Proteger os trabalhadores da saúde contra o SARS-CoV-2

  • Paulo Ferrinho Professor Catedrático de Saúde Internacional. GHTM, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
  • Joana Vidal Castro Médica de Saúde Pública, Unidade de Saúde Pública – Agrupamento de Centros de Saúde Espinho/Gaia, Administração Regional de Saúde de Norte, Portugal WHO Collaborating Center on Health Workforce Policy and Planning, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
  • Mohsin Sidat Professor de Epidemiologia e Medicina Preventiva; Diretor do Departamento de Saúde na Comunidade, Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Moçambique; convidado permanente das Reuniões Consultivas Técnico-Científicas Multidisciplinares de aconselhamento no contexto da COVID-19 ao Governo de Moçambique; membro da Equipa da Research Center on GHTM, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
  • Kamal Mansinho Professor de Clínica das Doenças Tropicais, Diretor do Serviço de Infeciologia do Hospital de Egas Moniz, Ministério da Saúde, Portugal GHTM, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Portugal
  • Artur Correia Diretor Nacional de Saúde, Ministério da Saúde, Cabo Verde
  • Carlos Masseca Diretor Geral do Hospital Sanatório de Luanda, Angola
  • Clotilde Neves Psicóloga; Administradora, Inspeção Geral da Administração da Saúde, Ministério da Saúde, Guiné-Bissau
  • Fernando Passos Cupertino de Barros Coordenador Técnico do Conselho Nacional de Secretários de Saúde (CONASS); Professor da Faculdade de Medicina da Universidade Federal de Goiás; Membro do Conselho do Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa; Coordenador da Comissão Temática da Saúde e Segurança Alimentar e Nutricional dos Observadores Consultivos da Comunidade dos Países de Língua Portuguesa

Resumo

A COVID-19 é uma séria ameaça à capacidade de resposta dos serviços de saúde. Neste contexto espera-se que os trabalhadores de saúde (TdS) laborem longas horas, sob grande pressão profissional, familiar e emocional, com recursos muitas vezes inadequados, enquanto aceitam os perigos inerentes à atividade, à proximidade com pessoas infeciosas, aos perigos inseparáveis dos ambientes de trabalho. O impacto na pandemia reflete-se nos TdS enquanto indivíduos, mas também afeta as suas famílias, quer relativamente ao menor tempo disponível quer ao nível da saúde mental. Fatores como a quantidade, o custo, a disponibilidade bem como a falta de hábito no uso de equipamentos de proteção individual (EPI) condicionam a sua utilização pelos TdS. A utilização de EPI não é proteção suficiente se não for acompanhada da adoção de outras medidas de controlo de infeção, como a higienização das mãos e distanciamento físico entre funcionários em todas as situações. Deve também ser dada prioridade à testagem de TdS. A pandemia desafia os sistemas de saúde a uma adaptação dinâmica na gestão dos recursos existentes, com um especial enfoque nos sistemas de informação. Os serviços digitalizados ou de telemedicina podem potencialmente reduzir o contato com o paciente e, portanto, os riscos de infeção por SARS- CoV-2. Na perspetiva de uma vacina contra o SARS-CoV-2 para breve, os TdS deverão estar entre os grupos prioritários para a receber. Os TdS são dos recursos mais importantes de um país, pelo que há que cuidar destes profissionais em todos os aspetos nas organizações de saúde, para que os TdS estejam em melhores condições de responder às exigências desta pandemia e outras que eventualmente irão ocorrer no futuro. A pandemia não reconhece fronteiras. Devendo ser abordada de forma a fortalecer uma colaboração internacional que possibilite a solidariedade e a partilha equitativa de recursos.

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Referências

World Health Organization. Rapid hospital readiness checklist: harmonized

health service capacity assessments in the context of the COVID-19 pandemic:

interim guidance, 25 June 2020. World Health Organization. 2020. Consultado a

09.2020 em: https://apps.who.int/iris/handle/10665/332779.

