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# An Online Survey of Healthcare Professionals in the COVID-19 Pandemic in the UK: : Perceptions of Risk Factors

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### Abstract

To explore the emerging concerns of COVID-19 related issues amongst health care workers, members of a range of healthcare organisations, governmental agencies, and the media, and online self-administered survey of healthcare workers was undertaken by the British Association of Physicians of Indian Origin in April 2020. Results The respondents were predominantly hospital doctors (67%), aged between 40-60 years (72%) and from Black, Asian, and Minority Ethnicity (BAME) backgrounds in the UK (86%). Thirty percent of respondents had one or more vulnerable comorbidities. Over 78% reported either lack of, or inappropriate Personal Protective Equipment (PPE) for their role and 68% of respondents felt that they were unable to comply with or that it was impractical to adhere to social distancing at work (including commuting). At the time of the survey, 18.5% of respondents reported having a confirmed or suspected diagnosis of COVID-19. In multivariate analysis, the BAME community emerged as an independent risk factor (OR 1.45) for COVID-19 when adjusted for confounding factors. Conclusions These results add to the emerging concerns expressed internationally on the observation that BAME ethnicity appears to have a higher risk of developing COVID-19. This is the first study that adjusted work-related factors (inability to maintain social distancing and inadequate PPE) and comorbidities. Our work supports the imperative for designing and conducting urgent larger studies to understand this risk and plan appropriate mitigation of the risks to health care workers

### Most cited references5

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### COVID-19: protecting health-care workers

(2020)
Worldwide, as millions of people stay at home to minimise transmission of severe acute respiratory syndrome coronavirus 2, health-care workers prepare to do the exact opposite. They will go to clinics and hospitals, putting themselves at high risk from COVID-2019. Figures from China's National Health Commission show that more than 3300 health-care workers have been infected as of early March and, according to local media, by the end of February at least 22 had died. In Italy, 20% of responding health-care workers were infected, and some have died. Reports from medical staff describe physical and mental exhaustion, the torment of difficult triage decisions, and the pain of losing patients and colleagues, all in addition to the infection risk. As the pandemic accelerates, access to personal protective equipment (PPE) for health workers is a key concern. Medical staff are prioritised in many countries, but PPE shortages have been described in the most affected facilities. Some medical staff are waiting for equipment while already seeing patients who may be infected or are supplied with equipment that might not meet requirements. Alongside concerns for their personal safety, health-care workers are anxious about passing the infection to their families. Health-care workers who care for elderly parents or young children will be drastically affected by school closures, social distancing policies, and disruption in the availability of food and other essentials. Health-care systems globally could be operating at more than maximum capacity for many months. But health-care workers, unlike ventilators or wards, cannot be urgently manufactured or run at 100% occupancy for long periods. It is vital that governments see workers not simply as pawns to be deployed, but as human individuals. In the global response, the safety of health-care workers must be ensured. Adequate provision of PPE is just the first step; other practical measures must be considered, including cancelling non-essential events to prioritise resources; provision of food, rest, and family support; and psychological support. Presently, health-care workers are every country's most valuable resource. © 2020 Denis Lovrovic/AFP/Getty Images 2020 Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
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### COVID-19 outbreak on the Diamond Princess cruise ship: estimating the epidemic potential and effectiveness of public health countermeasures

(2020)
Abstract Background Cruise ships carry a large number of people in confined spaces with relative homogeneous mixing. On 3 February, 2020, an outbreak of COVID-19 on cruise ship Diamond Princess was reported with 10 initial cases, following an index case on board around 21-25th January. By 4th February, public health measures such as removal and isolation of ill passengers and quarantine of non-ill passengers were implemented. By 20th February, 619 of 3,700 passengers and crew (17%) were tested positive. Methods We estimated the basic reproduction number from the initial period of the outbreak using SEIR models. We calibrated the models with transient functions of countermeasures to incidence data. We additionally estimated a counterfactual scenario in absence of countermeasures, and established a model stratified by crew and guests to study the impact of differential contact rates among the groups. We also compared scenarios of an earlier versus later evacuation of the ship. Results The basic reproduction rate was initially 4 times higher on-board compared to the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${R}_0$\end{document} in the epicentre in Wuhan, but the countermeasures lowered it substantially. Based on the modeled initial \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${R}_0$\end{document} of 14.8, we estimated that without any interventions within the time period of 21 January to 19 February, 2920 out of the 3700 (79%) would have been infected. Isolation and quarantine therefore prevented 2307 cases, and lowered the \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} }{}${R}_0$\end{document} to 1.78. We showed that an early evacuation of all passengers on 3 February would have been associated with 76 infected persons in their incubation time. Conclusions Conclusions: The cruise ship conditions clearly amplified an already highly transmissible disease. The public health measures prevented more than 2000 additional cases compared to no interventions. However, evacuating all passengers and crew early on in the outbreak would have prevented many more passengers and crew from infection.
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### The COVID-19 Pandemic: a Call to Action to Identify and Address Racial and Ethnic Disparities

The Coronavirus disease 2019 (COVID-19) pandemic has significantly impacted and devastated the world. As the infection spreads, the projected mortality and economic devastation are unprecedented. In particular, racial and ethnic minorities may be at a particular disadvantage as many already assume the status of a marginalized group. Black Americans have a long-standing history of disadvantage and are in a vulnerable position to experience the impact of this crisis and the myth of Black immunity to COVID-19 is detrimental to promoting and maintaining preventative measures. We are the first to present the earliest available data in the peer-reviewed literature on the racial and ethnic distribution of COVID-19-confirmed cases and fatalities in the state of Connecticut. We also seek to explode the myth of Black immunity to the virus. Finally, we call for a National Commission on COVID-19 Racial and Ethnic Health Disparities to further explore and respond to the unique challenges that the crisis presents for Black and Brown communities.
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### Author and article information

###### Contributors
(View ORCID Profile)
(View ORCID Profile)
(View ORCID Profile)
###### Journal
Sushruta Journal of Health Policy & Opinion
Sushruta
British Association of Physicians of Indian Origin
2732-5164
2732-5156
March 31 2020
March 31 2020
April 23 2020
July 15 2020
: 13
: 1
###### Affiliations
[1 ]St Georges University of London, UK
[2 ]Leeds Teaching Hospitals NHS Trust, Leeds, UK
[3 ]Royal Derby Hospital, UK
[4 ]King's College Hospitals, London, UK
[5 ]University of Birmingham, UK
[6 ]Frimley Park Hospital, UK
[7 ]British Association of Physicians of Indian Origin, UK
[8 ]Central Manchester Mental Health Partnership Trust, UK
###### Article
10.38192/13.2.9
865ae3b5-f75b-40dc-a40c-f0dc4f7d1092