Restructuring the Healthcare System to Protect Healthcare Personnel Amidst the COVID-19 Pandemic

COVID-19 infection caused by SARS-CoV2 has been declared a pandemic by the World Health Organization. Reports from China and France have shown that older age is a prognosticator of severity and mortality (1, 2). The number of elderly COVID-19 cases and the increased death rates among them compared to the younger population are surfacing across the world. The odds of hospitalization and the requirement of ICU facilities for the elderly are very high, which further adds burdens to the already compromised system in India where 0.55 beds are available per 1,000 of the population (3). ICU care is also very low, which aggravates the situation (3). Data from other countries have shown that even though 20% of cases are elderly people, they account for 79% of deaths, since associated comorbidities like diabetes, hypertension, respiratory diseases, which are common in the older population, fan the flames (4–6). A model-based analysis from China demonstrated a compelling age gradient in the case of fatality ratio 0.32 in < 60 years vs. 6.4% in >60 years and up to 13.4% in>80. Analogously, the hospitalization rate in infected individuals also upsurges with age (7). A study done from China analyzed data from 27 countries and highlighted age as the most important predictor for the odds of surviving from COVID-19 disease (8). In Wuhan, more than 3,300, and in Italy 4,800, front line medical staff were infected1. In China, out of the total overall deaths, 4.4% were health care workers and the median age was 55 years (9). Likewise in the USA, where 9,282 cases were reported among health workers and the median age was 42 years and 74.5% were female2. In Indonesia, 115 doctors had died because of COVID-19 as of September 2020 (10). The rate of infection among doctors in India is very high in comparison to other countries. As of late September 2020, 2,238 doctors have been infected and around 380 have died due to coronavirus, with 75% of them above the age of 50 years (11, 12). In the UK, mortality was higher among Black and Asian doctors (13). This vulnerability varies across ages and states. Across the world, the majority of the healthcare workforce is above 50 years of age1 and they are at high risk of being infected, owing to their nature of work (14–16).