United Nations. United Nations Comprehensive Response to COVID-19 Saving

Lives, Protecting Societies, Recovering Better. New York; United Nation;

September 2020. Consultado a 17.09.2020 em: https://unsdg.un.org/resources/

united-nations-comprehensive-response-covid-19-saving-lives-protecting-

-societies

Chan EYY, Goabt N, Kim JH, et al. Informal home care providers: the forgotten

health-care workers during the COVID-19 pandemic. Lancet. 2020; 395:

-1959. doi:10.1016/S0140-6736(20)31254-X

Chersich MF, Gray G, Fairlie L, et al. COVID-19 in Africa: care and protection

for frontline healthcare workers. Globalization and Health. 2020; 16: 46. doi.

org/10.1186/s12992-020-00574-3

Kang L, Li Y, Hu S, et al. The mental health of medical workers in Wuhan, China

dealing with the 2019 novel coronavirus. Lancet Psychiatry. 2020; 7(3): e14.

doi:10.1016/S2215-0366(20)30047-X

Rose C. Am I Part of the cure or Am I part of the disease? Keeping coronavirus

out when a doctor comes home. N Engl J Med. 2020; 382:1684-1685.

doi:10.1056/NEJMp2004768.

Schwartz J, King C-C, Yen M-Y. Protecting health care workers during the COVID-

coronavirus outbreak-Lessons from Taiwan’s SARS response. Clin Infect

Dis. 2020;71 (15): 858-860. doi: 10.1093/cid/ciaa255

Bielicki JA, Duval X, Gobat N, et al. Monitoring approaches for health-care

workers during the COVID-19 pandemic. Lancet Infectious Diseases. 2020; doi.

org/10.1016/S1473-3099(20)30458-8.

Nguyen LH, Drew DA, Graham MS, et al. Risk of COVID-19 among front-line

health-care workers and the general community: a prospective cohort study.

Lancet Public Health. 2020; 5: e475–83. doi.org/10.1016/S2468-2667(20)-

-X

Brasil. Ministério da Saúde. Boletim Epidemiológico Especial no. 30. Consultado

a 17.09.2020 em: https://www.saude.gov.br/images/pdf/2020/September/

/Boletim-epidemiologico-COVID-30.pdf.

Ruiu ML. Mismanagement of Covid-19: Lessons Learned from Italy. Journal

of Risk Research Routledge. 2020: 1–14. doi:10.1080/13669877.2020.17587

Zawiah M, Al-Ashwal FY, Saeed RM, et al. Assessment of Healthcare System

Capabilities and Preparedness in Yemen to Confront the Novel Coronavirus

(COVID-19) Outbreak: A Perspective of Healthcare Workers. Front. Public

Health. 2020; 8: 419. doi:10.3389/fpubh.2020.00419

Adam JG, Walls RM. Supporting the Health Care Workforce During the COVID-

Global Epidemic. JAMA. 2020; 323 (15): 1439-1440. doi:10.1001/

jama.2020.3972

Sim MR. The COVID-19 pandemic: major risks to healthcare and other workers

on the front line. Occup Environ Med. 2020;77:281–282. doi:10.1136/

oemed-2020-106567

Wilson N, Baker M, Crampton P, et al. The potential impact of the next influenza

pandemic10. on a national primary care medical workforce. Hum Resour

Health. 2005; 3(1): 7. doi:10.1186/1478-4491-3-7

Chen L, Hangvaravongchai P. HIV/AIDS and Human Resources -Editorial.

Bulletin of the World Health Organization. 2005, 83 (4): 243-244.

Dieleman M, Bwete V, Maniple E et al. ‘I believe that the staff have reduced

their closeness to patients’: an exploratory study on the impact of HIV/AIDS on

staff in four rural hospitals in Uganda. BMC Health Serv Res. 2007; 7: 205. doi.

org/10.1186/1472-6963-7-205

Ulrich C M. Ebola is causing moral distress among African healthcare workers.

