Family & Primary Care Doctors Most at Risk of Dying from COVID-19

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Among healthcare workers, those who work in primary care rather than the in-patient hospital setting, may have faced the highest risk of dying from COVID-1. A new study, led by researchers in the Perelman School of Medicine at the University of Pennsylvania, assessed 1,004 reported cases of COVID-19 deaths among healthcare workers globally as of May 13, 2020, and found that more than half of these reported deaths were among physicians. Notably, however, family physicians appeared to be affected much more often than “frontline,” hospital-based physicians. This report was published in the Journal of the American Board of Family Medicine.

“Frontline physicians including anesthesiologists, ICU specialists, emergency room physicians, and nurses form a much smaller group of COVD-19 cases, likely due to better access to personal protective equipment,” said senior author Basavana Goudra, MD, a clinical associate professor of Anesthesiology and Critical Care at Penn.

COVID-19, the disease caused by the new coronavirus SARS-CoV-2, has by now affected about 17 million people around the world, killing more than 650,000 globally. Health care providers who are for COVID-19 patients in the clinic and hospital has meant these workers were at higher risk of contracting the disease, particularly in the first few months of the pandemic when there was widespread shortages of personal protective equipment (PPE) such as masks, face shields, and gloves.

Goudra and colleagues assessed reports of healthcare worker deaths caused by COVID-19, analyzing data from the medical website Medscape. The website maintains a crowdsourced list of healthcare worker deaths worldwide, and requires confirming documentation for each report. In all, there were 1,004 such reports as of May 13, 2020, when the researchers finished gathering data.

The researchers found that nearly 55 percent of the COVID-19 deaths in the sample occurred among physicians. The physicians who died were, on average, 62 years old. The non-physicians who died, including nurses, physician assistants, paramedics, pharmacists, and support staff, were on average, 52 years old. Among the physicians who died, the largest subset (26.9 percent) included general practitioner/family medicine/primary care doctors. Physicians who were more likely to have been on the “frontline” of COVID-19 care, namely emergency medicine, critical care specialists, and anesthesiologists, comprised only 7.4 percent of the deaths in this cohort.

Goudra and colleagues suggest that during the period covered by the data, general practitioner/family medicine/primary care doctors may have been more likely to see patients with early-stage, mild or asymptomatic—but still contagious—SARS-CoV-2 infection, while having little to no personal protective equipment.

Consistent with other reports, Goudra and colleagues found that reported COVID-19 deaths of male healthcare workers in the United States were more common (132) than reported deaths of female healthcare workers (74).

The researchers noted that there are some limitations of this study, writing “the Medscape list of HCW deaths is a convenience sample and likely to be incomplete, as it is crowdsourced from its readers. There is likely more than 1,004 HCW deaths globally.”They went on to say that reporting of health care worker deaths vary widely from country to country. Reporting of deaths also varies from country to country, and causes of death may also vary in the reporting mechanisms.

Goudra’s co-authors on the study in Divakara Gouda of Rowan School of Osteopathic Medicine, Preet Mohinder Singh of Washington University School of Medicine in St. Louis, and Prabhakara Gouda of Saint Louis University.

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