First-line medical personnel that have to treat and interact with COVID-19 patients are subjected to numerous challenges, shortages, and even a high risk of infection that threatens their very lives. A recent study quantified the number of deaths among physicians caused by COVID-19, finding around 200 registered fatalities thus far.

Canadian researchers at the University of Toronto, University of British Columbia, and McGill University wanted to tally the number of deaths among medical doctors caused by COVID-19 in hopes of finding patterns and new protocols that might avert such fatalities in the future.

They turned to official government reports of deaths from COVID-19, as well as media reports of doctors being killed by the coronavirus up to April 5th, 2020.

A total of 198 doctors who died due to COVID-19 have been identified. Their average age at the time of death was 63.4 years (from 28 to 90 years old), and 90% were men.

General practitioners and emergency room doctors (78/192), respirologists (5/192), internal medicine specialists (11/192) and anesthesiologists (6/192) comprised 52% of those deaths, according to the results reported in the preprint server medRxiv. Two percent of the deceased were epidemiologists (4/192), 2% were infectious disease specialists (4/192), 5% were dentists (9/192), 4% were ENT (8/192), and 4% were ophthalmologists (7/192).

The countries with the most reported physician deaths were Italy (79/198), Iran (43/198), China (16/198), Philippines (14/198), the United States (9/192) and Indonesia (7/192).

In their study, the authors did not have additional details at their disposal which might differentiate between direct deaths due to COVID-19 or deaths due to associated chronic illness with the viral infection.

The real number of medical doctors killed by COVID-19 is likely much higher as not all countries have tallied all their fatalities — along with the fact that this is a pandemic in progress which is progressing furiously fast.

Also, it’s important to note that this study only sought to quantify deaths from COVID-19 among medical doctors. These figures do not include deaths among the broader medical personnel workforce.

Nurses, technicians, ambulance crews and so on have been left out of the study. The number of deaths, as well as hospitalizations, among medical personnel, in general, is likely very high — just how high is still nebulous at this stage.

For instance, as of April 6th, Washington state had more than 7,500 cases and New York had counted more than 110,000. But neither state knows how many of those cases are healthcare workers.

On the other hand, Ohio and Minnesota reported that 16% and 28%, respectively, of their COVID-19 cases involved healthcare workers. Overseas, in Spain, more than 12,000 healthcare workers have tested positive for the coronavirus, amounting to 14.4% of all reported cases.

Back to the study at hand, the most often cited problem that contributed to physician deaths was the lack of personal protection equipment. This was particularly true in Italy, as well as in developing countries.

However, the protective equipment is only as good as the healthcare worker’s training. Proper decontamination technique needs to be thoroughly instilled into the routine of front-line healthcare workers, the authors of the new study wrote.

Some physicians died of COVID-19 after examining patients who lied about their travel history. Having some mandatory passport checks before a patient comes in for a checkup is another approach that might help save doctors’ lives.

The authors stress that elderly doctors, as well as those with known COVID-19 comorbidities (diabetes, cardiovascular disease, hypertension, etc.) ideally, should not be stationed on the front line where they might directly interact with coronavirus patients. Instead, this category should stick to teleconferences and remote screening of patients.

“Physicians from all specialties may die from COVID, and these deaths will likely increase as the pandemic progresses. Lack of personal protective equipment was cited as a common cause of death. Consideration should be made to exclude older physicians from front-line work,” the authors wrote in conclusion.