Introduction
A pneumonia of unknown cause detected in Wuhan, China was first reported to the WHO Country Office in China on 31 December 2019.1 The causative agent was found to be severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The outbreak was declared a Public Health Emergency of International Concern by World Health Organisation (WHO) on 30 January 2020.2 WHO also advised about the possible modes of transmission and thereafter, world-wide, different national governments have issued guidelines on how to run the clinical practice with appropriate safety measures so that the health professionals can be protected from the infection. Ministry of Health & Family Welfare (MoHFW), Government of India (GoI) also issued a guidance note on the subject.3 However, the perception and practice at the ground level can be different. The present paper is an attempt to capture the perceptions and practice of those involved in delivering the care at the ground level in limited resource settings.
Practice of Otorhinolaryngology (ORL) unarguably involves exposure to the anatomical regions of the body with the highest viral load.4 Fear of getting infected and attendant morbidity and mortality are bound to affect the psyche of healthcare workers,5,6 especially so in ORL.
Practice of medicine in a LMIC differs from those in developed nations as public spending on health is less.7 Private sector is usually the bigger healthcare provider and social security penetration is not universal.8,9 These characteristics make economic factors more important in healthcare delivery to masses. After huge number of Covid-19 patients in China, Europe and United States, the focus is now shifting to developing nations and counties like Brazil and India are seeing a bigger and bigger surge of Covid-19 cases on daily basis.10 This is affecting the health of healthcare service providers where apart from pandemic related psychological stress as felt worldwide, economics of running the clinical practice is also playing on the minds of healthcare professionals. To do a ground check, authors decided to carry out an online cross-sectional survey to assess the economic and psychological impact of COVID 19 among different partners of ORL workforce in India; a first of the kind in any of the LMIC.