Health workers and COVID-19: flailing working conditions?

Vedovato, Tatiana Giovanelli; Andrade, Cristiane Batista; Santos, Daniela Lacerda; Bitencourt, Silvana Maria; Almeida, Lidiane Peixoto de; Sampaio, Jéssyca Félix da Silva

doi:10.1590/2317-6369000028520

person Tatiana Giovanelli Vedovato

schoolPontifícia Universidade Católica de Campinas (PUC-Campinas). Campinas, SP, Brazil.

person Cristiane Batista Andrade

schoolFundação Oswaldo Cruz (Fiocruz), Centro Latino-Americano de Estudos de Violência e Saúde Jorge Careli. Rio de Janeiro, RJ, Brazil.

0000-0003-1441-9171

person Daniela Lacerda Santos

schoolCentro Universitário Arthur Sá Earp Neto (UNIFASE), Saúde Coletiva. Petrópolis, RJ, Brazil.

0000-0002-6318-0809

person Silvana Maria Bitencourt

schoolUniversidade Federal de Mato Grosso (UFMT), programa de pós-graduação em Sociologia. Cuiabá, MT, Brazil.

0000-0002-3183-373X

person Lidiane Peixoto de Almeida

schoolUniversidade Federal do Rio de Janeiro (UFRJ). Rio de Janeiro, RJ, Brazil.

0000-0003-4130-3086

person Jéssyca Félix da Silva Sampaio

schoolPrefeitura do Rio de Janeiro. Rio de Janeiro, RJ, Brazil.

0000-0003-0304-7122

Corresponding author: Tatiana Giovanelli Vedovato
Email address:
tatiana.vedovato@puc-campinas.edu.br

The authors declare that the work was not funded and that there is no conflict of interest.

groups Authors’ contributions

Vedovato TG, Santos DL, Bitencourt SM contributed to the study design, data analysis, writing, text review and approval of the final version. Andrade CB contributed to the study design, data collection and analysis, writing, text review and approval of its final version. Almeida LP and Sampaio JFS contributed to data analysis, writing, text review and approval of the final version. All authors assume full responsibility for the study and the content herein published.

Date	Event	Developments
March 11, 2020	WHO declares COVID-19 a pandemic¹.	Global obligation to adopt measures to prevent and control the disease¹.
March 16, 2020	Rio de Janeiro and São Paulo (capitals) already had cases of community transmission¹².	Changes in protocols to identify suspected cases and reorganization of services due to increase in cases¹².
March 30, 2020	Cofen creates a form to notify suspected and/or confirmed cases of COVID-19 among health workers. Creation of the “Nursing Observatory” to monitor cases among workers².	Illness of workers on the front line is afforded visibility, showing the importance of discussions related to their work. Other councils did not follow suit, making it difficult to analyze the situation of multidisciplinary health teams².
April 8, 2020	President Jair Bolsonaro diverges on the issue of social distancing from recommendations and decisions taken by governors and mayors¹³.	The Federal Supreme Court (STF) grants an injunction requested by the Brazilian Bar Association (OAB) ensuring the power of states, municipalities and the Federal District to make decisions to face COVID-19, such as restrictions on movement of people, closing of schools, shops and other activities¹³.
April 9, 2020	The Oswaldo Cruz Foundation, a public health institution, creates the “COVID-19 Observatory.”¹⁴	The observatory was created as a channel for the disclosure of data and studies and integration with other projects¹⁴.
April 16, 2020	Political disagreements between President Bolsonaro and Health Minister Luiz Henrique Mandetta over actions and guidelines for coping with COVID-19¹⁵.	The health minister is dismissed in the midst of the pandemic¹⁵.
April 17, 2020	The new health minister, Nelson Teich, takes office.	Following disagreements with the president regarding the use of chloroquine, Nelson Teich resigns 29 days after his being appointed. No new health minister is appointed for 17 days¹⁶.
April 17, 2020	The new health minister, Nelson Teich, takes office.	Eduardo Pazuello assumes as interim minister and is officially appointed in September¹⁷.
April 30, 2020	85,380 confirmed cases¹⁸.	5,901 deaths from COVID-19¹⁸.

