Frontline health workers are the backbone of effective health systems because they play a critical role in providing solutions. Without frontline health workers, there would be immeasurable suffering because millions of sick people won’t access health care services (Liu et al., 2020). They act as the first link in providing healthcare services and other life-saving services for millions of people. Frontline health workers have been proven to be the central pillars of health systems. Well-supported or protected frontline health care workers bring about essential improvements in health conditions, especially during pandemics like the current Covid-19 pandemic.
Problem: Safety of Frontline Healthcare Workers Amid Covid-19
Since Covid-19 was declared a global pandemic, healthcare workers have experienced high levels of exposure, with the infection risks rising each time they are attending to patients who may be Covid-19 positive. Frontline healthcare workers are at the most significant risk of contracting Covid-19, representing the large percentage of new Covid-19 infections. An essential element when discussing frontline healthcare worker’s exposure to Covid-19 relates to the asymptomatic and pre-symptomatic transmission of this disease, which affects up to 30% of individuals (Nyashanu et al., 2020). New York City is among the cities that have been severely affected by Covid-19 since its outbreak, with widespread community infections including high-acuity disease burden. Considering the high risk of Covid-19 infection among frontline healthcare workers and the consequent distress and concerns from asymptomatic infection and transmission, it is essential to address the safety of frontline healthcare workers in the fight against Covid-19.
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Addressing Safety of Frontline Healthcare Workers Amid Covid-19
An implementation of a safety protocol could address the safety of frontline healthcare workers amid Covid-19 and strengthen the overall control of this pandemic. The proposed safety protocol would cover reasonable working hours, ward protection, and operating room protection. Reasonable working hours: Some of the frontline healthcare workers are infected due to a shortage of staff and inadequate supplies resulting from a large influx of Covid-19 patients from time to time. Severe fatigue during these times increases the probability of healthcare workers contracting Covid-19. Therefore, reducing the workload is a good strategy to defend frontline health workers from contracting the disease. Limiting frontline healthcare workers to work for 4 hours in quarantine wards and 7 hours cleaning office areas on regular days is an advisable routine. This would ensure frontline health workers have adequate rest time.
Ward protection: Covid-19 wards should be divided into four zones: quarantine where patients are admitted, first buffer zone where healthcare workers dress up before attending to patients, second buffer zone where they remove the PPEs and disinfect them, and the clean zone where healthcare workers rest after disinfection. Covid-19 patient’s access to those wards should be separated from that of healthcare workers attending to them. It should be mandatory for healthcare workers to wear PPEs before entering buffer zones. The buffer zone should involve two healthcare workers working together to ensure that PPEs have been worn well and assessing any default or damaged PPEs. In the quarantine ward, healthcare workers should be disinfected with sanitizer before and after interacting with patients. After attending to patients in the quarantine ward, healthcare workers should enter the second buffer zone to remove PPEs carefully, disinfect them, and enter the clean zone.
Operating room protection: Some elective surgeries should be suspended except for patients requiring immediate assessments and emergency surgeries. Surgeons must wear full-face masks, disinfect their hands with 75% concentrated sanitizers, put on the first pair of sleeve protectors and sterile surgical gloves, followed by sterile and disposable surgical gowns, and the second pair of gloves. Anesthesiologists attending to patients under general anesthesia must wear a full-face mask.
Ethical, Legal & Regulatory Concerns Relating to Safety of Frontline Healthcare Workers Amid Covid-19
Ethical, legal & regulatory issues will be expected to protect frontline healthcare workers amid Covid-19. For instance, achieving the safety of frontline healthcare workers amid Covid-19 will raise a host of ethical concerns. Still, key among them will be the possibility that healthcare systems will be forced to ration the scarce critical care resources to enhance patient’s ability to benefit from treatment and survive as the first-order considerations (McGuire et al., 2020). A legal concern expected is the healthcare employer’s liability and ensuring safe working conditions for frontline healthcare workers. One question that will be undoubtedly encountered is the extent to which healthcare employers should be liable (and thus responsible for damages) for frontline healthcare workers’ exposure to contracting Covid-19 and labor issues related to this pandemic.
Hundreds of lawsuits will be expected from frontline healthcare workers alleging that employers have violated regulations regarding their safety. Labor issues, especially the allegations of wrongful denial of leave, will be expected from frontline healthcare workers. The extent to which the two federal acts (Families First Coronavirus Act (FFCRA)) addressing the Covid-19 pandemic should be observed will raise regulatory concerns. Although FFCRA requires employers with fewer than 500 workers to provide employees with job-protected leave for reasons related to Covid-19 pandemics, such as caring for loved ones, employers will face challenged in deciding the exclusions from this leave, especially with the shortage of healthcare workers (Romig & Bryant, 2020).
Reason for Choosing Safety of Frontline Healthcare Workers
Safety of frontline healthcare workers has been chosen because protecting healthcare workers is the only way the health systems will keep functioning to conquer the Covid-19 pandemic. Protecting frontline healthcare workers is the only way to guarantee the safety of Covid-19 patients. As the frontline officers, failure to protect frontline healthcare workers will make healthcare systems vulnerable.
References
Liu, Y., Yang, S., Hung, M., Tong, W., & Liu, Y. (2020). Protecting healthcare workers amid the COVID-19 crisis: A safety protocol in Wuhan. Frontiers in Public Health, 8. https://www.frontiersin.org/articles/10.3389/fpubh.2020.577499/full
McGuire, A. L., Aulisio, M. P., Davis, F. D., Erwin, C., Harter, T. D., Jagsi, R., … & COVID-19 Task Force of the Association of Bioethics Program Directors (ABPD). (2020). Ethical challenges arising in the COVID-19 pandemic: an overview from the association of bioethics program directors (ABPD) Task force. The American Journal of Bioethics, 20(7), 15-27.
Nyashanu, M., Pfende, F., & Ekpenyong, M. (2020). Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK. Journal of Interprofessional Care, 34(5), 655-661.
Romig, K., & Bryant, K. (2020). Commentary: Policymakers should expand emergency paid leave in next coronavirus package. Center on Budget and Policy Priorities, 20.
