Modenese Alberto, Gobba Fabriziomaria
Department of Biomedical, Metabolic and Neural Sciences, Università degli Studi di Modena e Reggio Emilia, 41125 Modena, Italy.
Healthcare (Basel). 2020 Jun 3;8(2):155. doi: 10.3390/healthcare8020155.
To date, data on COVID-19-related death cases among physicians from different medical specialties are incomplete and scattered. In Italy, available data highlight that general practitioners (GPs) are, apparently, the most heavily affected group. Indeed, they currently represent 44.1% of the total COVID-19 related death cases occurred among physicians, whereas they constitute about 15% of the total number of doctors. This high proportion is most likely the consequence of a work-related contagion happening especially during the first weeks of the epidemic, and persisting also in the following weeks, after the national lockdown. There are various reasons for these higher contagion rates: GPs perform a lot of medical examinations daily, usually in close contact with patients. Especially at the beginning of the epidemic, GPs might have had scant information on the specific safety procedures for the prevention of SARS-CoV-2 transmission (e.g., there was limited knowledge on the possibility of contagions deriving from asymptomatic patients) and, moreover, the availability of personal protective equipment was insufficient. Furthermore, the risk of infection is highly increased by the virus' characteristics, like its survival for several hours/days on different surfaces and its persistence in the air after an aerosolization process, with possibilities to be transmitted over distances longer than two meters. Following these observations, and considering the high cost in term of GPs' lives, the COVID-19 pandemic will probably revolutionize the approach to patients in general practice. Clear and effective guidelines are absolutely and urgently needed for the refinement of adequate measures to prevent SARS-CoV-2 infections among GPs.
迄今为止，不同医学专业医生中与新冠病毒疾病（COVID - 19）相关死亡病例的数据并不完整且分散。在意大利，现有数据表明，全科医生（GPs）显然是受影响最严重的群体。事实上，他们目前占医生中发生的与COVID - 19相关死亡病例总数的44.1%，而他们在医生总数中约占15%。这一高比例很可能是工作相关感染的结果，尤其是在疫情的最初几周发生，并在全国封锁后的接下来几周仍持续存在。这些较高感染率有多种原因：全科医生每天进行大量医学检查，通常与患者密切接触。特别是在疫情开始时，全科医生可能对预防SARS-CoV-2传播的具体安全程序了解甚少（例如，对无症状患者传播感染的可能性了解有限），而且个人防护设备的供应也不足。此外，病毒的特性极大地增加了感染风险，比如它能在不同表面存活数小时/数天，在雾化过程后能在空气中持续存在，有可能在两米以上的距离传播。基于这些观察结果，并考虑到全科医生生命的高昂代价，COVID - 19大流行可能会彻底改变全科医疗中对待患者的方式。迫切需要明确有效的指南来完善预防全科医生感染SARS-CoV-2的适当措施。
