Cited by 1,498Healthcare Systems and ChallengesInfection Control and VentilationInfection Control in Healthcare

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Supporting the Health Care Workforce During the COVID-19 Global Epidemic

Adams, James G., Walls, Ron M.·2020·JAMA

DOI 10.1001/jama.2020.3972

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Abstract

This Viewpoint discusses the importance of protecting health care workers caring for patients with coronavirus disease 2019 (COVID-19) and measures that can be taken in and out of the hospital to prevent their and their families' exposure to SARS-CoV-2.

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Crossref · 10.1001/jama.2020.3972

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Research works printed but not linked: 5

Del Rio, COVID-19—new insights on a rapidly changing epidemic., JAMA
Bai, Presumed asymptomatic carrier transmission of COVID-19., JAMA
Radonovich, 2019, N95 respirators vs medical masks for preventing influenza among health care personnel: a randomized clinical trial., JAMA, 322, 824, 10.1001/jama.2019.11645 · DOI · Paper page
Ong, Air, surface environmental, and personal protective equipment contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from a symptomatic patient., JAMA
JAMA Network. Coronavirus disease 2019 (COVID-19). https://jamanetwork.com/journals/jama/pages/coronavirus-alert

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“Healthcare workers (HCW) are of significant risk for developing coronavirus, with thousands of providers becoming infected [1].”
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Rasappan, K., Oh, J., Ding, B., Fadhil, M. F. M., & Lee, K. T. (2020) · International Journal of Surgery · doi:10.1016/j.ijsu.2020.05.033 · Cited by 12
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Góes, F. G. B., dos Santos, A. S. T., Lucchese, I., da Silva, L. J., da Silva, L. F., & Silva, M. D. A. (2020) · doi:10.1590/1980-265x-tce-2020-0242 · Cited by 10
FACING UP COVID-19: WHAT CANNOT BE RELATIVIZED IN NURSING HIGHER EDUCATION
Peres, M. A. D. A., Brandão, M., Aperibense, P. G. G. D. S., de Lacerda, A. C., Paim, L., & Ferreira, M. D. A. (2020) · Texto & Contexto - Enfermagem · doi:10.1590/1980-265x-tce-2020-0236 · Cited by 10
Technology enabled clinical care (TECC): Protocol for a prospective longitudinal cohort study of smartphone-augmented mental health treatment
Rauseo-Ricupero, N., & Torous, J. (2021) · JMIR Research Protocols · doi:10.2196/23771 · Cited by 9
“Both the short-and long-term effects of the COVID-19 pandemic are already leading to a paradigm shift across the health care industry [1-3].”
Factors Associated with Burnout Syndrome in Serbian Healthcare Workers During the COVID-19 Pandemic
Safiye, T., Mahmutović, E., Biševac, E., Zimonjić, V., Dubljanin, D., Kovačević, A., Nenezić, N., Radlović, A., Salihagić, Z., Ajdinović, A., et al. (2025) · Healthcare · doi:10.3390/healthcare13020106 · Cited by 9
The effects of the COVID-19 pandemic on food systems: limitations and opportunities
Massoud, R., & Zoghi, A. (2024) · Discover Food · doi:10.1007/s44187-024-00183-8 · Cited by 8
“The pandemic interrupted human life routine and caused boredom that might be due to the high consumption of carbohydrates, proteins, and fat.”
Co-modification of engineered cellulose surfaces using antibacterial copper-thiosemicarbazone complexes and flame retardants
Dong, X.-W., Sun, Q., Shi, X., Yin, Z., Zheng, B.-N., Huang, Z., & Li, X. (2024) · Surfaces and Interfaces · doi:10.1016/j.surfin.2024.104688 · Cited by 9
Compassionate Care: A Qualitative Exploration of Nurses’ Inner Resources in the Face of Burnout
Flowers, S.-L. D., Guillén-Solà, M., Sansó, N., & Galiana, L. (2024) · Nursing Reports · doi:10.3390/nursrep14010006 · Cited by 8
“Although COVID-19 is not the focus of this study, it is important to note the significant impact it had on nurses, as well as highlighting gaps in health policies important to nurse retention [16–18].”
Background
