How can Health Workers fighting the coronavirus pandemic be better protected doctors and nurses around the world are risking their lives to treat the growing number of patients can the enormous mental and physical strain on them be reduced this is inside story. Hello and welcome to the program im homages to him the war against the coronavirus pandemic is being fought in hospitals around the world doctors and nurses are on the front line but the long hours and huge workload are taking their toll hospitals are not only running out of ventilators for patients they cant supply staff with protective gear such as masks and surgical gowns thousands of Health Workers are falling ill the number who have died is growing in spain medical staff account for 15 percent of reported cases and Health Workers in britain in the u. S. Say they cant get tested for the disease because there arent enough screening kits. Some medical staff have even been attacked in india police had to rescue doctors from crowds throwing stones many Health Workers have been sharing their experiences online. Learning how to quit. It becomes an emergency working as this and were getting. The one of the people in the background of that young. Healthy. This is not something thats left alone in the all please. Here this morning and do whatever nothing from. What is happening in madrid we are completely over float Health Workers are exhausted physically and emotionally because this is awful this is an inferno and Critical Care nurse that just finished voting i would support i just want to get some stuff in for the next 4 hours this no its no thanks to both i just im supposed to stay healthy. And most people who are here who just strictly because santa looks pretty sick foods. You just dont. People like me are going to be looking over see it when youre a yellow is just to open him. All right lets bring in our panel from the u. S. Capitol doctors are handled by you me is professor of medicine and founding director of the rotten institute at the George Washington school of medicine and Health Sciences and from Hong Kong Paul youre chair professor at the department of social work and social Administration University of hong kong welcome to you all john let me start with you just how vulnerable to infection are Health Workers on the front lines right now extremely vulnerable as you can imagine physicians. Nurses social workers even the people that mop the floors and deliver the food are extremely vulnerable depending on what procedures theyre doing they that their risk goes even higher so you can imagine when you have a critically ill patient that needs to go on a respirator the act of actually putting that 2000 the throat aerosolize is all those particles those droplets that are filled with with virus and can scatter anands and really make people extremely vulnerable and actually if you notice an italy in france and spain and china as well as in the United States there are many people on the front lines that unfortunately succumbed to cope with 90 paul could you talk more about some of the other challenges facing medical workers right now around the world one thing it is to be overlooked this is a hospital setting and on saw. Now they do not allow the visit is having to come into the to visit the patients does it actually you know who create additional work new thing for the Health Workers and also now we are running our minds and also the protective gear as we chose to expose i think a Mental Health look into comet 1000 john things are so bad now in some parts of the world that medical workers are actually having to to create having to make some of their own protective gear right. Thats correct i was talking to a dear friend whos an Infectious Disease physician up in new york which as you know is the sort of epicenter and hot spot here in the United States she is actually using a garbage bag to protect herself she wipes it down with bleach and between patients she has used this same basket for the past week and finally had to throw it out so yes people are making do but it is really really an untenable situation and it increases the risk to everybody but primarily the clinicians and the Health Care Workers that are providing the much needed care and Critical Care for patients who are really suffering and and also dont forget that the clinicians and the other rest of the team are usually the only contacts with the patients right families cant go visit a. Loved ones cant go visit so you can imagine a patient who is theyre probably disoriented from all the medications that were giving them to just stay sedated on the respirator and youve got somebody with a mask and a garbage bag i mean how horrible is that you can only imagine paul what are some of the ethical dilemmas that medical workers are confronting now due to the Health Care Systems around the world being so stretched. When they they are exposed to it is excessive stress is what has sent the full and theres an isolation theres a fear impending among the patient in them so not only affecting the physical health and. Mental health as well so i think nowadays how cool work now is the not only have to pull one support and gear i mean for the medical of for their physical health but at the same time i think they have to Pay Attention of into the Mental Health of the patients. That is redoubling the low end because the visitors can go in and can buy some source of ports i think to do to the patient as well let me ask you the same question because were hearing more and more about really just very difficult ethical choices that you know medical professionals are are having to face now or may have to face soon could you elaborate on that. Sure i mean enormous times not during the pandemic we face ethical dilemmas all the time we take care of people that are perhaps elderly or terminal and we have to have very difficult decisions and discussions with their Family Members you multiply by a 1000000 of a 1000000000 and when equipment is is limited and what we dont have treatments it becomes sort of this this decision of is there going to be a possibility that this individual patient is going to recover right and if theyre older about 80 in particular if they have chronic medical conditions which there are numerous ones which im not going to list because i think it would take the rest of the program to to list them or and the wishes of the individual patient to if we have that abscess living well or if theres a Family Member a durable power of attorney say look if im ever in this situation i do not want to consent you know and a lot of our older patients we try to encourage them its actually a medicare requirement that we ask about that in general in normal sort of time so the ethics of this are complex but i want to talk about another aspect where ethics are involved sort of outside of the hospital. You know when we talk about Health Disparities which is what the Wright Institute does is dedicated to when you think about lack of food lack of housing lack of transportation lack of education thats actually what makes people much more vulnerable to illness and to catching cove that 19 and so for example at washington