The COVID-19 is now affecting almost all the countries around the world. The disease, a viral flu-like illness caused by the novel coronavirus, has not only struck general people but also healthcare workers like doctors, nurses and paramedics. In Nepal also, over 500 healthcare workers have been affected by the disease. Globally, over 7,000 healthcare workers have died of the disease. Healthcare workers are at the frontline of treating COVID-19 patients. As the disease is highly contagious, there is always risk for healthcare workers of exposure to the disease. The disease is transmitted from person to person through airborne droplets that come out when the infected speak, cough or sneeze. Besides such direct hazards, healthcare workers may also be prone to other hazards like long working hours, fatigue, burnout, stigmas and even physical assaults.
Stigma As the disease has assumed pandemic proportions with over 200,000 infections detected every day around the world, healthcare workers are working day and night in the curative and palliative services of patients. Their untiring work deserves high appreciation. Still, some healthcare workers have fallen victim to stigmas and physical violence. The doctors and nurses were stigmatised as if they were spreading the disease in the locality. Considering the potential hazards to the healthcare workers, the World Health Organisation (WHO) has designed protocol on, inter alia, their safety and treatment and curative procedures. Health facilities like hospitals should ensure that their employees work safely at the workplace. Healthcare workers should be trained on occupational safety and health risks so that they can fulfil their duties in a safe environment. Occupational safety is very important because when healthcare workers themselves come down with the disease, how can they treat patients? In order to enhance safety at the workplace, safety gear like masks, face shields, gloves and personal protective equipment (PPE) needs to be provided for every healthcare worker. There are complaints in Nepal that not all healthcare workers have been provided with such protective equipment. The government should not be miserly at such a critical juncture. Safety first for healthcare workers should be the mantra against battling COVID-19. Further, test kits and other materials required for the detection and treatment of the disease should be in place. In Nepal, reverse transcription polymerase chain reaction (RT-PCR) tests are being conducted to detect the disease. However, the government has said that such tests should be reduced as it cannot bear the cost. In fact, test, trace and treatment should be the leitmotif of the government in the fight against the disease. Healthcare workers should not be forced to come to the workplace if there is a hazard to their health. When a hospital has detected several or many COVID-19 patients, it is generally sealed. This action is designed to stop the further spread of the disease. Some people opine that hospitals should not be sealed and all healthcare workers should attend the hospital. It would be suicidal for healthcare workers to attend the infected hospital. However, the management of the health facility should take appropriate steps such as disinfecting the premises and properly isolating the infected before allowing in their employees. As they have to work in a high-risk zone, healthcare workers should be entitled to compensation, rehabilitation and curative services in case they suffer in any way while in the line of duty. It may be noted that their exposure to the pathogen at the workplace is known as occupational exposure, whereas the resultant disease is called occupational disease. The provision for compensation, rehabilitation and curative services will motivate healthcare workers to work even more honestly and dutifully. There should be counselling services for some healthcare workers because they have to work in a stressful and adverse environment, sometimes even without breaks. The management should develop cooperation and rapport with their employees or their representatives. The synergy between these two actors will go a long way in producing positive outcomes in the battle against COVID-19. On the other hand, healthcare workers have their own duties and responsibilities as set forth in the WHO protocol. Healthcare workers should abide by occupational safety rules such as the wearing of face masks, gloves and PPE. They should follow test, treatment, triage and other procedures. They should be polite to their patients and treat them with respect and compassion. It is the bounden duty of healthcare workers to maintain patient confidentiality. They are not allowed to reveal the identity of patients in their charge. In line with this policy, the government has not disclosed the identity of people in whom COVID-19 has been detected. Some people may demand that the government identify the new-found patients, which is against the policy of non-disclosure of the identity of patients. The Supreme Court has directed the government not to disclose even the addresses of COVID-19 patients.
Safety Healthcare workers should take care of themselves while in the service of their patients. They should monitor their health regularly. Should they detect anything abnormal, they should report it to the management of their health facility. They should also report any risk to their health or life to the management. Moreover, if they are in stress or under any undue influence or duress, they should report it to the management. Healthcare workers cannot work well under adverse circumstances. The WHO protocol regarding the safety of healthcare workers, if strictly followed in the battle against COVID-19, will indubitably produce positive results. So the healthcare workers in Nepal should follow the protocol and the government should play a facilitating and supportive role in creating an enabling environment for them to work effectively in the fight against COVID-19.