From Our Bureau
11th April 2020
The Corona Virus (CPVID-19) pandemic situation continued to worsen globally, with the confirmed cases across the world jumping to 16,10,909 and the death toll reaching 99,690 in the 213 affected countries and territories, according to the latest update from the World Health Organization (WHO).
Globally, European region continued to be the worst-hit, with 8,39,257 confirmed cases and 70,565 deaths. American region came next with 5,36,664 confirmed cases and 19,294 deaths. Western Pacific region’s tally stood at 1,18,549 confirmed cases and 4,017 deaths. Eastern Mediterranean region reported 92,226 confirmed cases and 4,771 deaths. South-East Asia region recorded 14,161 confirmed cases and 617 deaths and African region witnessed 9,340 confirmed cases and 415 deaths. WHO Risk Assessment at global level remained very high.
Yemen reported its first case of COVID-19 in the past 24 hours. WHO has developed the following definition for reporting COVID deaths: a COVID-19 death is defined for surveillance purposes as a death resulting from a clinically compatible illness in a probable or confirmed COVID-19 case, unless there is a clear alternative cause of death that cannot be related to COVID disease (e.g., trauma). There should be no period of complete recovery between the illness and death.
WHO Director-General Dr. Tedros, in a press conference ON April 10th, highlighted the issue of planning the transition out of stay-at-home restrictions: “WHO wants to see restrictions lifted as much as anyone. At the same time, lifting restrictions too quickly could lead to a deadly resurgence.” WHO has updated its Q&A page on COVID-19 to provide information of how the virus spreads and how it is affecting people worldwide.
To date, there are a limited number of publications and national situation reports that provide information on the number of healthcare worker (HCW) infections. Understanding infection in HCWs is critical to informing the specific infection prevention and control measures needed to protect HCWs from infection.
Healthcare workers (HCWs) play an essential role at the front lines, providing care for patients. In the context of COVID-19 and during routine health services, they provide critical care to patients and ensure that infection prevention and control (IPC) measures are implemented and adhered to in healthcare facilities in order to limit healthcare-associated infections.
As of 8 April 2020, 22 073 cases of COVID-19 among HCWs from 52 countries had been reported to WHO. However, at the present time, there is no systematic reporting of HCW COVID-19 infections to WHO and therefore this number probably under-represents the true number of COVID-19 HCW infections globally. To date, there are a limited number of publications and national situation reports that provide information on the number of HCW infections. For example, a publication from China CDC on 44 672 confirmed cases as of 17 February 2020 indicated 1688 (3.8%) infections were among HCWs, including five deaths.
In Italy, a situation report from 10 April 2020 reported 15 314 infections among HCW, representing 11% of all infections at that time. Further publications have described the epidemiological and clinical characteristics of infections among HCWs. While many infections are indicated as mild, severe outcomes, including deaths, among HCWs have also been reported.
Understanding infection in HCWs is critical to informing the specific IPC measures needed to protect HCWs from infection. A limited number of publications have identified risk factors for infection among HCWs. Preliminary results suggest HCWs are being infected both in the workplace and in the community, most often through infected family members.
In healthcare settings, factors associated with HCW infection have included: late recognition or suspicion of COVID-19 in patients, working in a higher-risk department, longer duty hours, sub-optimal adherence to IPC measures such as hand hygiene practices, and lack of or improper use of personal protective equipment (PPE).
Other factors have also been documented, such as inadequate or insufficient IPC training for respiratory pathogens, including the COVID-19 virus, as well as long exposure in areas in healthcare facilities where large numbers of COVID19 patients were being cared for.