{"id":39507,"date":"2020-03-12T02:19:05","date_gmt":"2020-03-12T02:19:05","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmjgh\/?p=39507"},"modified":"2020-03-12T02:20:35","modified_gmt":"2020-03-12T02:20:35","slug":"protecting-chinas-healthcare-workers-during-covid-19","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmjgh\/2020\/03\/12\/protecting-chinas-healthcare-workers-during-covid-19\/","title":{"rendered":"Protecting China\u2019s healthcare workers during COVID-19"},"content":{"rendered":"

 <\/p>\n

With over a hundred thousand COVID-19 cases across 100 countries , the World Health Organization (WHO), has declared the outbreak as a Public Health Emergency of International Concern (1). \u00a0COVID-19 originated from Wuhan in the Hubei Province in China, the epicenter of the ongoing coronavirus outbreak since December 2019. COVID-19 is highly contagious and spreads mainly via person-to-person contact and respiratory droplets (2). However, in the past few months, China has been facing a greater challenge\u2014healthcare burnout accompanied by a shortage of trained healthcare workers and medical resources.<\/p>\n

It\u2019s been reported that many medical workers in Wuhan see patients without proper protective equipment (3). Apparently they are re-using goggles and gloves and sometimes even using plastic bags and raincoats when medical footwear and protective suits are not in supply (4). Health workers have to refrain from eating, drinking, or using the toilet for hours to make their protective suits last longer (4). By late February, more than 1,700 Chinese medical workers have been infected (4). In China\u2019s effort to contain the outbreak, these healthcare workers have made an immense sacrifice as they work multiple 24-hour shifts, see hundreds of patients a day, and spend very little time with relatives back at home (5). Indeed, China\u2019s medical workers have experienced a tremendous mental and physical exhaustion, as revealed in two Wuhan nurses\u2019 open letter pleading for medics from around the world to help China fight the virus (6).<\/p>\n

\"COVID-19
COVID-19 Outbreak Cases in Mainland China<\/figcaption><\/figure>\n

What has the ongoing outbreak revealed about China\u2019s healthcare system? We must remember that even before COVID-19 , shortage of doctor existed (7). For years, there has been a severe shortage of primary-care physicians in China. A recent study shows that there are just 60,000 licensed general practitioners in a country of 1.4 billion people (8).Till now, the Chinese government has maintained its pricing power over healthcare services and salaries, and as a result, China\u2019s physicians are severely underpaid. According to a 2017 white paper, the average starting salary for a junior physician in China had been $730 a month (9), a figure even lower than the country\u2019s national monthly average of $880 (10). Hence, doctors typically accept \u201cRed Envelops\u201d from patients or pharmaceutical sales for extra earnings (7).<\/p>\n

Besides low pay, China\u2019s medical workers have to deal with patient violence. As recent as December 2019, a Chinese doctor was stabbed in the neck by her patient\u2019s relatives and died (11). In a recent survey of general practitioners in Hubei Province, 18.9% of respondents reported being exposed to workplace violence in the preceding year (12). These factors have persuaded many not to pursue a career in medicine. In the past decade the percent of licensed doctors between the age of 25 and 34 has declined by 4%, while those aged 60 or above has increased by 5.2% (13). It\u2019s also found that 45% of the 150,000 Chinese doctors surveyed said they hope their children don\u2019t become doctors (13).<\/p>\n

Hence, for China to be better prepared against a crisis like this, it should first mend its healthcare system. New policies should be implemented to raise physician pay rate and protect China\u2019s healthcare workers from retaliations by patients and patients\u2019 relatives. We should also protect these healthcare workers\u2019 wellbeing by offering certified training programs, issuing early warnings against a potential deadly disease, and by making the delivery of donations and medical supplies to hospitals more efficient and transparent.<\/p>\n

Lastly, we should remember that we need to protect healthcare workers from burnout. Letting them sacrifice endlessly is not a solution and this is as important as quarantining and treating the infected patients during the outbreak.<\/p>\n

About the Author: <\/strong><\/p>\n

Yifei Wang is a medical student at Duke University. She plans to be a doctor who specializes in global public health. She is particularly interested in epidemiological research in infectious diseases, food and drug, the environment, and health policy in China.<\/p>\n

Competing Interests:<\/strong><\/p>\n

I have read and understood the BMJ Group policy on declaration of interests and declare no competing interests.<\/p>\n

