The COVID-19 pandemic has caused high mortality not only in patients but also health care providers. The COVID-19 pandemic has infected more than 4.5 million people in India, with an overall case fatality rate of 1.7% as of 10 September 2020. The doctors treating and interacting with patients during these times are at a very high risk of contracting the infection, leading to a possible higher mortality rate than the general public.
A research paper on COVID-19 related mortality data of Indian doctors was written by Aanandita Kapoor & Krishan Mohan Kapoor and was published on www.medrxiv.com on 30 September 2020. This study’s data was collected from the list of deceased doctors released by the Indian Medical Association, IMA, the top body of Indian doctors practicing modern allopathic medicine.
- The analysis results showed that the total COVID-related deaths in the Indian population till 10 September was 76,304 out of 4,559,725 total COVID-19 positive cases with a case fatality rate CFR of 1.7%. In all, 382 COVID related deaths were reported amongst doctors in India. These cases were out of 2174 total infected cases reported among doctors till 10 September 2020, a CFR of 16.7% among Indian doctors.
- The Indian doctors infected with COVID-19 formed a very small percentage of the total cases in the population (2174 out of 76304 cases; 0.05%), but while calculating the deaths, this percentage increased sharply compared to deaths among the general population (382 out of 76304; 0.5%).
- “The case fatality rate among Indian doctors at 16.7% was nearly ten times more than the general population (CFR 1.7%) on 10 September 2020,” said Aanandita Kapoor, the lead author of this paper.
- Out of 2174 doctors who got infected with COVID-19, 1023 (47%) were practicing doctors while 827 (38%) were the resident doctors, and 324 (15%) were house surgeons. The total deaths among resident doctors/ house surgeons were 10 out of 1151 infections, giving a CFR of 0.9%. On the other hand, deaths among practicing doctors were 372 out of 1023 infections, with a CFR of 36.4%, which is almost 22 times higher than the CFR of 1.7% in India’s general population.
- The age range of the deceased doctors was 24-88 years. The percentage of deaths below 30 was 1%, below 40 years was 5.8%, below 50 years it was 11.8%. The percentage of fatalities below 60 was 38%, while 62% of deaths among doctors were above 60. The average age of doctors at death was 60.8 years, with a median age of 60 years.
- The majority of the deceased, 225 (58.9%), were general practitioners. Among the specialists, the maximum brunt of COVID-19 was borne by paediatricians 26 (6.8%), medical specialists 24 (6.3%), general surgeons 22 (5.8%), obstetricians & gynecologists 16 (4.2%), and anaesthesiologists 14 (3.7%). Amongst other specialists who lost their lives, orthopaedic surgeons 9 (2.4%), ENT surgeons 8 (2.1%), radiologists 5 (1.3%), ophthalmologists 5 (1.3%), and psychiatrists 4 (1%) were major groups. There were three deaths (0.8%), each amongst pathologists, neurologists, and dentists.
- The super specialists who lost their lives comprised of neurologists 3(0.8%), cardiac surgeons 2(0.5%), urologists 2 (0.5%), oncologist 1 (0.26%), neurosurgeon 1 (0.26%) and cardiologist 1 (0.26%).
- The state-wise distribution of doctor deaths shows the highest deaths in Tamil Nadu, Andhra Pradesh, Gujarat, Maharashtra, and Karnataka. Tamil Nadu had the highest number of 61 deaths among the states.
Certain factors attributed in medical literature to death in frontline doctors include lack of adequate PPE, an inadequate technique of donning and doffing of PPE, and non-disclosure by patients of their exposure to possible COVID-19 infection, excessive working hours of doctors, and poor doctor-patient ratio. In the case of infections like COVID-19, the precautionary principle should be used for frontline health workers. There should be a uniform policy regarding the use of personal protective equipment where health workers’ occupational health and safety is a high priority. Providing food, rest breaks, decompression time, and adequate time off from work may be as important as the protocols and protective equipment during a protracted battle against COVID-19 infection. “A physically & mentally healthy and well-equipped healthcare workforce is essential for a country to effectively manage COVID-19 cases,” concluded Dr. Krishan Mohan Kapoor.