Portugal vs Internacional MD Experiences in Covid-19 first fase

Experiência médica portuguesa vs a internacional nos inícios do covid-19

Portugal vs Internacional MD Experiences in Covid-19 first fase

Gabriela Valadas1

1. Serviço de Cirurgia II - Centro Hospitalar Universitário do Algarve

mgvaladas@gmail.com

Medscape is a website with contents that provides me with relevant information for my clinical practice. Their website is a leading online global destination for physicians and healthcare professionals worldwide, offering the latest medical news and expert perspectives1 .

As a physician, I participated in an inquiry that looked into physical and mental health issues at risk, as we battle the coronavirus pandemic. In this COVID-19 survey, physicians from several countries told Medscape about their universal — yet also varied — struggles to save patients while perhaps also dealing with loneliness, strife in their personal lives, and a changed view of medicine and their career2 .

The participation of physicians from Portugal was significant enough to allow an analysis of their opinions in the context of the rest of the panel. It was possible to verify that in this survey there is a global answer that does not vary in amplitude. Generally speaking, we followed the analysis of the conclusions of this survey (2) and verified where Portugal deviates from the mean average of answers.

The methodology for this survey was to invite active physicians to participate in an online survey conducted in English. A total of 7414 responses were obtained fulfilling criteria to complete the survey: Portugal (n=382), Brazil (n=400), France (n=152), Germany (n=273), Mexico (n=400, Spain (n=400)), United Kingdom (n=402), USA (n=5005). The recruitment period ran from 9 June to 20 July 2020. It is possible to verify that, broadly speaking, in this survey there is a global answer that does not vary extremely in amplitude.

In all eight countries surveyed, a noteworthy proportion of physicians either sometimes, often, or always lacked appropriate personal protective equipment (PPE) when treating patients with COVID19. The USA (54%), Portugal (50%), Germany (46%), and the United Kingdom (45%) had the highest proportions of physicians who said they never treated patients with COVID-19 without appropriate PPE.

Portugal has one of the lowest percentages in the question "have you personally treated patients with covid-19?", with 57% being positive among all positive responses in person or telemedicine. As of August 2, 2020, COVID-19 deaths per 100,000 population (3) for various countries are as follows: United Kingdom, 69.6; Spain, 60.9; United States, 47.2; France, 45.2; Brazil, 44.7; Mexico, 37.6; Portugal, 16.9; Germany, 11.0.

Portuguese physicians who contracted COVID-19 was 6%, one of the countries with the lowest rate, as countries ranged from a minimum of 5% (USA) to a maximum of 20% (Spain).

Physicians in the seven countries surveyed saw a large decrease in income. (This question was not asked in the United Kingdom). Over 60% of physicians in the United States and Brazil experienced a decline in income. The percentage of physicians in Mexico (56%) and Portugal (49%) whose incomes decreased were also substantial. In the countries where this question was asked, small percentages of physicians saw their income increase: United States, 3%; Germany, 4%; Portugal, 9%; Brazil, 14%; France, 16%; Mexico, 17%; Spain, 20%.

About two thirds of Portuguese physicians say their burnout has become more intense. Increases in burnout in the Brazil, Mexico, Spain, United Kingdom and USA are similar to that. In Germany, only 45% of physicians report more intense burnout.

Because humans are social animals, distancing and restricting social activities has had a profound impact on people's mental state. Increased loneliness is widespread; Germany is among the countries with the smallest proportion of physicians experiencing this 32% and Portugal is in the top with 51% of answers being “more lonely”.

Physicians reported significant grief and trauma that arose from treating patients with COVID-19.

Physicians in most countries surveyed have a strong sense of ethics when it comes to putting themselves on the line for patients in need. Doctors in France are most likely to feel that it's their obligation compared with their peers in all other countries except Spain. Still, not everyone agreed. "Altruism must take second place where a real and present threat exists to my own personal existence," said one US internist.

In the period of the survey there was ongoing and potentially promising

research that physicians and the general population worldwide hoped would lead to a vaccine. About half or more physicians in all countries believed that this would happen at the end of 2021.

There is general alignment with feelings that are global. However, in Portugal, the largest contingent of female responses stands out (60%), as well as the largest percentage of positive responses to “Are you lonelier owing to stay-at-home guidelines and social distancing?”. Referências:

1. Medscape General Surgery. Who We Are. Available from: https://www.medscape.com/ public/about 2. Kane L. Medscape US and International Physicians' COVID-19 Experience Report: Risk, Burnout, Loneliness. September 11, 2020. Available from: https://www.medscape.com/ slideshow/2020-physician-covid-experience-6013151 3. Johns Hopkins Coronavirus Resource center – mortality Analyses. Available from: https://coronavirus.jhu.edu/data/mortality