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Virus Knocks Thousands of Health Workers Out of Action in Europe Virus Knocks Thousands of Health Workers Out of Action in Europe
(3 days later)
MADRID — Across Western Europe, health care professionals have used the language of war to describe the struggle against the coronavirus, which has left some hospitals on the brink of collapse.MADRID — Across Western Europe, health care professionals have used the language of war to describe the struggle against the coronavirus, which has left some hospitals on the brink of collapse.
And health care workers are the soldiers on the front lines.And health care workers are the soldiers on the front lines.
Out of Spain’s 40,000 confirmed coronavirus cases, 5,400 — nearly 14 percent — are medical professionals, the health ministry said on Tuesday. No other country has reported health care staff accounting for a double-digit percentage of total infections.Out of Spain’s 40,000 confirmed coronavirus cases, 5,400 — nearly 14 percent — are medical professionals, the health ministry said on Tuesday. No other country has reported health care staff accounting for a double-digit percentage of total infections.
But the problem is widespread throughout Europe. In Italy, France and Spain, more than 30 health care professionals have died of the coronavirus, and thousands of others have had to self-isolate.But the problem is widespread throughout Europe. In Italy, France and Spain, more than 30 health care professionals have died of the coronavirus, and thousands of others have had to self-isolate.
In Brescia province, the center of Italy’s outbreak, 10 to 15 percent of doctors and nurses have been infected and put out of commission, according to a doctor there.In Brescia province, the center of Italy’s outbreak, 10 to 15 percent of doctors and nurses have been infected and put out of commission, according to a doctor there.
In France, the public hospital system in Paris has tallied 490 infected staff members, a small but growing proportion of the system’s 100,000 or so employees.In France, the public hospital system in Paris has tallied 490 infected staff members, a small but growing proportion of the system’s 100,000 or so employees.
The same dynamics are starting to take hold in Britain and the United States, where the contagion is bearing down but has yet to fully bite.The same dynamics are starting to take hold in Britain and the United States, where the contagion is bearing down but has yet to fully bite.
At the La Paz hospital in Madrid, one of the largest in Spain’s capital, 426 employees — 6 percent of the medical staff — are isolated at home, after testing positive or showing possible symptoms of the coronavirus, according to internal numbers provided by a labor union that represents doctors in Madrid.At the La Paz hospital in Madrid, one of the largest in Spain’s capital, 426 employees — 6 percent of the medical staff — are isolated at home, after testing positive or showing possible symptoms of the coronavirus, according to internal numbers provided by a labor union that represents doctors in Madrid.
At the smaller Igualada hospital in Catalonia, a third of the 1,000 hospital staff has been sent home.At the smaller Igualada hospital in Catalonia, a third of the 1,000 hospital staff has been sent home.
“The virus was already among us when we were really only testing those who came from Wuhan and then from Italy,” said Ángela Hernández Puente, a doctor who is the deputy secretary general of the doctors’ union. “Some of our doctors unfortunately worked without adequate protection and acted as vectors.”“The virus was already among us when we were really only testing those who came from Wuhan and then from Italy,” said Ángela Hernández Puente, a doctor who is the deputy secretary general of the doctors’ union. “Some of our doctors unfortunately worked without adequate protection and acted as vectors.”
As doctors, nurses and other practitioners fall sick, the burdens increase on health care systems already groaning under the strain of an expanding epidemic. And infected workers and their hospitals are increasingly being recognized as vectors for the spread of the virus.As doctors, nurses and other practitioners fall sick, the burdens increase on health care systems already groaning under the strain of an expanding epidemic. And infected workers and their hospitals are increasingly being recognized as vectors for the spread of the virus.
The number of cases in Spain has been doubling every four days, and the country is fast shaping up as Europe’s next epicenter of the contagion. On Tuesday, Spain’s coronavirus toll reached 2,700 dead, the second-highest in Europe after Italy.The number of cases in Spain has been doubling every four days, and the country is fast shaping up as Europe’s next epicenter of the contagion. On Tuesday, Spain’s coronavirus toll reached 2,700 dead, the second-highest in Europe after Italy.
In Madrid, the focus of Spain’s outbreak, so many are dying that bodies are being placed in an Olympic-sized ice skating rink that has been converted into an emergency morgue.In Madrid, the focus of Spain’s outbreak, so many are dying that bodies are being placed in an Olympic-sized ice skating rink that has been converted into an emergency morgue.