d. C. 50 percent of the people in the poor wards were at 7 and 8 to 50 percent have diabetes that is a significant risk factor so when you look at the deaths in the you know patients and people in the unities the people who are living in the poorest communities where their baseline status is poor are a particular risk paul you wrote an article where you said we need to ensure we are well prepared for what lies ahead that means staying healthy and getting lots of rest while looking out for each other i want to ask you if that is possible right now for medical professionals give it professionals given the enormity of this crisis or years it is it is difficult but i think. What else can you do and what really can we need to do we try to stay the optimistic the we try to have sufficient wrist and i thing and everybody i think trying to stay away to to get control of the diseases and not to overload their husbands system again so i think what i really can see is that at this moment i think everyone have to come to gouda i think into medical help what could they do have the job to do but i think for theyre all doing citizen i think we also have to stay well and stay healthy and not to contact the diseases and otherwise it would just create additional work i think to the already overstretched hospital who have work all right lets look for a moment another aspect of this photos. Circulating online give us a glimpse of what daily life looks like for those Health Workers weve been speaking about many of them posted selfies showing the toll the fight against the virus is having on them probably the most striking images are of their faces these bruises are caused by wearing protective masks for hours a photo of an exhausted nurse in italy slumped over her keyboard also went viral and emotional pictures of staff reaching the breaking point or being comforted by their colleagues are also being shared Health Workers are discouraging nonessential visitors to hospitals to ease the pressure by staying at home john let me ask you about this seeing this these staggering pictures photos that are circulating online of just how exhausted and traumatized these medical workers are is this having an impact. Of course it is i mean just think of yourself as a human being any parent whos ever taken care of a newborn baby or faced any adversity themselves. I mean when youre not sleeping and i think for a clinicians in particular you know wed like to make sure that people are taking care of to alleviate suffering to cure people when we can but always to provide Compassionate Care and thats not something that we have control over the right. To be added aspect or burden of worrying about your personal health you know im of generation or i took care of people on the front lines during the aids epidemic and there are similarities and differences at that time it was 100 percent what year death 3 of course the rip it see among certain groups in terms of infection or was quite high however what you are seeing is still the fear of actually contracting a hiv was there but through blood borne products and so forth but not through obviously aerosolize this is a highly contagious infection i have a colleague or medical assistant who is concerned about giving care because she is the primary caretaker for her 73 year old mother and her 93 year old grandmother and i asked her why isnt there anybody else there can help you in the extended family so i know there is a bit so imagine the physical toll of the visible but as dr paul mentioned the Mental Health toll that is not visible that i think is just as important but youre also adding sleep deprivation i can tell you when i was working 120 hours a week during my internship d were not eating that well either. Then we know that just our ability to stay focused and sharp when we havent slept is these i mean its very very challenging in addition to you youre worried about your kids if you have your family having i have older parents im not able to see them and the burdens are many so imagine that everybody else has worried about cook at 19 and of Course Community members of the general population is already stressed and worried but all of these burdens and you can only imagine how stressful and difficult this process were talking about stresses were talking about the enormous toll that this is taking on Health Workers across the world from your Vantage Point could this lead to long term posttraumatic stress disorder and other problems for healthcare workers will you indeed i think give you know hong kong i think in 203 we have the sinus epidemics at the time being we have to thousands of cases and and and 250 but what happened in doing debt year we actually have we have the historical high number of suicides and then you know community and expose free among to i think the old and those. Why did killed him when we read at death knox is it just it it is the isolation is his defeat is there and sign he arising from the epidemic so i think what we can see is you we can learn something from some of the what we better to do do do with the commit 19 is its really time to how to. To to mature to contained our fear and and side seek and make sure that you even get in the isolation i mean how can we see you and how to connect these things connect to people and then you know order to maintain. Mental illness all right so were joined now by a 3rd guest from italy markets here kitty is president of the public clinical hospital in milan marco let me ask you 1st and foremost just how bad are things there right now for healthcare workers. Than everybody in. This situation for the workers now its really hot its really suffering because day and the re a great pressure and. At the moment if luckily we hope it will last like this that detained and that the pressure is a bit. Light and. But but still is still very strong because we are access to emergency its been we have. Fewer person accessing emergency now at the moment but we hope it will last now for the future but we had really really bad time in the last days and weeks marco i was in italy reporting from milan in late february and we were speaking to Health Workers there who were really worried that it could get much worse what are the conditions there whats the reason that it has gotten or the reason that it has gotten as bad as it has gotten. I think we have been after china did it different to line the 1st one to just say so this this virus and. I think we would. We will not. Understood very well how heavy and how difficult this will be and so maybe we reacted not as the same energy we understood we needed after a couple weeks. So i think at the beginning we stowed it was a something very. Easy to control instead it spread it around very very. Quick and fast and so we we were not prepared the beginning now after the 2 weeks of the for 10 days we have taken the measure and we have. The best condition how to react and how to to point us in front of this john youve been speaking a lot about the impact all this is having on on Family Members of patients i want to ask you more specifically about Family Members of of Health Workers i mean how difficult is it for