over the dilemma they face with UNB, understandably on condition of anonymity. As the number of infections is increasing day by day, many frontline healthcare workers are facing the ultimate challenge in collecting samples to detect the virus, for which one medical technologist is deployed in every upazila of the country. The Health Department directed them to collect 10 to 20 samples a day in their areas.

Although no up-to-date collated figures are available, the Coronavirus Resource Centre at Medscape, the online resource for doctors, collects and publishes a list of health workers who have become victims of COVID-19 in different countries of the world. The current list already includes hundreds of names, and it is updated almost every day.

As far back as 2011, the World Health Organization declared Bangladesh as one of 58 'crisis countries' facing an acute shortage of human resources in healthcare, based on the number of formally qualified, registered Health Care Providers (HCP), i.e. doctors (or physicians), nurses, and dentists in the country.

The HCP density was measured per 10 000 of population. Quoting from the study, there were "approximately five physicians and two nurses per 10 000, the ratio of nurse to physician being only 0.4." Substantial variation among different divisions was also found, with "gross imbalance" in distribution favouring the urban areas. No-one of it bodes well for dealing with the local outbreak during a pandemic.