Survey of the Level of Preparedness and Fears of Anaesthesia Staff regarding the Management of COVID-19 patients in ABUTH Zaria-Nigeria

Objectives: Data was collected to determine the level of preparedness and fears of anaesthesia staff regarding the management of COVID-19 patients in a low resource tertiary hospital in Zaria, Nigeria. Information obtained was used to request for missing equipment from the hospital management and to allay the fears of staff during the COVID-19 pandemic. Results: Data reported was from the survey of consenting anaesthesia staff at the Ahmadu Bello University Teaching Hospital Zaria. Information obtained include age, gender, marital status, professional role, level of preparedness, availability of working materials/equipment, fear of COVID-19, level of stress, stigmatization and the willingness or otherwise to volunteer in the management of COVID-19 patients. All 45 respondents stated that they do not have a life insurance. Forty four (97.8%) lack access to COVID-19 testing while 36 (80%) have not received any training on COVID-19 and the use of personal protective equipment. Twenty eight of 43 staff said that they were not willing or prepared to participate in the management of COVID-19 patients. Data will be useful to other researchers with a similar challenge. Data obtained was deposited at https://dx.doi.org/10.17632/stdmys22gk.1.


Introduction
Coronavirus disease 2019 (COVID-19) is a respiratory infection caused by a novel coronavirus rst observed in Wuhan China in December 2019 [1]. Some developed countries were caught unaware by the disease and faced lack of ICU beds among others [2]. The challenge was worse in Africa due to inadequate number of health personnel, intensive care units and ventilators. The high level of poverty, overcrowding and infectious diseases such as malaria, HIV and tuberculosis further complicated things [3]. The Johns Hopkins Center for Health Security publication reported Africa as least prepared among other continents to respond to health emergencies, provide treatment for the sick and protection for health personnel [4]. The fear being entertained by health workers in Nigeria concerning COVID-19 is because of shortage of protective equipment in hospitals and poor infection prevention and control policy [5]. Studies have shown that healthcare staff in COVID-19 treatment centres suffers stigmatization from friends and family members due to fear of contracting the disease [6,7]. A study in Nigeria reported that "over 65% of healthcare workers strongly agreed that their willingness to go to work has been affected by the COVID-19 pandemic". They went further to state that "majority of participants 162 (54%) went to work four days in a week during this pandemic in comparison to 226 (75.33%) who went to work for ve days during the pre-Covid-19 period" [5]. This data was collected to determine the level of preparedness and fears of anaesthesia staff regarding the management of COVID-19 patients in a low resource tertiary hospital in Zaria, Nigeria. Information obtained was used to request for missing equipment from the hospital management, address shortcomings and to allay the fears of staff during the COVID-19 pandemic. Data was not published in a research paper because of lack of funds for publication.

Methods
During the period April 11-18, 2020 structured questionnaires were sent out by WhatsApp to physician anaesthetists, nurse anaesthetists, intensive care nurses, biomedical engineers and health assistants in Ahmadu Bello University Teaching Hospital Zaria, Nigeria and those who consented lled and returned the questionnaires. Requirement for Ethics approval was waived by the Ahmadu Bello University Teaching Hospital Ethics Committee to enable documentation of the situation of things in anaesthesia department ABUTH Zaria during the COVID-19 pandemic. All participants of the survey consented to the lling of questionnaires and reporting of ndings.
Data obtained include age, gender, marital status, professional role, level of preparedness, availability of working materials/equipment, fear of COVID-19, level of stress, stigmatization and the willingness or otherwise to volunteer in the management of COVID-19 patients. Information collected were analyzed using SPSS version 21. The level of signi cance was set at p < 0.05.

Results
Fifty questionnaires were sent out and 45 responses were received. The Mean Age SD of participants were 40.25 9.62. The age group of respondents was as shown in Figure 1 (Data le 1 in Table 1) [8]. The demographic characteristics of respondents were as in Table 2 in the legend. There were 22 (48.9%) females and 23 (51.1%) males. All 45 respondents stated that they have no life insurance. Forty four (97.8%) lack access to COVID-19 testing while 36 (80%) have not received any training on COVID-19 and the use of personal protective equipment (PPE) as shown in Table 3 in the legend. The Table 3 in Data le 1 of Table 1 showed that while 32 (71.1%) of staff agreed that they have hand sanitizers for use at work 43 (95.6%) indicated that other PPE's for use while on duty were inadequate (p < 0.001) [8]. In addition, 90% of respondents said that there are no enough ventilators and other necessary equipment for the management of COVID-19 patients in the health facility ( Figure 2) [8]. Regarding the fear of COVID-19 forty participants expressed the concern of being infected while on duty (p < 0.001) as shown in Table 4 [8]. Twenty three (51.1%) of staff stated that they have become stressed up during the COVID-19 pandemic ( Figure 3) while Table 5 showed the various ways they respond to stress [8]. Thirty two (71.1%) respondents reported that family members did not avoid associating with them because of fear of contracting the disease (p= 0.007). Twenty eight of 43 staff said that they were not willing or prepared to participate in the management of COVID-19 patients as shown in Table 6 [8].

Discussion
This study found that no staff in the department had a life insurance and almost all lack access to COVID-19 testing. Majority of staff had also not received training on the disease and the use of personal protective equipment. In a similar study by Ogolodom and co-workers on the Knowledge, Attitudes and Fears of Healthcare Workers towards the Corona Virus Disease pandemic in South-South, Nigeria; authors reported that 61% of healthcare workers saw themselves at the risk of being infected with COVID-19 while 62% of them indicated that there was inadequate safety in the hospital coupled with lack of insurance policy which posed a challenged to the e cient care of patients [5]. Our study involved the staff of anaesthesia department in one institution while the work of Ogolodom and colleagues was multi-center that involved various categories of healthcare workers which adds to the strength of their ndings. The level of knowledge of a disease has been shown to affect ones understanding of the risk of contracting the disease [9]. The same situation applies to COVID-19. Receiving training on the disease by healthcare workers will assist in empowering them with the necessary skills for safety precautions to take while treating patients to avoid being infected. Majority of our staff had no PPE for use while on duty as at the time of study. The importance of provision of PPE's for use while treating COVID-19 patients cannot be over emphasized. The same applies for the availability of ventilators to manage critically ill patients. The World Economic Forum reported in March 2020 that Africa has the lowest capacity to providing critical and intensive care in the world [10]. Half of our staff reported being stressed up during the pandemic with only one third who witnessed stigmatization from family members. The reverse was the case in a study by Uvais et al on COVID-19 related stigma and perceived stress among dialysis staff. They documented that 54.6% of participants suffered signi cant stigma while 36.1% had stress. Their study had 335 respondents compared to ours that had only 45 participants. Two thirds of staffs in anaesthesia were not willing to participate in the management of COVID-19 because of fear of infection and lack of safety, protection and working facilities. This is an indication that the hospital needs to be proactive in the provision of working materials and being ready for emergency situations such as COVID-19.

Conclusion
This survey showed that majority of staff had no life insurance, lack access to COVID-19 testing and did not receive any training on the disease and the use of PPE. While a signi cant number of them expressed the fear of being infected with COVID-19 only half became stressed up during the pandemic with about two thirds not willing to participate in the management of infected patients.

Limitations
The data obtained cannot be generalized to other hospitals. It only described the situation at the Ahmadu Bello University Teaching Hospital Zaria, Nigeria as at April 2020.     Figures 1-3 are available for viewing via the dataset link provided in the paper.