Differences in vulnerability between health workers and the general population: Is volunteer selection required for COVID-19 control in Nigeria?

Abstract

As of November 8th 2020, the prevalence of the COVID-19 infection in Nigeria is 9.3% while the cumulative fatality rate was 1.8%.Health care workers play important roles in controlling pandemics. However, their health status determines to a great extent thestability or vulnerability of a health system. The stress accruing from high patient flow amidst scarcity of healthcare resourcesmay impact on their health negatively. Stress and lack of a good diet plan may facilitate the development of some diseases suchas hypertension (HTN), diabetes mellitus (DM), chronic kidney disease (CKD) and cardiovascular diseases (CVD). These diseasesare confirmed correlates of COVID-19 morbidity and fatality. Despite the high awareness of preventive healthcare services amonghealth workers (65%), the prevalence of these diseases are high due to low treatment and control. Although the pooled prevalenceof HTN and DM were lower among health workers than the in general population (22.0% vs 37.8% and 6.5% vs 8.1%, respectively),the prevalence of pre-HTN and pre-DM were higher in health workers than in the general population (35.1% vs 22.3% and 19.4% vs5.9%, respectively). Some of these diseases go undiagnosed until their late stages. Thus, increasing their vulnerability to COVID-19.To prevent controllable fatalities, health workers should be screened before they are engaged in the treatment of COVID-19 patients,irrespective of their previous medical history. Simultaneous testing for comorbidities and COVID-19 should also be carried out in thegeneral population, especially for high-risk groups to prevent future vulnerabilities to communicable diseases.