References:<\/strong><\/p>\n

    \n
  1. World Health Organization. Rolling Updates on Coronavirus Disease (COVID-19). https:\/\/www.who.int\/emergencies\/diseases\/novel-coronavirus-2019\/events-as-they-happen<\/a>. 2020.<\/li>\n
  2. Centers for Disease Control and Prevention. How COVID-19 Spreads. https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/about\/transmission.html<\/a>. 2020.<\/li>\n
  3. The Straits Times. Doctors at China\u2019s Coronavirus Epicenter Wuhan Overworked and Unprotected. https:\/\/www.straitstimes.com\/asia\/east-asia\/doctors-at-chinas-coronavirus-epicentre-wuhan-overworked-and-unprotected<\/a>. 2020.<\/li>\n
  4. The New York Times. China\u2019s Doctors, Fighting the Coronavirus, Beg for Masks. https:\/\/www.nytimes.com\/2020\/02\/14\/world\/asia\/china-coronavirus-doctors.html<\/a>. 2020.<\/li>\n
  5. South China Morning Post. Meet the Doctors Working Round the Clock to Battle China\u2019s Coronavirus Outbreak. https:\/\/www.scmp.com\/news\/china\/society\/article\/3047219\/meet-doctors-working-round-clock-battle-chinas-coronavirus<\/a>. 2020.<\/li>\n
  6. The Guardian. Wuhan Nurses\u2019 Plea for International Medics to Help Fight Coronavirus. https:\/\/www.theguardian.com\/world\/2020\/feb\/26\/wuhan-nurses-plea-international-medics-help-fight-coronavirus<\/a>. 2020.<\/li>\n
  7. Bloomberg Opinion. China Had a Doctor Crisis Before Coronavirus Hit. https:\/\/www.bloomberg.com\/opinion\/articles\/2020-01-28\/china-had-a-doctor-crisis-before-coronavirus-hit-wuhan<\/a>. 2020.<\/li>\n
  8. The Washington Post. In Wuhan\u2019s Virus Wards, Plenty of Stress by Shortages of Everything Else. https:\/\/www.washingtonpost.com\/world\/asia_pacific\/in-wuhans-virus-wards-plenty-of-stress-but-shortages-of-everything-else\/2020\/01\/24\/ba1c70f0-3ebb-11ea-afe2-090eb37b60b1_story.html<\/a>. 2020.<\/li>\n
  9. http:\/\/www.cmda.net\/u\/cms\/www\/201807\/06181247ffex.pdf<\/a><\/li>\n
  10. Trading Economics. China Average Yearly Wages. https:\/\/tradingeconomics.com\/china\/wages<\/a>. 2020.<\/li>\n
  11. South China Morning Post. Chinese Doctor\u2019s Murder Overshadows New Law to Improve Public Health Care. https:\/\/www.scmp.com\/news\/china\/politics\/article\/3043842\/chinese-doctors-murder-overshadows-new-law-improve-public<\/a>. 2019.<\/li>\n
  12. Gan et al. Prevalence and Risk Factors Associated with Workplace Violence Against General Practitioners in Hubei, China. 2018; 108(9): 1223-1226.<\/li>\n
  13. Sixth Tone. Why China\u2019s Young Doctors Want Out of the System. https:\/\/www.sixthtone.com\/news\/1003446\/why-chinas-young-doctors-want-out-of-the-system<\/a>. 2019.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

      With over a hundred thousand COVID-19 cases across 100 countries , the World Health Organization (WHO), has declared the outbreak as a Public Health Emergency of International Concern (1). \u00a0COVID-19 originated from Wuhan in the Hubei Province in China, the epicenter of the ongoing coronavirus outbreak since December 2019. COVID-19 is highly contagious and […]<\/p>\n

    Read More…<\/a><\/p>\n","protected":false},"author":350,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[25,172,10],"tags":[53,164,173,174],"class_list":["post-39507","post","type-post","status-publish","format-standard","hentry","category-communicable-disease","category-covid-19","category-health-system","tag-china","tag-covid-19","tag-health-workforce","tag-human-resources-for-health"],"yoast_head":"\nProtecting China\u2019s healthcare workers during COVID-19 - BMJ Global Health blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmjgh\/2020\/03\/12\/protecting-chinas-healthcare-workers-during-covid-19\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Protecting China\u2019s healthcare workers during COVID-19 - BMJ Global Health blog\" \/>\n<meta property=\"og:description\" content=\"  With over a hundred thousand COVID-19 cases across 100 countries , the World Health Organization (WHO), has declared the outbreak as a Public Health Emergency of International Concern (1). \u00a0COVID-19 originated from Wuhan in the Hubei Province in China, the epicenter of the ongoing coronavirus outbreak since December 2019. 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