Dr. Anthony Fauci thanked American health workers who “put themselves in danger” every day during the pandemic, although he acknowledged that the lack of PPE had contributed to the deaths of more than 3,600 of them.
“We rightly refer to these people without exaggeration – that they are true heroes and heroines,” he said in an exclusive interview with The Guardian. The death of so many health workers from Covid-19 is “a reflection of what health workers have done in the past, but they are putting themselves at risk by living up to the oath they take in becoming doctors and nurses,” said Fauci.
KHN and The Guardian tracked deaths of healthcare workers during the pandemic on the Lost on the Frontline database. The database has recorded more than 3,600 health worker deaths, which is considered the most authoritative record keeping in the country.
Personal protective equipment – including gloves, robes and critical masks – has been in short supply since the beginning of the pandemic, increasing the casualty rate. The US is the world’s largest importer of PPE, making it particularly vulnerable to the demand shock and export restrictions that hit world markets last spring.
“In the critical times when there were bottlenecks, people had to use everything that was available to them,” said Fauci. “I’m sure this has increased the risk of infection for healthcare providers.”
The shortages were compounded by the federal government’s failure to maintain a national supply of personal protective equipment and the Trump administration’s refusal to order more domestic production of PPE. The health workers had to use garbage bags as robes, reuse N95 for weeks and sometimes get by without gloves at all.
The shortage sparked protests from health workers who said working without equipment amid the pandemic left them like “sheep slaughtering”. Nina Forbes, a nurse in an assisted living facility, had to carry a garbage bag at times, according to her daughter, and later died. A year after the pandemic began, clothes and gloves are still in short supply, according to the Food and Drug Administration.
Almost 560,000 Americans have died from the Covid pandemic, and many more have long-term symptoms of the Covid pandemic.
Health workers were particularly at risk from the pandemic as they treated patients through early waves, when the lack of personal protective equipment was particularly acute, summer waves and a disastrous climax in winter.
A study of health workers in the US and UK in The Lancet found that health workers are three times more likely to be infected with the Covid virus than the general public, disproportionately affecting minority health workers.
“It’s very clear just to go into the media and see the images on TV – the stress and strain on the faces of health care providers, nurses, doctors and other people involved in the health company,” said Fauci.
Even so, the US government has not systematically counted health worker deaths. Members of Congress, the Department of Health and Human Services, and academic reporting have cited The Guardian and KHN’s coverage as the most comprehensive. A growing chorus of policy experts and trade unions have called for a comprehensive health worker death count.
“We definitely want to get an accurate count of the people who are dying,” said Fauci, not realizing when the government should make such efforts. “Sure, that’s something I think would come under the auspices of the federal government.”
Even if the adoption of the vaccine gains momentum, health workers will continue to be at risk. More than 400 died between the start of the rollout and the end of February. Infections among vaccinated health workers have fallen sharply, but with deaths being a delayed indicator of the spread of Covid, some health workers will have gotten sick before widespread vaccination.
At the same time, immunity to coronaviruses generally decreases over time, and variants can affect the effectiveness of some vaccines. A global shortage of vaccines means dozens of poor nations have not vaccinated a single person. Proponents argue that this has led to a global “vaccine apartheid” that will contribute to the further emergence of variants. Both scenarios could put health workers at risk again and require a new round of mass vaccination for adults.
Studies are currently underway on the duration of vaccine immunity and the effects of variants on vaccines. “If we have to perform boosting with a variant-specific boost, [we] I’ll be prepared because we’re already doing a study, ”said Fauci. This research takes place at the National Institute for Allergies and Infectious Diseases, which he directs. Even so, “our ability to protect against variants with the standard vaccine appears to be better than expected.”
Regardless of how future vaccination campaigns play out, US policymakers should learn from events over the past year, Fauci said.
“We’d better make sure that the lesson we are going to learn is that we will never again be in a situation where people who are putting their health and safety at risk do not have the proper equipment to protect themselves safe to protect, “he said.
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