BMJ. 2014; 349: g6672. doi:10.1136/bmj.g6672

McMahon SA, Ho LS, Brown H, et al. Healthcare providers on the frontlines:

a qualitative investigation of the social and emotional impact of delivering health

services during Sierra Leone’s Ebola epidemic. Health Policy Plan. 2016; 31(9):

–1239. doi: 10.1093/heapol/czw055

McMahon SA, Ho LS, Scott K, et al. “We and the nurses are now working

with one voice”: How community leaders and health committee members describe

their role in Sierra Leone’s Ebola response. BMC Health Serv Res. 2017;

(1): 495. doi.org/10.1186/s12913-017-2414-x

Selvaraj SA, Lee KE, Harrell M, et al. Infection Rates and Risk Factors for

Infection Among Health Workers During Ebola and Marburg Virus Outbreaks: A

Systematic Review. The Journal of Infectious Diseases. 2018; 218 (suppl 5): 15:

S679–S689. doi.org/10.1093/infdis/jiy435

Kapiriri, L., Ross, A. The Politics of Disease Epidemics: a Comparative Analysis

of the SARS, Zika, and Ebola Outbreaks. Glob Soc Welf 7, 33–45 (2020). doi.

org/10.1007/s40609-018-0123-y

Karlsson U, Fraenkel C-J. Complete protection from COVID-19 is possible

for health workers. All they need is the right protective equipment. BMJ.

;370:m2641 doi.org/10.1136/bmj.m2641

Health & Care Professions Council. How we will continue to regulate in light

of novel coronavirus. Joint statement from Chief Executives of statutory regulators

of health and care professionals.03.03.2020. Consultado a 17.09.2020 em:

https://www.hcpc-uk.org/registrants/updates/2020/how-we-will-continue-

-to-regulate-in-light-of-novel-coronavirus/

Ordem dos Médicos. Ministra da Saúde responde a pedido do bastonário e

vai acautelar situações em que os dois pais são médicos ou das profissões prioritárias

nesta fase crítica. Comunicado. 15.03.2020. Consultado a 17.09.2020 em:

https://ordemdosmedicos.pt/ministra-da-saude-responde-a-pedido-do-bastonario-

e-vai-acautelar-situacoes-em-que-os-dois-pais-sao-medicos-ou-das-profissoes-

prioritarias-nesta-fase-critica/

Ordem dos Médicos. Falta de equipamentos de proteção para profissionais

estão a ser calcanhar de Aquiles no combate ao novo coronavírus. Nota de Imprensa.

03.2020. Consultado a 17.09.2020 em: https://ordemdosmedicos.

pt/wp-content/uploads/2020/03/2020.03.17_NI-Falta-de-equipamentos-de-

-protec%CC%A7a%CC%83o-para-profissionais-esta%CC%83o-a-ser-calcanhar-

de-Aquiles-no-combate-ao-novo-coronavi%CC%81rus.pdf

Ferrinho P, Sidat M, Leiras G, et al. Principalism in public health decision

making in the context of the COVID-19 pandemic. Int J Health Plann Mgmt.

;1–4. doi: 10.1002/hpm.3015

Public Services International. Public Health, Once and for All! Concept

Note. 19.03.2020. Consultado a 17.09.2020 em https://publicservices.international/

resources/news/public-health-br-once-and-for-all-?id=10648〈=en

Gorry C. Global Collaboration in Times of COVID-19: Cuba’s Emergency

Medical Contingent. MEDICC Rev. 2020;22(2):64-66.

Ferrinho P, Biscaia A, Fronteira I, et al. Patterns of perceptions of workplace

violence in the Portuguese health care sector. Human Resources for Health.

; 1(1): 11. doi:10.1186/1478-4491-1-11

Patrício SR, Sidat, M, Ferrinho P. Violência Contra os Trabalhadores da Saúde

no Local de Trabalho na Cidade de Lichinga, Província de Niassa, Moçambique

entre março e maio de 2019. Anais do IHMT. 2020. Aceite para publicação.