Effects of COVID-19 on sexual and reproductive health services access in the Asia-Pacific region: a qualitative study of expert and policymaker perspectives
Marzouk, M., Sze, T.-L., Durrance-Bagale, A., Nagashima-Hayashi, M., Neo, P., Ung, M., Zaseela, A., Aribou, Z., Agarwal, S., & Howard, N. (2023) · Sexual and Reproductive Health Matters · doi:10.1080/26410397.2023.2247237 · Cited by 9
“Our findings that insufficient PPE and COVID-19 testing could decrease frontline health workers’ willingness to engage with service-users supported findings on the effects of insufficient and substandard PPE on COVID-19 infection and mortality among healthworkers in many other settings.(45,46) Additionally, religio-cu…”
Result
A qualitative descriptive study of the impact of the COVID-19 pandemic on staff in a Canadian intensive care unit
Leigh, J. P., Mizen, S. J., Moss, S. J., Brundin‐Mather, R., de Grood, C., Dodds, A., Honarmand, K., Shah, S., & Mehta, S. (2023) · Canadian Journal of Anesthesia/Journal canadien d anesthésie · doi:10.1007/s12630-022-02377-z · Cited by 11
Burnout among Physicians Working in Palliative Care During the COVID-19 Pandemic in Portugal: A Cross-Sectional Study
Gonçalves, J. V., Castro, L., Nunes, R., & Rêgo, G. (2022) · Acta Médica Portuguesa · doi:10.20344/amp.18361 · Cited by 11
“Regarding the number of years working in palliative care, the median (Q1, Q3) was 6 (3, 9) years.”
Background
Seroprevalence of SARS-CoV-2 Antibodies and Associated Factors in Healthcare Workers before the Era of Vaccination at a Tertiary Care Hospital in Turkey
Sönmezer, M. Ç., Erul, E., Şahin, T. K., Al, I. R., Coşgun, Y., Korukluoglu, G., Zengin, H., Dizman, G. T., Inkaya, A., & Unal, S. (2022) · Vaccines · doi:10.3390/vaccines10020258 · Cited by 9
“It might also help understand the asymptomatic spread of SARS-CoV-2 and the infection control committee’s efficacy in preventive measures [1,2,7,14,15].”
Background
Digital SARS-CoV-2 Detection Among Hospital Employees: Participatory Surveillance Study
Leal-Neto, O. B., Egger, T., Schlegel, M., Flury, D., Sumer, J., Albrich, W. C., Flury, B. B., Kuster, S. P., Vernazza, P., Kahlert, C. R., et al. (2021) · JMIR Public Health and Surveillance · doi:10.2196/33576 · Cited by 10
“COVID-19 presents a challenge for public health in general, while health care workers (HCWs) are at particular risk of acquiring COVID-19 [8].”
Background
Gender and Race on the Frontline: Experiences of Health Workers in Brazil during the COVID-19 Pandemic
Wenham, C., Fernández, M., Corrêa, M., Lotta, G., Schall, B., Rocha, M. C., & Pimenta, D. N. (2021) · Social Politics International Studies in Gender State & Society · doi:10.1093/sp/jxab031 · Cited by 13
“Several international studies point to the importance of ensuring minimum material conditions (such as access to quality PPE, testing, training, etc.) (Adams and Walls 2020; Zhang et al. 2020) for the performance of frontline professionals.”
Background
Prevalence and persistence of SARS-CoV2 antibodies among healthcare workers in Oman
Al-Naamani, K. M., Al-Jahdhami, I., Al-Tamtami, W., Al-Amri, K., Al-Khabori, M. K., Al‐Sinani, S., Said, E. A., Omer, H., Al-Bahluli, H., Al-Ryiami, S., et al. (2021) · Journal of Infection and Public Health · doi:10.1016/j.jiph.2021.09.006 · Cited by 12
The Initial Positive and Negative Impacts of the COVID-19 Pandemic on Rural Healthcare Providers: Associations With Team Culture and Leadership
Terry, D. L., Hui, P. A., & Buntoro, S. P. (2021) · Journal of Healthcare Management · doi:10.1097/jhm-d-20-00258 · Cited by 11
Outcomes of Tracheostomy in COVID-19 Patients: A Single Centre Experience
Chandran, A., Kumar, R., Kanodia, A., Shaphaba, K., Sagar, P., & Thakar, A. (2021) · Indian Journal of Otolaryngology and Head & Neck Surgery · doi:10.1007/s12070-021-02758-8 · Cited by 9
The therapeutic itinerary of health workers diagnosed with COVID-19
da Silva, L. F., Cursino, E. G., Brandão, E. D. S., Góes, F. G. B., Depiant, J. R. B., da Silva, L. J., & de Aguiar, R. C. B. (2021) · Revista Latino-Americana de Enfermagem · doi:10.1590/1518-8345.4691.3413 · Cited by 9
