One in twelve people infected by the novel coronavirus in Italy so far have been health workers, according to new figures that come as frontline hospital staff in other countries, including the US and Britain, raise the alarm over serious shortages of the protective equipment they need to treat patients with the virus.
Analysis published by the Italian National Institute of Health, ISS, revealed that of 35,713 COVID-19 cases in Italy, 2,898 have been health workers.
The institute, which is the leading scientific body of the Italian National Health Service, notes that the data indicates profession and this does not necessarily mean they all caught the disease on the front line — but reports from across Italy have shone a light on the massive burden that the coronavirus is placing on health workers.
Two weeks ago the World Health Organisation warned that "severe and mounting disruption" to the global supply of personal protective equipment (PPE) was putting lives at risk and leaving nurses and doctors dangerously ill-equipped. Health care workers rely on PPE to protect themselves and their patients from the highly contagious disease.
That warning appears to not have been fully met.
In the US, doctors and nurses told BuzzFeed News how they were facing frightening shortages of masks.
And in the UK, the British Medical Association (BMA), the doctors’ union, said some medics had been forced to go to DIY stores and even building sites to buy masks because none were available at work.
They also said some staff who did have hospital-grade masks had not had them test-fitted ahead of treating patients, which was crucial for the masks to provide protection.
One NHS hospital told the Independent it was just 24 hours away from running out of the personal protective equipment that was vital to keep its frontline staff safeguarded — despite claims from the UK prime minister on Wednesday that Britain had “stockpiles” of the kit.
In Italy, the head of the doctors' guild of the city of Bergamo told an Italian newspaper this week that a quarter of its primary care doctors are ill or in quarantine.
The head of the Doctors' Guild of #Bergamo, Lombardy, 🇮🇹 epicenter of Italy's #COVID19 crisis @repubblica : —Out of 600 primary care doctors, **118** are sick or in quarantine, and 1 died. —"It's an apocalyptic scenario" 🔥Hospitals🌎: Take steps NOW to prevent this! 🔥
Bergamo, which has a population of 122,000, is currently at the centre of the outbreak in northern Italy. Some 93 people passed away on Wednesday alone, Italian media reported. And the spokesperson of the city’s mayor confirmed to BuzzFeed News reports that the army has been brought in to transport coffins to neighbouring regions as the city's crematory can't cope with the numbers.
Even in regions that have so far been less hit by the virus, its impact on frontline staff has been significant. A doctor at a hospital in Sardinia told a local newspaper that some staff had to buy protective masks from local welders because their hospital had run out.
A health care official on the Italian island told BuzzFeed News that an estimated 50% of the 134 people that have so far tested positive for the coronavirus in Sardinia work in the health service. The official spoke on condition of anonymity because health workers have been told they are not authorised to talk to the press.
Italian media is full of similar stories from across the country. A doctor from Aosta said he was offered a handkerchief as a mask, while others have taken to social media to appeal for help.
The head of the department of medicine at a hospital in Bergamo said they were in “desperate need of both nurses and physicians together with ventilators and dispositive for protection.” Several doctors and frontline health workers in Italy have died from the coronavirus.
A doctor in Bergamo, Italy recorded a video asking for donations to help his hospital's fight against #coronavirus
The staggering figures have led to calls from medical experts in both the UK and Italy for more protective gear and testing for frontline health workers.
Nino Cartabellotta, the director of GIMBE, the Italian group for evidence-based medicine, told BuzzFeed News that data on the number of infected health workers in Italy had only become available on March 11 — and the situation was “alarming.”
He said: "First, if doctors, nurses and other health professionals on the front line, in hospitals or across the country, fall sick then the health service cannot ensure assistance to the population. Second: infected health professionals risk transmitting the infection to patients, and in particular to fragile patients with underlying conditions that are most at risk from COVID-19 complications, worsening their condition and mortality rates."
Cartabellotta added: "Health structures need to be urgently provided with all the required protective equipment along the 'whatever it takes' logic. If we are to win this war it is fundamental to take care of those that are taking care of us."
In the UK, British Medical Association chair of council Dr Chaand Nagpaul said: “There are limits to the risks to which doctors, indeed all health care workers, can reasonably be expected to expose themselves to.
“Frontline staff must have the proper personal protective equipment if they are treating patients with COVID-19 or suspected to have COVID-19.
“We are hearing of staff trying to buy masks from DIY stores in desperation because they are not being provided with it by their employers. This is totally unacceptable; health care workers should not, and do not, have to expose themselves to high-risk situations without having adequate PPE.
“If any health care worker, treating someone with COVID was to become ill, or worse, due to a lack of PPE, the consequences will be dire and the impact on patient care catastrophic."
In China, there were at least 18 reported deaths of medical workers involved in the COVID-19 response as of last month, according to a count by the Los Angeles Times. Among these were Li Wenliang, the doctor who tried to warn authorities early on about the challenge.
UK prime minister Boris Johnson came under pressure from MPs on Wednesday to explain why so many medics were short of the protective kit they needed.
“Our NHS should feel that they are able to interact with patients with perfect security and protection,” the PM said.
"There is a massive effort going on, comparable to the effort to build enough ventilators, to ensure that we have adequate supplies of PPE equipment not just now, but throughout the outbreak."
A Department of Health and Social Care spokesperson said: “We are rightly taking every possible action to tackle this virus and have central stockpiles of a range of medical products to help ensure the uninterrupted supply to the NHS.
“We have well-established procedures to deal with supply issues, should they arise, by working closely with industry, the NHS and others in the supply chain to help prevent shortages and minimise any risks to patients.”
Government sources suggested that shortages of PPE in some hospitals had been caused by an increase in global demand and a ban on the export of these products from China. Beijing has sent medics as well as test kits and protective clothing to Italy and other EU member states.