ABSTRACT
BackgroundThe Covid-19 pandemic brings major new challenges to health services resulting from the lack of a vaccine and from the enormous resources it can consume over a prolonged period. The available control measures are currently limited to quarantining, contact tracking and tracing and social distancing. Disease transmission to health care workers is common and deaths among clinical and nursing staff have been reported in the UK (where serious concerns about the availability of personal protective equipment - PPE - have been raised) and elsewhere; particularly in Lombardy, where General Practitioners (Medici di Base) have died in disproportionate numbers. MethodsData from Italy and Spain was obtained from publicly available sources which are more comprehensive than that available to date (April 2020) in the UK and the advanced timing of the crisis in these locations allows their sources to propose a strategy of allocating staff roles with due respect to the age and sex of staff in order to reduce the pressure on the limited resource of critical care beds and diminish the quantity of hospital acquired infections encountered in treating the known large proportions of patients who were infected as healthcare workers. Such strategy would dramatically reduce unnecessary death and illness in the caring professions and assist employers in reasonable health and safety compliance for their workforce. In addition to those staff employed in patient care roles prior to the pandemic, doctors and nurses who have recently retired from the NHS have been invited via their respective regulatory bodies such as the United Kingdom General Medical Council (GMC) and Nursing & Midwifery Council (NMC) to return to the front-line. Those who are qualified for clinical and nursing roles, but who are now working in research, education and management roles have also been welcomed by the NHS and placed in clinical roles undertaking face-to face delivery of care. The first COVID-19-related deaths reported in NHS doctors were all male clinicians from BAME background over 50 years of age. ResultsHerein, we construct a measure of fatality as a function of population Covid-19 status to examine the data from Spain and Italy, where the pandemic struck much sooner. This shows a doubling in relative risk for men compared to women and a 20-fold increase for those 60-19 compared to women 40-49. ConclusionThe analyses suggest a stratified approach to allocating staff, through making these results available to those who volunteer for front line roles. This should result in preserving as many of the valuable older doctors and nurses as possible with their expertise, experience, managerial skills and to maintain the coherence and leadership of their teams and research groups.