In some retirement homes, soldiers deployed to disinfect the premises found elderly people abandoned, or dead in their beds, prompting Spain’s public prosecutors to open an investigation.In some retirement homes, soldiers deployed to disinfect the premises found elderly people abandoned, or dead in their beds, prompting Spain’s public prosecutors to open an investigation.
It has not helped that Spain’s population, on average, is among the world’s oldest. But the government was also late to impose restrictions on the movement of people.It has not helped that Spain’s population, on average, is among the world’s oldest. But the government was also late to impose restrictions on the movement of people.
Even as a tragedy unfolded in northern Italy, mass events went ahead earlier this month in Madrid, and the government waited until March 14 to declare a state of emergency that has since forced people to stay indoors, barring exceptional circumstances.Even as a tragedy unfolded in northern Italy, mass events went ahead earlier this month in Madrid, and the government waited until March 14 to declare a state of emergency that has since forced people to stay indoors, barring exceptional circumstances.
Spain also did not shore up its stock of medical equipment early on. Doctors and nurses have had to work with a dangerous shortage of masks, gloves and other essential gear that has proved disastrous for them.Spain also did not shore up its stock of medical equipment early on. Doctors and nurses have had to work with a dangerous shortage of masks, gloves and other essential gear that has proved disastrous for them.
The grim situation has left many of Spain’s health care professionals overwhelmed and pleading for more equipment, doctors, nurses and ambulance crews have told The New York Times. For those who have been infected, a feeling of powerlessness has sunk in.The grim situation has left many of Spain’s health care professionals overwhelmed and pleading for more equipment, doctors, nurses and ambulance crews have told The New York Times. For those who have been infected, a feeling of powerlessness has sunk in.
“You are used to taking care of others and now you’re being asked to stay home and take care of yourself,” said Marc Arnaiz, a doctor in the internal medicine unit of the Igualada hospital, who tested positive earlier this month.“You are used to taking care of others and now you’re being asked to stay home and take care of yourself,” said Marc Arnaiz, a doctor in the internal medicine unit of the Igualada hospital, who tested positive earlier this month.
“For most of us this job is a vocation, so it’s shocking and frustrating,” he said.“For most of us this job is a vocation, so it’s shocking and frustrating,” he said.
Mr. Arnaiz, 31, said he had likely been infected by a patient. He noticed the first symptoms on March 9, the day his patient was confirmed positive, among the first in the hospital, which has since become one of the worst infection clusters in northeastern Spain.Mr. Arnaiz, 31, said he had likely been infected by a patient. He noticed the first symptoms on March 9, the day his patient was confirmed positive, among the first in the hospital, which has since become one of the worst infection clusters in northeastern Spain.
While it’s impossible to know how many patients infected doctors and vice versa, the alarming spread within hospitals has forced the government to struggle with a shortage of both professionals and equipment.While it’s impossible to know how many patients infected doctors and vice versa, the alarming spread within hospitals has forced the government to struggle with a shortage of both professionals and equipment.
Last week, the government launched an emergency recruitment plan to add 50,000 health care workers, ranging from medical students to retired doctors.Last week, the government launched an emergency recruitment plan to add 50,000 health care workers, ranging from medical students to retired doctors.
After employees began complaining openly about the stresses on the system, some Madrid hospitals told their staff not to speak out. Many of those interviewed by The New York Times were not authorized to comment publicly and asked that their full names not be used for fear of retribution.After employees began complaining openly about the stresses on the system, some Madrid hospitals told their staff not to speak out. Many of those interviewed by The New York Times were not authorized to comment publicly and asked that their full names not be used for fear of retribution.
One, Yolanda, has been a nurse for 30 years, working in a public hospital in Madrid. But earlier this month, as the outbreak worsened in Spain, she said she was moved instead to a makeshift emergency ward, where she had to learn new skills on the job while working without decent protective gear.One, Yolanda, has been a nurse for 30 years, working in a public hospital in Madrid. But earlier this month, as the outbreak worsened in Spain, she said she was moved instead to a makeshift emergency ward, where she had to learn new skills on the job while working without decent protective gear.