ILO/ICN/WHO/PSI Joint Programme on Workplace Violence in the Health

Sector. Framework guidelines for addressing workplace violence in the health

sector / Joint Programme on Workplace Violence in the Health Sector. Geneva :

International Labour Organization. 2002. Consultado a 17.09.202 em: https://

apps.who.int/iris/handle/10665/42617

Declaration By The Health Care in Danger Community of Concern About

the Current Situation of Violence Against Health Care. Consultado a 17.09.202

em: https://healthcareindanger.org/wp-content/uploads/2020/05/Declaration_

HCiD_Current_Situation_against_HC_PDF1-002.pdf

Grover S, Singh P, Sahoo S, Mehra A. Stigma related to COVID-19 infection:

Are the Health Care Workers stigmatizing their own colleagues? [published

online ahead of print, 2020 Aug 27]. Asian J Psychiatr. 2020;53:102381.

doi:10.1016/j.ajp.2020.102381

Do Duy C, Nong VM, Van AN, et al. COVID-19 related stigma and its association

with mental health of health-care workers after quarantined in Vietnam

[published online ahead of print, 2020 Jul 23]. Psychiatry Clin Neurosci.

;10.1111/pcn.13120. doi:10.1111/pcn.13120

Lempel H, Epstein JM, Hammond RA. Economic Cost and Health Care Workforce

Effects of School Closures in the U.S. PLoS Curr. 2009; 1: RRN1051.

doi:10.1371/currents.RRN1051

Di Tella M, Romeo A, Benfante A, Castelli L. Mental health of healthcare

workers during the COVID-19 pandemic in Italy. J Eval Clin Pract. 2020; 1– 5.

https://doi.org/10.1111/jep.13444

Keubo FRN, Mboua PC, Tadongfack TD, et al. Psychological distress among

healthcare professionals of the three COVID-19 most affected Regions in Cameroon:

prevalence and associated factors. Annales Médico-psychologiques,

revue psychiatrique. 2020; journal pre-proof, doi:https://doi.org/10.1016/j.

amp.2020.08.012

Ying Y, Ruan L, Kong F et al. Mental health status among family members of

health care workers in Ningbo, China, during the coronavirus disease 2019 (COVID-

outbreak: a cross-sectional study. BMC Psychiatry. 2020; 20(1): 379.

doi: 10.1186/s12888-020-02784-w

Yildirim TT, Atas O, Asafov A, et al. Psychological Status of Healthcare Workers

during the Covid-19 Pandemic. Journal of the College of Physicians and

Surgeons--pakistan : JCPSP. 2020; 30(6): 26-31. doi:10.29271/jcpsp.2020.

supp1.s26

Pozzan E, Cattaneo U. Women health workers: Working relentlessly in hospitals

and at home, ILO news story, 7 Apr. 2020. Consultado a 17.09.202 em: https://

www.ilo.org/global/about-the-ilo/newsroom/news/WCMS_741060/

lang--en/index.htm

Klompas M, Morris CA, Sinclair J, Pearson M, Shenoy ES. Universal Masking

in Hospitals inlick the Covid-19 Era. N Engl J Med. 2020; 382;21: e63(1-3).

doi:10.1056/NEJMp2006372

Nagesh S, Chakraborty S. Saving the frontline health workforce amidst the

COVID-19 crisis: Challenges and recommendations. Journal of Global Health.

; 10 (1): 1-4. doi:10.7189/jogh-10-010345

Rosenbaum L. The Untold Toll — The pandemic’s effects on patients without

Covid-19. N Engl J Med. 2020;382:2368-71. doi:10.1056/NEJMms2009984

Van Damme W, Van Lerberghe W. Epidemics and fear. Tropical Medicine

and International Health. 2000; 5 (8): 511–514. doi.org/10.1046/j.

-3156.2000.00599.x

Mykytyn PP. COVID-19 and Its Impacts on Managing Information Systems. Information

Systems Management. 2020; doi: 10.1080/10580530.2020.1818900

Baumgart DC. Digital advantage in the COVID-19 response: perspective

from Canada’s largest integrated digitalized healthcare system. npj Digit. Med.

; 3, 114. https://doi.org/10.1038/s41746-020-00326-y

Whitelaw S, Mamas MA, Topol E, Van Spall HGC. Applications of digital technology

in COVID-19 pandemic planning and response. Lancet Digital Health.

