key: cord-333872-shhugvx0
authors: Kumar, Jitendra; Khatana, P.S.; Raina, Rajni
title: The conundrum of rising Covid19 infection among health care workers: An emerging paradigm
date: 2020-07-04
journal: Am J Emerg Med
DOI: 10.1016/j.ajem.2020.07.001
sha: 
doc_id: 333872
cord_uid: shhugvx0

nan

in your esteemed journal has drawn our attention and we read it very keenly. Many other reports along with our own experience which we are sharing here, strongly suggests that we need to think outside the box to protect our HCWs in the current challenging situation.

First of all, we would like to illustrate few of the case events which we witnessed in our own tertiary care hospital. One unsuspected case of a young male with acute abdomen was being conservatively managed for a week then suddenly he developed respiratory distress. His

In the beginning of the pandemic, lack of knowledge about covid19 was blamed for infection among HCWs [4, 5] . Maybe it is true but with time, situation is not improving either. In fact, in some cases it has become worse [6, 7] . So far, most of the reports cited reason for this large number of infections among HCWs are lack of resources like PPE kits, lack of infection control training, long working hours & stressful environment and particular procedure with potential of high aerosol generation [4] [5] [6] . Not only an article by Smereka J. et al. [2] but almost every relevant article on the safety issues of HCWs has paid lot of attention to personal protection kit (PPE) for protection of HCWs while available evidence is not strong enough that makes it 100% effective [8] .

With the time, issue of asymptomatic HCWs infected with covid19 has also become a big concern. Such asymptomatic infected HCWs can transmit infection unknowingly to the patients and other HCWs. At one of the London hospital, sample for RT-PCR testing for covid19 taken from asymptomatic and healthy HCWs at multiple point of time. In a total number of 1,479 health care worker's sample, 1.1% to 7.1% (at different point of time) were found positive for Covid19 [9] . That's why, now epidemic surveillance and routine testing at multiple point of time for every HCWs including asymptomatic one is strongly recommended [10] .

Worse of all, no country around the world is tracking or reporting any data related to covid19 infection among HCWs. W.H.O. and International Council of Nurses (ICN) raised serious concern regarding lack of data of Covid19 related infection and deaths among HCWs. In spite of this, no steps have so far been taken by any concerned authorities across the world.

Unless we maintain transparency in record keeping related to covid19 infection among HCWs, we can't analyse and prevent it further.

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COVID-19 and the Risk to Health Care Workers: A Case Report

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COVID-2019) Infection Among Health Care Workers and Implications for Prevention Measures in a Tertiary Hospital in Wuhan, China

Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19

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