“We’ve been put on the front line not only without enough protection, but also sometimes with the stress of a very different work environment,” she said, noting that she had never before handled intubated patients. The nurses in her unit wore face masks and gowns, but they had to reuse them because of a shortage.“We’ve been put on the front line not only without enough protection, but also sometimes with the stress of a very different work environment,” she said, noting that she had never before handled intubated patients. The nurses in her unit wore face masks and gowns, but they had to reuse them because of a shortage.
“Putting on a face mask again and again is as useless as sticking a piece of paper on your face,” she said.“Putting on a face mask again and again is as useless as sticking a piece of paper on your face,” she said.
Last Thursday, Yolanda went home feeling feverish. On Sunday, she tested positive for coronavirus, along with about 30 colleagues. “We have done our best, but some of us sadly became part of the contamination chain,” she said.Last Thursday, Yolanda went home feeling feverish. On Sunday, she tested positive for coronavirus, along with about 30 colleagues. “We have done our best, but some of us sadly became part of the contamination chain,” she said.
Hospital workers’ unions were less hesitant to point fingers.Hospital workers’ unions were less hesitant to point fingers.
“When we already knew that the virus was circulating in hospitals, we were still being told that the usage of protective gear should be limited to specific circumstances,” said Juanjo Menéndez, the communications director of SATSE Madrid, a nurses’ union. “It’s the kind of basic error that a student learns to avoid in the first year of medical school.”“When we already knew that the virus was circulating in hospitals, we were still being told that the usage of protective gear should be limited to specific circumstances,” said Juanjo Menéndez, the communications director of SATSE Madrid, a nurses’ union. “It’s the kind of basic error that a student learns to avoid in the first year of medical school.”
In Spain, France and Italy, officials and health care professionals said they were shocked by equipment shortages.In Spain, France and Italy, officials and health care professionals said they were shocked by equipment shortages.
Updated June 12, 2020Updated June 12, 2020
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement.
Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks.
A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study.
The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April.
Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.Mass protests against police brutality that have brought thousands of people onto the streets in cities across America are raising the specter of new coronavirus outbreaks, prompting political leaders, physicians and public health experts to warn that the crowds could cause a surge in cases. While many political leaders affirmed the right of protesters to express themselves, they urged the demonstrators to wear face masks and maintain social distancing, both to protect themselves and to prevent further community spread of the virus. Some infectious disease experts were reassured by the fact that the protests were held outdoors, saying the open air settings could mitigate the risk of transmission.
Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.Exercise researchers and physicians have some blunt advice for those of us aiming to return to regular exercise now: Start slowly and then rev up your workouts, also slowly. American adults tended to be about 12 percent less active after the stay-at-home mandates began in March than they were in January. But there are steps you can take to ease your way back into regular exercise safely. First, “start at no more than 50 percent of the exercise you were doing before Covid,” says Dr. Monica Rho, the chief of musculoskeletal medicine at the Shirley Ryan AbilityLab in Chicago. Thread in some preparatory squats, too, she advises. “When you haven’t been exercising, you lose muscle mass.” Expect some muscle twinges after these preliminary, post-lockdown sessions, especially a day or two later. But sudden or increasing pain during exercise is a clarion call to stop and return home.
States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.States are reopening bit by bit. This means that more public spaces are available for use and more and more businesses are being allowed to open again. The federal government is largely leaving the decision up to states, and some state leaders are leaving the decision up to local authorities. Even if you aren’t being told to stay at home, it’s still a good idea to limit trips outside and your interaction with other people.
Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.
If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.)
Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.Taking one’s temperature to look for signs of fever is not as easy as it sounds, as “normal” temperature numbers can vary, but generally, keep an eye out for a temperature of 100.5 degrees Fahrenheit or higher. If you don’t have a thermometer (they can be pricey these days), there are other ways to figure out if you have a fever, or are at risk of Covid-19 complications.
The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.The C.D.C. has recommended that all Americans wear cloth masks if they go out in public. This is a shift in federal guidance reflecting new concerns that the coronavirus is being spread by infected people who have no symptoms. Until now, the C.D.C., like the W.H.O., has advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. Masks don’t replace hand washing and social distancing.
If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others.
If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.If you’re sick and you think you’ve been exposed to the new coronavirus, the C.D.C. recommends that you call your healthcare provider and explain your symptoms and fears. They will decide if you need to be tested. Keep in mind that there’s a chance — because of a lack of testing kits or because you’re asymptomatic, for instance — you won’t be able to get tested.