; 2: e435–440. doi.org/10.1016/S2589-7500(20)30142-4

Peine A, Paffenholz P, Martin L, et al. Telemedicine in Germany During the

COVID-19 Pandemic: Multi-Professional National Survey. J Med Internet Res

;22(8):e19745. doi: 10.2196/19745

Shann F. The non- specific effects of vaccines. Arch. Dis. Child. 2010; 95:

–667. doi: 10.1136/adc.2009.157537

Belizário JE. Trained innate immunity, COVID-19 therapeutic dilemma, and fake science. Clinics. 2020; 75: e2124. doi.org/10.6061/clinics/2020/e2124.3.

Benn CS, Netea MG, Selin LK, Aaby P. A small jab – a big effect: nonspecific

immunomodulation by vaccines. Trends in Immunology. 2013; 34 (9): 431-439.

doi:10.1016/j.it.2013.04.004

Higgins JPT, Soares-Weiser K, López-López JA, et al. Association of BCG,

DTP, and measles containing vaccines with childhood mortality: systematic review.

BMJ. 2016;355:i5170. doi.org/10.1136/bmj.i5170

Miller A, Reandelar MJ, Fasciglione K, et al. Correlation between universal

BCG vaccination policy and reduced morbidity and mortality for COVID-

: an epidemiological study. medRxiv 2020; 28 March 2020. doi:

1101/2020.03.24.20042937.

Klinger D, Blass I, Rappoport N, Linial M. Significantly Improved COVID-19

Outcomes in Countries with Higher BCG Vaccination Coverage: a Multivariable

Analysis. Vaccines. 2020, 8, 378; doi:10.3390/vaccines8030378

Salman S, Salem ML. Routine childhood immunization may protect

against COVID-19. Med. Hypotheses. 2020, 140, 109689. doi: 10.1016/j.

mehy.2020.109689

Redelman-Sidi G. Could BCG be used to protect against COVID-19? Nat Ver

Urol. (2020) 17:316–7. doi: 10.1038/s41585-020-0325-9

O’Neill LAJ, Netea MG. BCG- induced trained immunity: can it offer protection

against COVID-19? Nature Reviews Immunology.2020; 20: 336-337.

doi: 10.1038/s41577-020-0337-y

Namkoong H, Horita N, Ebina-Shibuya R. Concern over a COVID-19-related

BCG shortage. International Journal of Tuberculosis and Lung Disease. 2020;

(6): 642-643. doi.org/10.5588/ijtld.20.0240

Wise J. Covid-19: Health and care workers will be “highest priority” for vaccination,

says JCVI. BMJ. 2020; 369: m2477. doi.org/10.5588/ijtld.20.0240

Bowen RAR. Ethical and organizational considerations for mandatory COVID-

vaccination of health care workers: A clinical laboratorian’s perspective.

Clin Chim Acta. 202; 510: 421-422. doi: 10.1016/j.cca.2020.08.003

Editorial. COVID-19: protecting health-care workers. The Lancet. 2020;

: 922. doi:10.1016/S0140-6736(20)30644-9

Hall TJ, Mejia A (eds.). Health Manpower Planning: Principles, Methods,

Issues. Geneva: WHO. 1978.

Hall T: Why plan human resources for health? Human Resource Devel J.

, 2 (2): 77-86.

Lerberghe W, Adams O, Ferrinho P. Human resource impact assessment. Bulletin

of the World Health Organization. 2002; 80 (7): 525.

Ferrinho P & Dal Poz M (editors) 2003. Towards a Global Health Workforce

Strategy. Studies in HSO&P. ITG Press, Antwerp.

Ferrinho P, Omar C 2006. Recursos Humanos da Saúde em Moçambique.

Ponto de Situação. Banco Mundial, Região de África.

Sousa A, Scheffler RM, Nyoni J, Boerma T (2013). A comprehensive health

labour market framework for universal health coverage. Bulletin of the WHO.

; 91:892-894. http://dx.doi.org/10.2471/BLT.13.118927

Menezes L. Job Satisfaction and Quality Management: an empirical analysis.

International Journal of Operations & Production Management. 2013; 32 (3):

-328.

Publicado
2020-10-21

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