In December 2019, news of a strange new illness, mainly in Wuhan, the capital of Hubei Province in China, came through social media. Little was known about the virus until 11 February 2020, when it was named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (World Health Organization (WHO), 2020a). Although a member of the family of coronaviruses and similar to the virus implicated in the SARS outbreak of 2003, virologists have reported some differences, making COVID-19 a novel coronavirus.
By mid-February, the virus had crossed borders to other parts of the world, especially Europe, leading to the WHO declaring COVID-19 a ‘Public Health Emergency of International Concern’ on 30 January 2020 (WHO, 2020b).
In a global quest to find the mode of transmission of the virus causing COVID-19, a variety of symptoms have been reported. Some patients experience severe pneumonia-like symptoms, while others have symptoms similar to those of common flu. All infected persons can spread the virus to others, including health workers, through droplets when sneezing, coughing or exhaling. A grimmer scenario is presented in a report by Wei et al (2020) that a source patient who is asymptomatic can spread the virus for 1 to 3 days before becoming symptomatic.
As frontline workers, doctors, nurses, midwives and other health professionals are at risk of becoming infected in the line of duty, particularly because of the mystery surrounding how coronavirus spreads from one person to another. Although we know that coronavirus spreads from person to person through respiratory droplets, is it airborne? That is a puzzle yet to be solved (Centers for Disease Control and Prevention, 2020; Lewis, 2020). But no matter how the virus spreads, it is in every country's interest to protect frontline workers.
Since COVID-19 was declared a pandemic, there has been a global outcry from health personnel about the lack of personal protective equipment (PPE). This cry for PPE sounds loudest from high-income countries such as the UK and USA. In March 2020, the New York Post (Bowden et al, 2020), reported that nurses were improvising using trash bags as protective gowns at the Mount Sinai West Hospital. A lack of PPE was a problem in many European countries.
In the global war against the coronavirus, frontline workers are the soldiers the world is counting on to fight this common enemy. But are these ‘military personnel’ being sent into battlefields without their full armour? What are the expectations if these ‘soldiers’ go into battle without appropriate face masks, goggles and gloves?
Deaths of healthcare workers have been reported around the world. In the UK, 100 fatalities were reported among NHS workers by the BBC on 28 April (BBC News, 2020). These are not just numbers, but individuals who were cherished family and community members. Some were the sole breadwinners for their families as well as role models in communities. There may be economic recovery after COVID-19, but these lives have been lost forever.
The crux of the matter is were these deaths among frontline workers avoidable? Did any of them meet their untimely death because of no or inadequate PPE? Is there still a shortage of PPE for our surviving workers? And has the world learned lessons from this tragedy?
In 2003, it was SARS, in 2014 it was Ebola and in 2020 it is COVID-19. Lessons from yesterday and lessons learned today for tomorrow include governments and health services acting immediately in the event of a similar infection, and improving and sustaining protection for all frontline workers.