Healthcare workers preparedness for COVID-19 pandemic in the occupied Palestinian territory: a cross-sectional survey

  1. Osaid Alser
  2. Heba Alghoul
  3. Zahra Alkhateeb
  4. Ayah Hamdan
  5. Loai Albarqouni
  6. Kiran Saini

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Abstract

Background

The COVID-19 pandemic threatens to overwhelm the capacity of a vulnerable healthcare system in the occupied Palestinian territory (oPt). We aimed to evaluate the availability of personal protective equipment (PPE) and the level of preparedness among HCWs in the oPt.

Methods

A cross-sectional study was conducted using a validated online questionnaire distributed through convenient sampling between March 30, 2020 and April 12, 2020. Outcomes were availability of PPE, healthcare workers (HCWs) preparedness in oPt for COVID-19 pandemic, and regional and hospital differences in oPt in terms of availability of PPE and HCWs preparedness. Descriptive statistics and univariate analysis were used in this study.

Results

Of 138 respondents, only 38 HCWs (27.5%) always had access to facemasks and 15 (10.9%) always had access to isolation gowns. Most HCWs did not find eye protection ( n  = 128, 92.8%), N95 respirators ( n  = 132, 95.7%), and face shields ( n  = 127, 92%) always available. Compared to HCWs in West Bank, those in the Gaza Strip were significantly less likely to have access to alcohol sanitizers ( p  = 0.03) and gloves ( p  < 0.001). On average, governmental hospitals were significantly less likely to have all appropriate PPE than non-governmental institutions ( p  = 0.001). Only 16 (11.6%) surveyed felt confident in dealing with a potential COVID-19 case, 57 (41.3%) having received any COVID-19-related training, and 57 (41.3%) not having a local hospital protocol.

Conclusion

HCWs in oPt appear to be underprepared and severely lacking adequate PPE provision. The lack of PPE provision will exacerbate spread of COVID-19 and deepen the crisis, whilst putting HCWs at risk.

Article activity feed

  1. Version published to 10.1186/s12913-021-06804-7
  2. Version published to 10.21203/rs.3.rs-112643/v1 on Research Square
  3. Version published to 10.21203/rs.3.rs-30144/v1 on Research Square
  4. ScreenIT

    SciScore for 10.1101/2020.05.09.20096099: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    IBM SPSS Statistics for Windows, Version 26.0.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Potential limitations of this study include small sample size, which may impact generalizability to the greater population of Palestinians. Another weakness of our study was the failure to elicit whether the lack of appropriate PPE was one of the driving factors in reducing HCW confidence in their preparedness. This would then imply attempts to target increasing PPE provision could both protect HCW and improve clinical confidence in managing COVID-19 patients. Potential selection bias arises due to sampling method. Most study participants were recruited from social media posts and emails to the networks of the researchers involved, which may limit some of the study’s generalizability. However, other studies have demonstrated the viability of social media recruitment and snowball sampling to access difficult to reach populations.16 Additionally, participants were asked to report on their individual experiences and thus may or may not be wholly representative of the institutions in which they are employed. The cross-sectional nature of this study is also by definition unable to take into account any changes in equipment or training preparedness over time and is only representative of the point-in-time data were collected. These limitations were acknowledged by the authors during study enrolment due to the need to publish findings within the international community in a time-sensitive manner and address the gap in literature regarding COVID-19’s unique impact on the population i...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  5. Version published to 10.1101/2020.05.09.20096099 on medRxiv