Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries
Authors: Huy Nguyen Tien , Chico R. Matthew , Huan Vuong Thanh , Shaikhkhalil Hosam Waleed , Uyen Vuong Ngoc Thao , Qarawi Ahmad Taysir Atieh , Alhady Shamael Thabit Mohammed , Vuong Nguyen Lam , Truong Le Van , Luu Mai Ngoc , Dumre Shyam Prakash , Imoto Atsuko , Lee Peter N. , Tam Dao Ngoc Hien , Ng Sze Jia , Hashan Mohammad Rashidul , Matsui Mitsuaki , Duc Nguyen Tran Minh , Karimzadeh Sedighe , Koonrungsesomboon Nut , Smith Chris , Cox Sharon , Moji Kazuhiko , Hirayama Kenji , Linh Le Khac , Abbas Kirellos Said , Dung Tran Nu Thuy , Mohammed Ali AL-Ahdal Tareq , Balogun Emmanuel Oluwadare , Duy Nguyen The , Mohamed Eltaras Mennatullah , Huynh Trang , Hue Nguyen Thi Linh , Khue Bui Diem , Gad Abdelrahman , Tawfik Gehad Mohamed , Kubota Kazumi , Nguyen Hoang-Minh , Pavlenko Dmytro , Trang Vu Thi Thu , Vu Le Thuong , Hai Yen Tran , Yen-Xuan Nguyen Thi , Trang Luong Thi , Dong Vinh , Sharma Akash , Dat Vu Quoc , Soliman Mohammed , Abdul Aziz Jeza , Shah Jaffer , Hung Pham Dinh Long , Jee Yap Siang , Phuong Dang Thuy Ha , Quynh Tran Thuy Huong , Giang Hoang Thi Nam , Huynh Vy Thi Nhat , Thi Nguyen Anh , Dhouibi Nacir , Phan Truc , Duru Vincent , Nam Nguyen Hai , Ghozy Sherief ,   contributors of the TMGH-Global COVID-19 Collaborative
Published: December 2021

Background
Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave.

Methods
This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training.

Results
We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0–14.0) and the median awareness score was 29.6 (IQR = 26.6–32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a ’great-extent-of-confidence’ in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors.

Interpretation
There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type.