doctors and nurses and other medical professionals who are grappling with the idea not just they are that they are vulnerable to infection but that they can also be infectious to their loved one especially their spouses and their children. Well thats i mean thats the whole concern i mean what is most important to people in general then your family and your loved ones that is a real issue i can tell you when i start working in the hospital i want to stay in a hotel just so minimize my contact with Family Members i know that other clinicians who can afford to are doing the same and you know about that further kind of worsens the isolation we are social animals how you evolve is to connect with each other and actually scientifically speaking when we connect and when we interact just the mere fact that were interacting increases the dope i mean levels that believe our brains and those are the sort of the feel good neural hormones that circulate and so being isolated and not being able to hug i mean this business of not touching it is really deprivation i mean that is deprivation for a parent who has a child is fresh infant and to not be able to hold that infant that can have some longer lasting impacts but i think you know one of the at positive aspects if you will of all of this i cannot tell you how many of my patients have reached out and said look were thinking about you we love you please stay safe and healthy i think whats different about this pandemic is the connection between people overall with each other and the clinicians i mean now in new york city every day at 7 oclock people just applaud they go out in or on their balconies and applaud the Health Care Workers and i think thats different and it really speaks to Community Resilience because we have to look at it as as america right and we have to see ourselves as being connected. You you asked a really important question about why italy why the United States why were kind of behind the 8 ball well this underscores the importance of Public HealthPreventative Health as well as knowledge of working interpret freshly whether its social workers you know clinicians nurses doctors looking at the social determinants of health just food housing etc marco let me ask you on a more personal note how concerned are you how concerned is your family for you and what are the kinds of things youre hearing from colleagues working in the Health Care Profession there. Is a we have we have a very war it. And i completely agree we didnt have vacation made made before because its debt does really. Really tough for a floor operators and from patient to. 2 faced as it did that something new is Something Different isnt just so strong in an a dramatic and so did the warring its its completely. Scaling up and i think the socialization when this would finish i hope it would finish would be really hard to reach a gate and i noticed that everywhere we. React in the same way up there was it from balcony to 2 to transition some nurses to the to the Health People and thats finally its something that we recognize how useful in our important is to reenforce the public has to system because. We have a person syllabic. Nurses about physician that and not going home since we have since weeks and we are trying to support them with a special service made by a website colleges that psychiatric we will we made it as soon as possible to release them because its quite its really hard for them not to go home and not to see the the law that they love us one and this went for patient we use tablets to make them communicate with a family thats very important as well the way they can react to recover a sooner marco we dont have a whole lot of time with the let me just ask you are you are you starting to get a sense that the government of italy is going to be providing you with more of the equipment and gear that you need is there any light at the end of this tunnel right now. Yeah thats a thats a great point because that luck of the protection of mosque because all the word is is looking for that and with the globalization weve moved to production in just one place no one in town to produce their own mosques they survived because we delegate everything. In china especially and so now is lots of industry. Moving 2 days production every need telly and so i hope soon we will lead production in a home productions enough that to to give the day to the protection gear to our people that as soon as possible because its a its really a fight as well between in a hospital in another and in one government and the t. V. To get the the right for the their own as people and i think we must collaborate more between the International Community to organize better Production Industry which today mean in a better way are i will we have run out of times were going to have to leave it there thanks so much to all our guest doctors are hunted by you meat market your carrie and paul hip and thank you too for watching you can see the program again any time by visiting our website aljazeera dot com and for further discussion go to our Facebook Page thats facebook dot com forward slash a. J. Inside story you can also join the conversation on twitter our handle is at a. J. Inside story for me my homage and ruin the whole team here bye for now. Aljazeera. Every. When you see big groups of people walking through your theyre all individuals with children the lowlifes you have to deal with them and to treat them with something thats in respects april and out to stand back. Countries are imposing drastic measures to contain the corona virus pandemic well bring you all the latest developments from around the world both and im telling stories from across asia in the pacific when i want east brings new insights from the well tonight 500. 00 region as the democratic president ial race narrows how will the corona Virus Outbreak impact the u. S. Election campaign the name gets to be investigated well actually running cat group of independent journalist and i. Q. Well in the global fight against fake means the u. S. Will count its population and a once in a decade census with coronavirus concerns will it get the full picture. On aljazeera. To his supporters hungarys Prime Minister is a guardian of europes borders manning the ramparts against migrant holds. To others viktor orban is an authoritarian demagogue whose far right agenda poses a significant threat to Democratic Values people in power investigates the leader taking his country to extremes hungary europes bad boy on a 0. We understand the differences and similarities have cultures across the land. Some amount i want to see how does iraq bring you the needs and current fans that matter to you. Aljazeera. Im about this in and doha with the top stories on the new york citys mayor is urging people to wear face masks in public to stop the spread of the virus president tom says medical equipment is being produced on a war footing after he struck deals with private firms from mosques ventilators and other equipment were now conducting well over 100000 corona virus test per day over at that 100000. 00 test a day and these are accurate tests and then moving rapidly which is more than in