Title, source and date	PPE and COVID-19	Workers with comorbidities on the front line	Illness and death due to work	Access to treatment and work leave due to COVID-19	Resigning from work and professional updating for COVID-19
Death of technicians from COVID-19 at the Osid hospital causes apprehension among workers: Worker is resigning¹⁹.	Scarce or inadequate PPE, according to workers.	No information.	Death of two nursing technicians and workers get ill from COVID-19.	Health professionals put on leave due to COVID-19. Psychological support, according to labor management.	Reports about fear of contagion and resignation.
G1, on April 30, 2020.	Scarce or inadequate PPE, according to workers.	No information.			Reports about fear of contagion and resignation.
Almost 50% of health care workers heard by Public Labor Prosecutors in Minas Gerais report that workers with symptoms of COVID-19 are not granted leave²⁰.	Lack of adequate gowns and N95 masks.	No information.	No information.	Doctors and nurses with COVID-19 are not granted leave.	No information.
G1, on April 30, 2020.	Lack of adequate gowns and N95 masks.	No information.	No information.	Doctors and nurses with COVID-19 are not granted leave.	No information.
More than 2,200 health workers in RJ were put on leave with suspected COVID-19 contagion or for belonging to risk groups²¹.	No information.	2,200 at-risk health workers with suspected contagion were put on leave.	Death of health workers (11 doctors and 18 nurses) from COVID-19.	Workers with COVID-19 put on leave.	No information.
G1, on April 30, 2020.	No information.			Workers with COVID-19 put on leave.	No information.
Nurses protest against lack of PPE to care for patients with COVID-19²².	Lack of and inadequate PPE (face masks and gowns), according to the workers. Labor management reports purchase of PPE.	No information.	No information.	Availability of COVID-19 tests for health care workers is reported.	Training courses were offered to about 60 workers.
G1, on April 25, 2020.		No information.	No information.		Training courses were offered to about 60 workers.
More than 250 health care workers tested positive for COVID-19 in Maranhão²³.	No information.	Death of a 61-year-old nursing assistant with diabetes and obesity.	250 workers tested positive for the disease, 127 recovered and 6 died.	The nursing assistant who died from the disease was on leave.	No information.
G1, on April 25, 2020.	No information.				No information.
Health workers face fear and pressure in the fight against coronavirus²⁴.	Lack of and inadequate PPE (face masks and gowns), according to the workers.	No information.	Workers report psychological stress, fear, panic syndrome, psychic distress, use of anxiolytics and/or anti-depressants and insomnia. Death of 53 nurses.	More than 7 thousand health workers put on leave. Psychological support for health workers.	Workers are resigning, according to a doctor.
G1, on April 26, 2020.		No information.			Workers are resigning, according to a doctor.
Every 11 minutes, a nurse working in care against COVID-19 seeks psychological assistance²⁵.	Shortage of PPE.	Reports that health workers over 60 are denied leave for COVID-19 or psychological problems.	Reports of cases of depression, panic syndrome, anxiety, stress, insomnia, exhaustion and fear of contagion.	Difficulty to obtain sick leave for COVID-19 treatment and/or mental health problems.	Workers report lack of training to care for patients with the new coronavirus.
G1, on April 24, 2020.	Shortage of PPE.
Paraná has 63 staff of state hospitals on leave due to COVID-19²⁶.	Shortage of PPE and hospital equipment.	No information.	Psychological symptoms such as fear of contamination. Underreporting of illness cases.	63 health workers on leave due to the disease. All staff with symptoms are placed on leave.	No information.
G1, on April 24, 2020.	Shortage of PPE and hospital equipment.	No information.			No information.
In two days, the number of health workers with COVID-19 increases 66% in ES²⁷.	Shortage of PPE.	No information.	284 health workers contaminated by COVID-19.	One worker reported to be on leave.	Report that no training for COVID-19 care was offered at the outbreak of the pandemic.
G1, on April 22, 2020.	Shortage of PPE.	No information.	284 health workers contaminated by COVID-19.	One worker reported to be on leave.
Staff of the Miguel Couto Hospital at risk for COVID-19 say they have not been given leave²⁸.	Shortage of or inadequate PPE, according to workers. The hospital management says PPE is sufficient.	At-risk health workers are not given leave.	Reports of death of workers, including those at risk (diabetes) for COVID-19.	No information.	No information.
G1, on April 23, 2020.		At-risk health workers are not given leave.		No information.	No information.
