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Fear psychosis for the medical physicists’ profession in the worldwide COVID‑19
crisis

Article  in  Current Medicine Research and Practice · July 2021

DOI: 10.4103/cmrp.cmrp_32_21

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Short Communication

Fear psychosis for the medical physicists’ profession in the

worldwide COVID‑19 crisis
Mahasin Gazi1,2*, Biplab Sarkar1
1
Department of Medical Physics, Apollo Gleneagles Hospitals, Kolkata, West Bengal, India, 2School of Studies in Environmental
Radiation and Archaeological Sciences, Jadavpur University, Kolkata, West Bengal, India

ABSTRACT
Background: The coronavirus infectious disease 2019 (COVID‑19) has spread over 213 countries around the world and two
international conveyances. This has become a cause of public health emergencies as well as a crisis internationally. Realising
its deadlier effects the World Health Organisation has already declared this crisis as a pandemic on 11th, March, 2020.
Material and Methods: Hospitals authority mostly do not provide complete personal protective equipment (PPE) for medical
physicists every day as in general, they do not come in direct contact with patients frequently, shortages of PPE and economic
barriers.
Results: In this commentary, we have highlighted different aspects of fear psychosis dominantly acting on medical physicists
working in the hospital where both confirmed and suspected COVID‑19 patients are being treated during this pandemic.
Further, a series of novel methods are proposed to reduce the risk of viral exposure for medical physicist community and
other health care workers, and patients.
Conclusion: In the absence of proper PPE, medical physicists should maintain proper physical distancing along with wearing
the available protective devices (gloves and face mask) avoid casual touching of the mouth and nose to reduce the risk of
infection.

Keywords: Coronavirus infectious disease 2019 pandemic, medical physicist, medical physics, radiation oncology,
severe acute respiratory syndrome coronavirus‑2

INTRODUCTION COVID‑19 related infections and deaths are 124.9 million

On December 2019, China first reported to its World
Health Organisation (WHO) country office about unknown
pneumonia which was subsequently identified as coronavirus
infectious disease 2019 (COVID‑19).[1] The WHO declared this
crisis as a global pandemic on 11th March, 2020.[1,2]
Present COVID‑19 attributed to severe acute respiratory
syndrome coronavirus‑2  (SARS‑CoV‑2) affecting excesses
of 213 countries worldwide.[3] As of 23rd March, 2021, the
Submitted: 23‑Mar‑2021  Revised: 18‑Apr‑2021  Accepted: 21‑May‑2021  Published: 30‑Jun‑2021
and 2.7 million, respectively; with 100.3 million people have
recovered globally.[3]
Infection in India started a bit late than developing world,
however, reached the second‑highest position on COVID‑19
infection/deaths after the United States by September 2020
and maintaining until March 2021.[4] Infections are attributed
to different factors such as (i) vast populations and crowded
*Address for correspondence: Mr. Mahasin Gazi,
Department of Medical Physics, Apollo Gleneagles Hospitals,
Kolkata ‑ 700 054, West Bengal, India.
E‑mail: gmahasin@gmail.com

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DOI:
How to cite this article: Gazi M, Sarkar B. Fear psychosis for the medical
10.4103/cmrp.cmrp_32_21 physicists’ profession in the worldwide COVID‑19 crisis. Curr Med Res
Pract 2021;11:152-5.

