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Das N, Mishra P. Protecting Healthcare Workers From COVID-19 and the Assaulting Society: Indian Perspective. Pharm Biomed Res 2020; 6 :5-8
URL: http://pbr.mazums.ac.ir/article-1-343-en.html
1- Department of Psychiatry and NDDTC, AIIMS, New Delhi, India.
2- Department of Ophthalmology, RPC, AIIMS, New Delhi, India.
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Dear Editor
Since its beginning in December 2019, (till May 15, 2020) 4.4 million confirmed cases of the novel coronavirus disease (COVID-19) have been reported worldwide with a case fatality rate of (approximately) 5% [1]. The world is now facing the toughest health crisis of this century. From the socioeconomic perspective in many ways, all subgroups of the population are in danger, but the Healthcare Workers (HCWs) appear to be the hardest hit [2]. For instance, Dr Li Wenliang (China), an ophthalmologist at the Wuhan General Hospital, faced opposition from authorities, and later on, he died from the same illness after treating patients of COVID-19 admitted in Intensive Care Unit (ICU) [3]. Likewise, many HCWs have encountered a similar fate as the estimated rate of infection among HCWs is high (up to 10% as per WHO) as well as the case fatality [4]. Across the world, the problems for all HCW looked similar: the lack of medical equipment(s) that force HCWs to choose among patients with best chances of survival, lack of personal protective gears that expose thousands of HCWs to the deadly virus, very long work hours that endangers the psychological wellbeing of all frontline HCWs, and experiencing the psychological trauma of losing co-workers or relatives [5] In India, however, HCWs are facing a unique threat from the very society they are trying to save. On many occasions over the last decade or so, the South-East Asian country has seen violence against healthcare providers [6]. Even now, there have been several reported incidents of physical and psychological abuse from fellow citizens—while serving them in testing, isolation, or treatment facilities of COVID-19 (Table 1).

In some instances, HCWs have been forced to vacate their home by the neighbors and landlords or denied cremation (who died after serving COVID-19 patients) out of fear, frustration, and stigma [7]. Most researchers believe that presently, health-care workers are every country’s most valuable resource [8]. It appears that the fellow Indians have failed to recognize the fact.
Further studies are needed to assess the possible reasons for such population behavior, how to address such issues and the psychological impact of violence on HCWs. But more importantly, we need to intervene. The mental healthcare professionals need to step-up, to provide due psychological first aid and preparedness to the frontline HCWs as well as the suffering patients and the grieving families to curtail such incidents in the future. However, at the same time, the government has to ensure the security and safety of every HCW. In the end, this is a fight against an invisible enemy and if we let ourselves be nervous, then what would happen to the people [3]. Only together we can fight this battle, and together we will.

Ethical Considerations
Compliance with ethical guidelines

There were no ethical considerations to be considered in this research.

Funding
This research did not receive any grant from funding agencies in the public, commercial, or non-profit sectors. 

Authors' contributions
Both authors were equally contributed in preparing this article.

Conflict of interest
The authors declared no conflict of interest.


Reference
  1. Johns Hopkins Coronavirus Resource Center. COVID-19 in the USA. COVID-19 data in motion [Internet]. 2020 [Updated: 2020 Apr 9]. Available from: https://coronavirus.jhu.edu/
  2. Das N. Psychiatrist in post-COVID-19 era – are we prepared? Asian J Psychiatr. 2020; 51:102082. [DOI:10.1016/j.ajp.2020.102082] [PMID] [PMCID]
  3. Misra A. Doctors and healthcare workers at frontline of COVID 19 epidemic: Admiration, a pat on the back, and need for extreme caution. Diabetes Metab Syndr. 2020; 14(3):255–6. [DOI: 10.1016/j.dsx.2020.03.006]
  4. World Health Organization. How to protect health workers now: WHO COVID-19 briefing [Internet]. 2020 [Updated: 2020 Apr 24]. Available from: https://www.weforum.org/agenda/2020/04/10-april-who-briefing-health-workers-covid-19-ppe-training/
  5. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to Coronavirus Disease 2019. JAMA Netw Open. 2020; 3(3):e203976. [DOI:10.1001/jamanetworkopen.2020.3976] [PMID] [PMCID]
  6. Sharma DC. Rising violence against health workers in India. The Lancet. 2017; 389(10080):1685. [DOI: 10.1016/S0140-6736(17)31142-X]
  7. Altstedter A, Shrivastava B, Pandya D. Doctors come under attack in india as coronavirus stigma grows [Internet]. 2020 [Updated: 2020 Apr 24]. Available from: https://www.bloomberg.com/news/articles/2020-04-13/doctors-come-under-attack-in-india-as-coronavirus-stigma-grows
  8. The Lancet. COVID-19: Protecting health-care workers. The Lancet. 2020; 395(10228):922. [DOI:10.1016/S0140-6736(20)30644-9] [PMID] [PMCID]
Type of Study: Letter to Editor | Subject: General

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