“Additionally, because COVID-19 is a disease caused by a highly transmissible virus, having an infected health professional working in a healthcare unit, without having a confirmed diagnosis, may entail consequences, especially because it increases the exposure of other workers and the population seeking health service…”
Background
“I felt useless”: a qualitative examination of COVID-19’s impact on home-based primary care providers in New York
Gorbenko, K. O., Franzosa, E. C., Masse, S., Brody, A. A., Sheehan, O. C., Kinosian, B. P., Ritchie, C. S., Leff, B. A., Ripp, J., Ornstein, K. A., et al. (2021) · Home Health Care Services Quarterly · doi:10.1080/01621424.2021.1935383 · Cited by 10
“Elevated anxiety and stress levels among health care providers in hospital settings across the globe during COVID-19 have been documented (Adams & Walls, 2020; Bohlken, Schömig, Lemke, Pumberger, & Riedel-Heller, 2020; Lai et al., 2020; Preti et al., 2020; Zhang et al., 2020).”
Background
Should healthcare workers be prioritised during the COVID-19 pandemic? A view from Madrid and New York
de Asúa, D. R., & Fins, J. (2021) · Journal of Medical Ethics · doi:10.1136/medethics-2020-107050 · Cited by 9
Analysis of Monitoring, Early Warning and Emergency Response System for New Major Infectious Diseases in China and Overseas
Du, X.-L., Zhao, X.-R., Gao, H., Shen, W., & Liao, J.-F. (2021) · Current Medical Science · doi:10.1007/s11596-021-2319-0 · Cited by 9
Personal protective equipment usage, recycling and disposal among spine surgeons: An Asia Pacific Spine Society survey
Chiu, C. K., Chan, C. Y. W., Cheung, J. P. Y., Cheung, P. W. H., Gani, S. M. A., & Kwan, M. K. (2021) · Journal of orthopaedic surgery · doi:10.1177/2309499020988176 · Cited by 12
Burnout among Physicians in Egypt during COVID-19 Pandemic
Omar, D., Hani, B., & Abd-Ellatif, E. (2021) · The Egyptian Journal of Hospital Medicine · doi:10.21608/ejhm.2021.150385 · Cited by 9
“These results agree with the results of a survey conducted by Medical economics staff, which revealed that more than two-thirds of studied physicians [65%] reported that the COVID-19 pandemic had increased their feeling of burnout in 2020 ((14)).”
Result
Controlled apneic tracheostomy in patients with coronavirus disease 2019 (COVID-19)
Weiss, K. D., Coppolino, A., Wiener, D., Mcnamee, C., Riviello, R., Ng, J.-M., Jaklitsch, M., Marshall, M., & Rochefort, M. (2020) · JTCVS Techniques · doi:10.1016/j.xjtc.2020.11.016 · Cited by 9
“Tracheostomy to ventilator liberation 11 (2-42)”
Availability of personal protective equipment and satisfaction of healthcare professionals during COVID-19 pandemic in Ethiopia
Deressa, W., Worku, A., Abebe, W., Gizaw, M., & Amogne, W. (2020) · medRxiv · doi:10.1101/2020.10.30.20223149 · Cited by 9
A survey of preparedness against coronavirus disease 2019 (COVID-19) in hospitals in Tokyo, Japan, with healthcare personnel with COVID-19 and in-facility transmission
Tagashira, Y., Takamatsu, A., Hasegawa, S., Uenoyama, Y., & Honda, H. (2020) · Infection Control and Hospital Epidemiology · doi:10.1017/ice.2020.1304 · Cited by 18
“The questionnaire collected the following information: (1) probable COVID-19 transmission routes and outcomes, including clinical outcomes, in all the infected HCP and patients; (2) nosocomial transmission to inpatients and their clinical outcomes; (3) impact of COVID-19 transmission on hospital functions; (4) institu…”
Background
Preparing an orthopedic department for COVID-19
Jensen, R. D., Bie, M., Gundsø, A. P., Schmid, J., Juelsgaard, J., Gamborg, M., Mainz, H., & Rölfing, J. (2020) · Acta Orthopaedica · doi:10.1080/17453674.2020.1817305 · Cited by 9
“Hence, the widespread use of recommended personal protection equipment (PPE) in the care of all patients with respiratory symptoms had the highest priority (Adams and Walls 2020).”
Background
Why Healthcare Workers Ought to Be Prioritized in ASMR During the SARS-CoV-2 Pandemic
Aulisio, M. P., & May, T. (2020) · The American Journal of Bioethics · doi:10.1080/15265161.2020.1779411 · Cited by 11
