London School of Hygiene & Tropical Medicine

A survey of healthcare workers in 57 countries found that while overall levels of preparedness for, and awareness of, the COVID-19 pandemic were considered acceptable, there were significant differences in these levels across groups of healthcare workers and countries, according to a new study published in PLOS ONE.

Among healthcare workers, awareness and preparedness regarding COVID-19 is central to reducing risk of transmission at hospitals and keeping healthcare workers safe. Understanding the extent to which healthcare workers are aware and prepared is needed to inform policies for both the ongoing pandemic and potential future outbreaks of other diseases.

The study was carried out by researchers from Nagasaki University, Pham Ngoc Thach University of Medicine, Islamic University of Gaza, Vietnam National University,  the London School of Hygiene & Tropical Medicine (LSHTM), and other international partners, and was funded in part by the School of Tropical Medicine and Global Health, Nagasaki University.

The team conducted a survey of healthcare workers from 371 hospitals in 57 different countries, receiving a total of 17,302 responses between February and May of 2020 – during the first wave of the COVID-19 pandemic. The survey included questions to evaluate COVID-19 awareness and preparedness, adapted from several COVID-19 preparedness checklists developed early on in the pandemic.

Statistical analyses of survey responses found that the median COVID-19 preparedness score was 11 of 15, whereas the median COVID-19 awareness score was 29.6 of 40. The researchers consider these levels to be acceptable. These scores were significantly higher among healthcare workers with previous outbreak experience or who received training for the COVID-19 outbreak. However, preparedness scores were higher among male compared to female healthcare workers and nurses relative to doctors.

Dr Matthew Chico, Associate Professor at the LSHTM and study author, said: “This global survey during the first wave of the coronavirus is historic in scope, the results of which suggest that female healthcare workers may not have had equal training opportunities to prepare them for the pandemic compared to their male counterparts.

“This may have translated into higher burden of SARS-CoV-2 infection that we have seen in many countries. Training opportunities must be gender-equitable moving forward to safeguard the whole workforce and stem transmission within healthcare facilities.”

In addition, preparedness varied according to national wealth and sociodemographic characteristics. For instance, healthcare workers from countries in East Asia and the Pacific had significantly higher preparedness scores than those of countries in sub-Saharan Africa, the Middle East, and Latin America.

These findings suggest the need for training opportunities that are more equitable across genders. This may take the form of rapid in-service training for healthcare providers on mobile apps or social media platforms where quality information and regular updates are made available from trusted sources that reach all levels of healthcare workers. The researchers also call for better knowledge sharing between countries to learn from prior outbreaks. Future research could examine how awareness and preparedness among healthcare workers has evolved over the course of the pandemic.

The researchers acknowledge limitations of this study, including that it was conducted online at a relatively early stage in the pandemic so may be more reflective of the experience of healthcare workers who have resources and facilities like internet access.

Publication

Nguyen Tien Huy et al. Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries. PLOS ONE. DOI: 10.1371/journal.pone.0258348

*Based on a press release by PLOS*