Giorgio Gori, the mayor of Bergamo, one of the hardest hit towns in Italy, said “the doctors weren’t protected,” and lacked “the sufficient defenses,” adding that he was still receiving requests for masks and gloves from doctors making home visits.Giorgio Gori, the mayor of Bergamo, one of the hardest hit towns in Italy, said “the doctors weren’t protected,” and lacked “the sufficient defenses,” adding that he was still receiving requests for masks and gloves from doctors making home visits.
Jean-Paul Hamon, the president of one of France’s biggest doctor unions, told the LCI television broadcaster on Tuesday that he was particularly worried about workers who are not in hospitals but are still in close contact with patients, like general practitioners or retirement home employees.Jean-Paul Hamon, the president of one of France’s biggest doctor unions, told the LCI television broadcaster on Tuesday that he was particularly worried about workers who are not in hospitals but are still in close contact with patients, like general practitioners or retirement home employees.
Three of the five doctors who have died of Covid-19 so far in France were general practitioners, and one was a gynecologist. “The state is absolutely unprepared,” said Mr. Hamon, who is himself infected. “The state is going to owe an explanation.”Three of the five doctors who have died of Covid-19 so far in France were general practitioners, and one was a gynecologist. “The state is absolutely unprepared,” said Mr. Hamon, who is himself infected. “The state is going to owe an explanation.”
In Spain, doctors warned that hospitals were now paying the price of the loose measures announced in the early days of the outbreak.In Spain, doctors warned that hospitals were now paying the price of the loose measures announced in the early days of the outbreak.
“The lack of protection is everywhere, the improvisation seems to be widespread,” said Antonio Antela, a doctor who coordinates the infectious disease unit at the university hospital of Santiago de Compostela, in northwestern Spain. He has been hospitalized for a week after developing pneumonia and testing positive.“The lack of protection is everywhere, the improvisation seems to be widespread,” said Antonio Antela, a doctor who coordinates the infectious disease unit at the university hospital of Santiago de Compostela, in northwestern Spain. He has been hospitalized for a week after developing pneumonia and testing positive.
“The lesson is: take care of your public health care system, because there will be other epidemics and we ought to be better prepared,” he added in a telephone interview from his hospital bed.“The lesson is: take care of your public health care system, because there will be other epidemics and we ought to be better prepared,” he added in a telephone interview from his hospital bed.
At a medical center in the heart of Madrid, María, another nurse who is now isolated at home with coronavirus, said that she spent several days working without a face mask and gloves, handing out masks only to visitors who reported breathing problems or had recently been in Italy.At a medical center in the heart of Madrid, María, another nurse who is now isolated at home with coronavirus, said that she spent several days working without a face mask and gloves, handing out masks only to visitors who reported breathing problems or had recently been in Italy.
On March 11, the day she first felt fever, her medical center finally ordered all staff to wear masks. “We probably didn’t have enough face masks, but we also acted for far too long as if this was a limited problem, mostly imported from Italy,” she said.On March 11, the day she first felt fever, her medical center finally ordered all staff to wear masks. “We probably didn’t have enough face masks, but we also acted for far too long as if this was a limited problem, mostly imported from Italy,” she said.
The Spanish government is now stepping up efforts to buy medical equipment, as well as distributing about 650,000 new test kits across the country. Two Chinese cargo planes filled with face masks and other gear landed in Madrid and Zaragoza on Tuesday.The Spanish government is now stepping up efforts to buy medical equipment, as well as distributing about 650,000 new test kits across the country. Two Chinese cargo planes filled with face masks and other gear landed in Madrid and Zaragoza on Tuesday.
“We are a target like everybody else, but we are also a threat to other co-workers,” said Juan, a 37-year-old doctor in a Madrid public hospital. “Also, if you test everyone and there’s no health care workers left in the hospitals, what can you do?”“We are a target like everybody else, but we are also a threat to other co-workers,” said Juan, a 37-year-old doctor in a Madrid public hospital. “Also, if you test everyone and there’s no health care workers left in the hospitals, what can you do?”
Raphael Minder reported from Madrid and Elian Peltier from Barcelona. Reporting was contributed by Jason Horowitz in Rome and Aurelien Breeden in Paris.Raphael Minder reported from Madrid and Elian Peltier from Barcelona. Reporting was contributed by Jason Horowitz in Rome and Aurelien Breeden in Paris.