Coronavirus: nurses in Rio claim lack of support and equipment in ICU²⁹.	Shortage of and inadequate use of PPE.	Report that health services management ignores which workers are at risk.	11 nurses dead and 548 on leave. Emotional symptoms like fear and depression.	Lack of tests for workers suspected of COVID-19 contagion.	No information.
G1, on April 23, 2020.	Shortage of and inadequate use of PPE.			Difficulties to obtain psychiatric care.	No information.
President of the medical association talks about contamination of workers by COVID-19³⁰.	Shortage of PPE and hospital supplies.	No information.	Death of health workers from COVID-19 and fear of contagion.	No information.	Recently graduated health workers called to assist in the pandemic.
G1, on April 23, 2020.	Shortage of PPE and hospital supplies.	No information.		No information.
Number of health workers with COVID-19 in Paraíba increases 66% in one week³¹.	Importance of having adequate PPE for workers.	No information.	45 workers infected by the disease.	Purchase of COVID-19 tests for health care workers.	Courses on donning and removing PPE to avoid contamination of workers.
G1, on April 22, 2020.	Importance of having adequate PPE for workers.	No information.	Death of health workers from COVID-19.	Purchase of COVID-19 tests for health care workers.
58-year-old nurse is the first health worker to die from COVID-19 in Amapá³².	Report of purchase of PPE and hospital sanitization and cleaning products.	No information.	Death of a nurse who was on leave due to contagion; according to family members, she was not contaminated in the workplace.	52 nurses placed on leave due to contagion.	No information.
	Shortage of PPE.
G1, on April 22, 2020.	Complaints of water shortage in the hospital environment, denied by hospital management.
ES records 101 new cases and totals 1,313 people infected by COVID-19; 206 are health workers³³.	No information.	No information.	206 health workers infected by coronavirus.	No information.	No information.
G1, on April 21, 2020.	No information.	No information.	206 health workers infected by coronavirus.	No information.	No information.
RJ has 6 deaths and more than 1,800 health workers on leave due to COVID-19: “It took a piece of us,” says the victim’s daughter³⁴.	No information.	No information.	Six deaths and around 1,800 health workers on leave due to COVID-19. Symptoms related to COVID-19 and feelings of sadness.	No information.	No information.
G1, on April 21, 2020.	No information.	No information.		No information.	No information.
12 health workers in São Paulo have died from COVID-19, says city official³⁵.	Need to purchase PPE to provide care for the disease.	No information.	There have been 12 deaths from COVID-19 in the capital city of São Paulo. 3,336 workers are on leave due to the disease.	No information.	No information.
G1, on April 21, 2020.	Need to purchase PPE to provide care for the disease.	No information.		No information.	No information.
More than 4,000 nurses have been contaminated with COVID-19³⁶.	Shortage and inadequate use of PPE.	Workers in at-risk groups must be removed from contact with people with COVID-19.	About 4,600 nurses contaminated with the new coronavirus.	Approximately 500 workers placed on leave per day.	No information.
G1, on April 20, 2020.	Shortage and inadequate use of PPE.		About 4,600 nurses contaminated with the new coronavirus.	Approximately 500 workers placed on leave per day.	No information.
68-year-old hospital cleaner is entitled to Covid testing but cannot get a test³⁷.	Shortage and inadequate use of PPE	Hospital cleaning worker member in at-risk group is denied leave from work.	One worker fallen ill with COVID-19.	Testing for the disease is required, especially for workers in direct contact with COVID-19.	No information.
Uol, on April 28, 2020.	Shortage and inadequate use of PPE		One worker fallen ill with COVID-19.		No information.
In Pará, 42% of confirmed coronavirus cases are in the health care field³⁸.	Shortage of PPE.	Permanence of at-risk workers in COVID-19 care.	Almost half of COVID-19 cases are health workers, seven of them died.	No information.	No training to provide health care for people with COVID-19.
Uol, on April 28, 2020.	Shortage of PPE.	Permanence of at-risk workers in COVID-19 care.		No information.
Technician resigns from hospital in RJ: “I’ve never experienced anything like this.”³⁹	Shortage of PPE.	No information.	No information.	No information.	A nursing technician quits her job due to poor working conditions.
Uol, on April 29, 2020.	Shortage of PPE.	No information.	No information.	No information.
PE has waiting list for ICU; workers already have to choose who to admit⁴⁰.	No information.	No information.	Work overload due to increase in cases of the disease, which can lead to occupational illness.	No information.	Need to hire health care staff.
Uol, on April 29, 2020.	No information.	No information.		No information.	Need to hire health care staff.

Health workers and COVID-19: flailing working conditions?

Abstract