Human rights protections are needed alongside PPE for health-care workers responding to COVID-19
Authors: Joseph J Amon
Journal: The Lancet Global Health (2020)

On May 6, 2020, the International Council of Nurses reported that worldwide an estimated 90 000 health-care workers had been infected with COVID-19.1International Council of NursesICN calls for data on healthcare worker infection rates.https://www.icn.ch/news/icn-calls-data-healthcare-worker-infection-rates-and-deathsDate: May 6, 2020Date accessed: May 21, 2020Google Scholar Other sources have reported more than 50 dead and 3000 infected in China (as of April 3, 2020),2Chinese Red Cross FoundationPublic announcement.https://new.crcf.org.cn/article/20099Date: April 30, 2020Date accessed: May 21, 2020Google Scholar and 27 dead and 9282 infected in the USA (as of April 9, 2020).3US Centers for Disease Control and PreventionCharacteristics of health care personnel with COVID-19—United States, February 12–April 9, 2020.MMWR Morb Mortal Wkly Rep. 2020; 69: 477-481Crossref PubMed Scopus (537) Google Scholar In Russia, in mid-May 2020, 260 doctors have reportedly died of COVID-19. Health-care workers have experienced violence, harassment, and discrimination in their communities, and have been forced to move from their homes or physically attacked.4Semple K "Afraid to be a nurse": health workers under attack.The New York Times. April 27, 2020; https://www.nytimes.com/2020/04/27/world/americas/coronavirus-health-workers-attacked.htmlDate accessed: May 19, 2020Google Scholar Qian Liu and colleagues (June, 2020)5Liu Q Luo D Haase JE et al.The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study.Lancet Glob Health. 2020; 8: e790-e798Summary Full Text Full Text PDF PubMed Scopus (858) Google Scholar examined health workers' experience responding to COVID-19 in Hubei province, China. The authors highlight three key themes, related to duty and sacrifice, the challenges of working in a crisis setting, and resilience amid challenges.5Liu Q Luo D Haase JE et al.The experiences of health-care providers during the COVID-19 crisis in China: a qualitative study.Lancet Glob Health. 2020; 8: e790-e798Summary Full Text Full Text PDF PubMed Scopus (858) Google Scholar Absent from this picture were two themes reported elsewhere—the Chinese government failing to protect health-care workers or censoring and detaining them for speaking out. In February, 2020, a nurse from Wuhan Central Hospital posted a devastating picture of neglect of health workers and fear of government reprisal on social media, writing that the actual situation was "not as good as reported. The situation is more serious…Nobody dare[s] to speak the truth…Now nobody has time to care for us. Supplies are not distributed. We can only report good news not bad news…There is certainly gratitude, but more is [sic] anger."6Pan N "I don't want to be a deserter nor a hero"—the real situation of Wuhan medical care. ABC Chinese.https://www.abc.net.au/chinese/2020-02-15/doctor-nurse-and-patient-tell-true-story-of-wuhan/11967670Date accessed: May 19, 2020Google Scholar In China, speaking critically of the government can bring about harsh punishment. Since January, 2020, numerous people have been detained for their online speech, and often accused of rumour-mongering. Dr Li Wenliang, who first raised the alarm about COVID-19, was forced to sign a confession in which he was accused of making false statements that disturbed the public order.7Green A Li Wenliang.Lancet. 2020; 395: 682Summary Full Text Full Text PDF Google Scholar The Chinese government is currently detaining three Beijing-based activists who operated a webpage to collect censored COVID-19 stories, and two citizen journalists after reporting on the pandemic.8Human Rights WatchChina: free Covid-19 activists, "Citizen Journalists": arbitrary detentions, "disappearances," for sharing coronavirus information.https://www.hrw.org/news/2020/04/27/china-free-covid-19-activists-citizen-journalistsDate: April 27, 2020Date accessed: May 19, 2020Google Scholar The message to health-care workers is clear—resilience amid challenges does not include demanding adequate personal protective equipment (PPE) or speaking out about conditions. Censorship and attacks on health-care workers responding to COVID-19 are not limited to China. In the Indian state of West Bengal, a criminal complaint was registered against a doctor who spoke out about the lack of PPE for frontline health workers.9Chaudhuri N COVID-19: restricting health workers' free speech has a chilling effect.https://www.hhrjournal.org/2020/05/covid-19-restricting-health-workers-free-speech-has-a-chilling-effect/Date: May 4, 2020Date accessed: May 19, 2020Google Scholar From March 1, to April 30, 2020, the non-governmental organisation Insecurity Insight identified 360 events in 77 countries, ranging from protests, to blocking health-care facilities, to threats and attacks on health workers in the context of COVID-19.10Insecurity InsightAid Security and COVID-19 Data. April 2020. v2. Insecurity Insight, Switzerland2020https://data.humdata.org/dataset/aid-security-and-covid-19Date accessed: May 21, 2020Google Scholar The nightly demonstrations of appreciation for health-care workers taking place worldwide have been heartening, and there is no doubt that workers are showing a sense of duty, forbearance, and resilience. But these workers need more than PPE and appreciation. They also need their human rights to be respected, including the right to speak out and to be protected from attack, government intimidation, harassment, and arrest. I declare no competing interests. The experiences of health-care providers during the COVID-19 crisis in China: a qualitative studyThe intensive work drained health-care providers physically and emotionally. Health-care providers showed their resilience and the spirit of professional dedication to overcome difficulties. Comprehensive support should be provided to safeguard the wellbeing of health-care providers. Regular and intensive training for all health-care providers is necessary to promote preparedness and efficacy in crisis management. Full-Text PDF Open Access