Los Angeles Times

Mexico health workers decry exposure risk

Hospital personnel say they lack safety gear even as virus toll in their ranks climbs.

- By Patrick J. McDonnell and Cecilia Sánchez McDonnell is a Times staff writer and Sánchez a special correspond­ent.

MEXICO CITY — The emergency room doctor shielded his wife and son from his growing unease about a lack of safety gear at the public hospital where he regularly treated coronaviru­s patients.

He focused on caring for the sick while insulating his family, following a strict regimen for cleanlines­s at home — leaving shoes outside the house, diligently bathing and washing clothes, disinfecti­ng the car and sleeping alone in a spare bedroom.

“My husband was dedicated to doing all he could to save his patients,” Patricia Bravo said recently by telephone. “He would start talking about how there wasn’t enough protective material, but when he saw the look of concern on my face he would change the subject .... He was always worried about us.”

Her husband, Dr. Daniel Leglisse, died April 16 of complicati­ons from COVID-19. He was 47. Later, his wife and son would learn more about the extent of Leglisse’s on-the-job exposure, and the significan­ce of his efforts to protect them.

Leglisse is among at least 149 healthcare profession­als in Mexico who have succumbed to the virus, according to the country’s health ministry. The casualty numbers among medical personnel — they account for more than 1 in 5 of all confirmed COVID-19 cases in the country — are at the core of a controvers­y about whether Mexico is doing enough to protect front-line caregivers facing great risks of exposure.

Healthcare workers in many nations, including the United States, have cited a lack of adequate protective equipment. But protests from health personnel have occurred at hospitals across Mexico and have persisted even as authoritie­s say sufficient safety gear is available.

Overall, Mexico reported more than 74,500 confirmed cases of coronaviru­s and more than 8,100 deaths as of Wednesday. The United States had more than any country, with more than 1.6 million cases and in excess of 100,000 deaths.

More than 11,000 Mexican healthcare workers have tested positive for the coronaviru­s, according to government statistics. An additional 8,275 cases among Mexican health workers were labeled “suspicious,” awaiting lab results.

Doctors account for more than half of the coronaviru­s-related deaths among health personnel in Mexico, about 55%, while nurses represent 17%. The remaining 28% includes ambulance workers, maintenanc­e staff, lab technician­s and others.

The contagion has battered healthcare workers in many countries, including the United States, where the Centers for Disease Control and Prevention reported more than 62,600 coronaviru­s cases among U.S. health personnel as of Wednesday, including 294 deaths, though the CDC acknowledg­es an undercount.

There is no nation-by-nation breakdown of health profession­als stricken by COVID-19, making it difficult to assess whether Mexican caregivers are faring worse or better than counterpar­ts elsewhere.

In Mexico, there is a disconnect between healthcare workers’ persistent complaints about a lack of safety equipment and government assurances that all is well.

Since the first coronaviru­s case was recorded in Mexico in late February, doctors, nurses and others have regularly taken to the streets to protest a lack of sanitary gear. Many hospitals have seen outbreaks, exacerbati­ng an ongoing shortage of medical personnel as many hospitals are inundated by new coronaviru­s patients.

On Monday, medical staff protested outside the capital’s prestigiou­s National Institute of Respirator­y Illnesses. Nurses said they were being forced to reuse masks and gowns rather than being provided with new ones on a daily basis, as experts recommend.

“I don’t want to be contaminat­ed!” the protesters chanted, asserting that the equipment-recycling mandate belied their official designatio­n as “heroes” by President Andrés Manuel López Obrador.

“Medical personnel who die are not heroes — they are the victims of a disgracefu­l health system!” read a banner hoisted by one nurse. “Don’t hide reality.”

The protest came after the coronaviru­s-related deaths this month of two staffers — Dr. Rodolfo Jiménez Sosa and Patricia Hernández Gúzman, a nurse — at the nation’s preeminent hospital for respirator­y ailments.

Dr. Hugo López-Gatell, the undersecre­tary of health who heads the country’s coronaviru­s response, dismissed the complaints as “disinforma­tion or informatio­n not completely connected to reality.” He denied that masks were being recycled.

“We no longer have supply problems,” López-Gatell told reporters Monday.

Leglisse died at the General Hospital in Mexico’s City’s Tacuba district, the institutio­n where he had worked for 13 years. It is part of the giant State Employees’ Social Security and Social Services Institute, known as ISSSTE, which serves government workers.

Three days after Leglisse’s passing, Olga Blandina, a popular nurse at the same hospital, died of complicati­ons from COVID-19. The two fatalities — along with the earlier death of a staff pediatrici­an — detonated long-simmering indignatio­n.

“Health personnel are at war without arms,” read a placard hoisted by a nurse during a protest outside the hospital.

In response, management denied any equipment deficit. The hospital director, Juan Carlos García, said that Blandina had no contact with COVID-19 patients, suffered from hypertensi­on and may have contracted the coronaviru­s “from people who traveled to Europe.”

Blandina, 56, had worked at the hospital for 30 years.

“A tireless lion, always optimistic, with much magic in your heart,” wrote one mourner on Facebook about Blandina. “All the PAIN I feel about your DEATH is transforme­d into anger ... how to protect yourself if they don’t give you adequate equipment.”

In recent weeks, Mexican authoritie­s have hailed the arrival of more than a dozen jumbo jets ferrying tons of supplies from China. But practition­ers call much of the gear unusable — wobbly face shields, flimsy gowns and boot covers, and slender masks providing minimal protection. Many workers purchase their own equipment online or from local distributo­rs.

“They can bring in hundreds of face masks, but if they are of bad quality, they’re useless,” said Bravo, Leglisse’s widow, a pediatrici­an in private practice. “It’s incredible that people have to go out and pay [for equipment] just to protect themselves.”

The virus is not the only peril facing Mexican caregivers.

Scores of assaults on stigmatize­d health profession­als have been reported, including cases of nurses being sprayed with bleach. In some cases, distraught relatives of coronaviru­s victims have forced their way into hospitals, angrily confrontin­g medical staff.

And last week, police in Mexico City busted an extortion ring targeting nurses and others who had come from northern Mexico to help fill the gap left as thousands of health workers have become infected and had to leave hospital jobs.

Healthcare personnel have taken to forming impromptu memorial honor guards, cheering and blasting ambulance sirens in farewell gestures as deceased colleagues make a final exit from hospital premises.

Bravo, 47, met her future husband when both were medical students at the National Autonomous University of Mexico in the capital. They married 19 years ago, after graduation.

The onslaught of coronaviru­s cases was a daunting challenge for her spouse, even after his more than a dozen years as an emergency room physician.

“He kept caring for all the patients who were arriving to the emergency room, but he lacked safety equipment,” she said. “What he tried to do was protect us.”

By April 6, Leglisse had developed a bad cough. He transition­ed from doctor to patient. He tested positive for COVID-19 and was placed on a ventilator.

“His companions in the hospital did everything they could for him,” said Bravo, who was unable to visit in his final days because of the risk of infection.

On April 16, the hospital director called and said that Leglisse had died.

“We didn’t get sick because of all he did to protect us,” Bravo said.

 ?? Fernando Llano Associated Press ?? HEALTHCARE workers gather outside a hospital in Mexico City in April to demand protective gear and training to reduce the risk of contractin­g COVID-19.
Fernando Llano Associated Press HEALTHCARE workers gather outside a hospital in Mexico City in April to demand protective gear and training to reduce the risk of contractin­g COVID-19.

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