“Reports of mental health crises among frontline caregivers are now rampant with documented increases in depression, suicidal ideation, and identifiable symptoms of post-traumatic stress disorder (Abbasi 2020; Adams and Walls 2020; Lai et al. 2020).”
Background
Safe performance of echocardiography during the COVID-19 pandemic: a practical guide.
Cameli, M., Pastore, M., Henein, M., Aboumarie, H. S., Mandoli, G., D'Ascenzi, F., Cameli, P., Franchi, F., Mondillo, S., & Valente, S. (2020) · Reviews in cardiovascular medicine · doi:10.31083/j.rcm.2020.02.90 · Cited by 9
“Thus, it is of paramount importance to scrutinize the use of echocardiography during the current COVID-19 pandemic in an attempt to protect healthcare professionals, their relatives (Adams and Walls, 2020) and also other patients, both for their own health benefit as well as for controlling the spread of the disease (…”
Background
Occupational health in the framework of the COVID-19 pandemic: a scoping review.
Betancourt-Sánchez, L. C., Ochoa-Gelvez, E. O., Velásquez-Bernal, C. C., Rozo-Silva, Y. A., & Quiroga-Vargas, D. A. (2020) · Revista de Salud Pública · doi:10.15446/rsap.v22n3.87238 · Cited by 9
“The effect of the pandemic on the workforce will continue to intensify and impact the global health system and the health of health personnel due to the risk of infection (24).”
Background
Safety in digestive endoscopy procedures in the covid era recommendations in progres of the italian society of digestive endoscopy
Galloro, G., Pisani, A., Zagari, R., Lamazza, A., Cengia, G., Ciliberto, E., Conigliaro, R., Carrara, P. D. M., Germana', B., & Pasquale, L. (2020) · Digestive and Liver Disease · doi:10.1016/j.dld.2020.05.002 · Cited by 9
Analysis on mental health status and needs of health care workers in designated medical institutions of tuberculosis during the epidemic period of COVID-19Preprint
Fang, X.-H., Wu, L., Lu, L.-S., Kan, X., Wang, H., Xiong, Y.-J., Ma, D.-C., & Wu, G.-C. (2020) · doi:10.21203/rs.3.rs-22402/v1 · Cited by 9
A Review of Novel Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
Rostami, F., Esfahani, B. N., Ahadi, A. M., & Shalibeik, S. (2020) · Iranian Journal of Medical Microbiology · doi:10.30699/ijmm.14.2.154 · Cited by 9
“The development and comfort of worldwide journey can similarly expand it around the world (29 ,30).”
Background
Dental professionals' use of personal protective equipment during COVID-19: a cross-sectional study in China
Wan, Q., Han, L., Yang, X., Yu, S.-L., & Zheng, X.-H. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1183580 · Cited by 8
Lived experiences and resilience of hospital pharmacists during the COVID-19 pandemic: An interpretative phenomenological analysis
Flotildes, M. J., Garcia, G., Piol, A. M., Simeon, E. N. J., Miranda, K. J., & Carandang, R. R. (2023) · Exploratory Research in Clinical and Social Pharmacy · doi:10.1016/j.rcsop.2023.100299 · Cited by 12
“Also, they often experience heightened mental stress due to fear and the prospect of endangering their own lives.(34,35) Poor mental health can have more severe consequences down the line and may lead to turning over of hospital pharmacists and other healthcare workers.”
Hospital Resilience in Three COVID-19 Referral Hospitals in Brazil
de Sousa, K. M. P., Oliveira, S. R. D. A., Furtado, B. M. A. S. M., de Vasconcelos, A. L. R., de Medeiros, S. G., Cazarin, G., Sampaio, A. S., & Ridde, V. (2023) · Health systems and reform · doi:10.1080/23288604.2023.2205726 · Cited by 8
Knowledge, attitude, and practices on COVID-19 prevention and diagnosis among medical workers in the radiology department: A multicenter cross-sectional study in China
Sun, Q., Yu, C.-Y., Zheng, Z.-D., Wu, Q., Zhang, J., Jiang, P., & Liu, Y. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1110893 · Cited by 8
“Indeed, the protection of medical workers from occupational exposure is a key part of the epidemic prevention and control system, and reducing the occupational risk of frontline medical workers is also an important guarantee to effectively control the spread of the epidemic and maintain public health safety (1, 10).”
Background

