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New study examines risks facing frontline medical staff during pandemic

A leading Swansea University clinician is among a group of experts calling for the introduction of a risk assessment for frontline health professionals treating coronavirus patients.

Their study - Risk stratification for healthcare workers during the COVID-19 pandemic – examined the demographics of those who had been hospitalised and ultimately died due to COVID-19 compared to the general population.

Its authors¸ a group of clinical academics and clinicians who belong to the British Medical Association, include Dr Angharad Davies, clinical associate professor in medical microbiology at Swansea University Medical School.

Dr Davies said: “Figures show that healthcare workers are at higher risk of contracting COVID-19. It is critically important for health systems to protect the health and lives of their staff, especially those on the frontline.”

The research is a preliminary report which has been published on medRxiv, a site used by researchers to share new findings on timely issues before they have been peer-reviewed for publication in a journal.

The team examined recently collated data to develop a risk stratification tool that can be used when it comes to assigning frontline care duties to health professionals during the pandemic.

The authors said it may not be possible to completely neutralise the risk of increased exposure for health workers but they suggest the tool could help identify those individuals at highest risk of an adverse outcome from CoViD-19 in order to allocate roles with minimal exposure.

The paper identifies three types of risk facing medical staff:
• Demographics - age, sex and ethnicity;
• Co-morbidities that have accrued through life; and,
• Their knowledge of, access to and use of PPE.

It adds that physiological factors which have affected the immune system and workplace influences such as environmental risks, access to PPE training and the confidence to raise concerns can also play a part.

Dr Davies said: “An assessment of risk score may help guide allocation of duties.

“The highest risk individuals should be excluded from patient-facing clinical areas while those at intermediate risk should have careful consideration of their exposure in frontline areas and in duties with close contact such as ENT, ophthalmology and dentistry.”

In conclusion, the authors said: “There is an urgent and immediate need that every single doctor has a formal risk assessment.

“There also needs to be appropriate, detailed consent for all doctors who are being asked to work in patient-facing areas, so they also understand their risks. All doctors should wear appropriate PPE for any clinical examination or investigation on the basis that … infected patients, … may be asymptomatic."

The risk stratification tool has already been welcomed by frontline medical professionals and recommendations based on it are being made in some NHS organisations. It is now under consideration by health leaders across the UK.

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