key: cord-0943155-ooc29lvm
authors: Henriquez‐Marquez, Karla Iveth; Lainez‐Murillo, Doris Carolina; Sierra, Manuel; Muñoz‐Lara, Fausto; Valenzuela‐Rodriguez, German; Pecho‐Silva, Samuel; Arteaga‐Livias, Kovy; Zambrano, Lysien I.; Rodriguez‐Morales, Alfonso J.
title: High impact of SARS‐CoV‐2 or COVID‐19 in the Honduran health personnel
date: 2020-12-17
journal: J Med Virol
DOI: 10.1002/jmv.26702
sha: c6c68c7d3d67a6ca8a22ab131136d17c7cf8e9c5
doc_id: 943155
cord_uid: ooc29lvm

After more than half of 2020, the pandemic due to the Coronavirus Diseases 2019 (COVID-19) is causing a devastating impact around the world (1). The first line of workers against COVID-19 is the health sector, which undoubtedly is the fundamental piece in this emergency. This article is protected by copyright. All rights reserved.

the reported in other countries of Latin America, that have focused mainly in physicians (Table 1) . 4, 5 The majority of health personnel affected by COVID-19 are between the ages of 20-40 years old ( Figure 1 ).

In addition to poor health infrastructure, the Honduran health system tends to persist with a recurrent shortage of equipments, medicines, supplies, and human resources. The pandemic has imposed a significant toll on health services, that is insufficient to satisfy the demands of the population. The lack of personal protective equipment (PPE) for COVID-19 associated with overexposure to the virus 3,6 caused a higher contagion rate in exposed personnel (Table 1) . On top of this high-risk environment, there is a need to perform a higher number of tests, compared to the current average of 1300 tests per day during the last months. The possibility of investigating the factors that contribute to the shortage of PPE should be considered, since in addition to the limited availability in the country, the inappropriate use of this can be a contributing factor. 7 There are several protective measures for health personnel, such as availability and proper use of Personal Protective Equipment (PPE). WHO recommends the use of masks (N95, FFP2, FPP3 or equivalent, and of guaranteed quality), however, in Honduras, some lots of N95 that were purchased during the emergency were not certified or were for industrial use.

Most of the national health infrastructure was built in the period 1960-1970. Therefore, the implementation of exclusive spaces for the evaluation and admission of COVID-19 patients was a challenge and very soon, we had cross-infections among different health services. A deficient culture on risk management and the disposition of contaminated materials was another challenge to the health system. 6 Due to the lack of opportune laboratory testing and diagnosis, only health personnel with high-risk factors for severe disease or with signs and symptoms compatible with COVID-19 were removed from their work. 3, 6 Last year health students and recently under graduated health professionals were also hired to address the increasing demand.

The enormous psychological and physical burden involved in seeing a large number of patients and colleagues dying from COVID-19 causes a psychological impact on health personnel. In addition to the risk of exposure and "Burn Out" syndrome, psychological pathologies can arise or can be exacerbated by this situation 8, 9 Psychological assistance should be continuous to evaluate and 

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