Authors: Adams, J. G., & Walls, R. M.
Affiliations: Northwestern University (US)
Brigham and Women's Hospital (US)
Corresponding author: Adams, James G.
ORCID: Adams, James G.
Venue: JAMA
Publisher: American Medical Association (AMA)
Published: 2020-04-21
Volume: 323
Issue: 15
Pages: 1439
ISSN: 0002-9955 (ISSN-L)
0098-7484
DOI: 10.1001/jama.2020.3972
OpenAlex: W3010574983
Cited by: 1,498
References: 0
Citations by year: 2026: 18 · 2025: 41 · 2024: 79 · 2023: 142 · 2022: 265 · 2021: 420 · 2020: 526
FWCI: 353.03
Type: journal article
Language: en
Open access: closed
Locations: JAMA (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Health Professions › General Health Professions › Healthcare Systems and Challenges
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
Health Sciences › Medicine › Infectious Diseases › Infection Control in Healthcare
Keywords: COVID-19 pandemic, SARS-CoV-2, healthcare workers, occupational exposure, infection control, personal protective equipment, family exposure
MeSH terms: Betacoronavirus, Workforce, COVID-19, SARS-CoV-2, Health Personnel, Humans, Pneumonia, Viral, Infectious Disease Transmission, Patient-to-Professional, Coronavirus Infections, Disease Transmission, Infectious, Pandemics

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Supporting the Health Care Workforce During the COVID-19 Global Epidemic

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