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Gazi and Sarkar: The fear psychosis: Medical physicist
settlements, general ignorance about disease and its severity
due to illiteracy and poverty and political negligence ii)
deficient infrastructure well below the recommended
standards.[4,5]
The community spade and the cluster transmission of
the disease introduced public health emergencies.[5] The
clinics and hospitals were transformed into COVID specialty
establishments reducing the facilities for other patients.
Furthermore, the footfall of the patients suffering from other
noninfectious diseases has been restricted due to lockdown
and fear psychosis on visiting the hospital. Selective surgeries
were delayed and outpatient department‑based consultations
were pushed online. Nonetheless, the treatment for diseases
such as cancer treatment cannot be delayed. The risk of
getting a COVID‑19 infection for an immunocompromised
cancer patient was higher than a normal person.[6] Cancer
patients need hospitalisation for surgery and daycare for
chemotherapy and radiotherapy. The primary healthcare
workers  (HCW) who encounter such patients are nurses,
technicians, and doctors. It is difficult to provide the personal
protective equipment as it add up to the treatment cost,
unavailability of the product, and its doubtful protection
ability.[6]
Shankar et  al. reported that at least 2629 health workers
have been infected onset of the outbreak in February 2020
only.[6] As reported by the Indian Medical Association the
number of doctors who died until February 2021 was 734.[7]
However, no reliable information on infection and deaths
for HCW is available excluding doctors. Some reported
a total of 116 and 199 HCW was died and affected until
7th September, 2020; which is an underestimated figure.[8]
A study on 138 cancer patients from Zhongnan Hospital of
Wuhan University reported a 41.3% rate of hospital‑acquired
COVID‑19 infection.[9] Therefore, the HCW are at the potential
risk of getting the infection through immunocompromised
cancer patients, leading to a fear psychosis among the HCW
and their family members. The systemic review by Spoorthy
et al., analysed the anxiety of the HCW attributed to the fear
of infection and sometimes as death fear.[10] With a doubtful
efficacy of the vaccination frontline, health workers remain
in the anxiety of infection.
In this commentary, we have highlighted different aspects
of fear psychosis dominantly acting on medical physicists
during the pandemic. We have also highlighted different
novel ideas and actions for medical physicists to reduce
the risk of infection and continuing radiation treatment
service.
Current Medicine Research and Practice / Volume 11 / Issue 3 / May-June 2021
MATERIAL AND METHODS
Staffing and duties of medical physicists
Medical physicists mainly work in radiotherapy for cancer
patient.[11,12] The cancer therapy workflow included the
patient simulation, treatment planning, quality assurance
and delivery setup verification. The first and last point a
medical physicist gets directly exposed to the patient. In
general, personal protective equipment (PPE) kits for medical
physicists are not provided, therefore to reduce the risk of
exposure from patients precautionary measures need to be
taken.
In this pandemic, one should follow rules and regulations
as stipulated by the Ministry of Health and Family
Welfare, Government of India. [13] Doctors, nurses and
technicians having direct contact with such patients and
their caregivers needs to be protected from infection.
The HCW is mostly prioritised and eligible for obtaining
complete PPE from the hospital authority. Nonetheless,
medical physicists do not receive PPE on a daily basis
as i) the contact with patients are limited although they
are at finite risk of getting infected ii) shortages of PPE
iii) miser attitude of hospital authority cannot be ruled
out and lastly a universal reason of anxiety iv) efficacy of
PPE. Nevertheless, medical physicists need to perform
their duty daily, even at the peak of the infection. Few
institutions have reduced the number of working days by
exorbitantly increasing the duty hours to fulfill the weekly
duty hours schedule. Other than personal safety, medical
physicists always carry a fear of infecting the other family
members, especially the aging parents or young children,
who are vulnerable to infection.
A complete PPE setup consists of an N‑95 mask or medical
mask, disposable gown, transparent face shield or goggles,
head cap, shoe cover and hand gloves. Out of these medical
physicists usually are using a surgical mask daily, a few of
them are using a reusable N‑95 mask, face shield, hand
gloves and head cap. Sometimes medical physicists, in
addition to their normal responsibilities, has to help or
support radiation technologists in different tasks such as to
fabricate patients’ immobilisation cast, blocks, mouth bite
and lift ambulatory patients to computed tomography (CT)
or treatment couch from their stretchers owing to having
fewer technologists or heavy workload. The possibilities
of hospital‑acquired COVID‑19 infection at any of the
mentioned steps to them are a major safety concern.
Moreover, as of 11 th  February 2021, India still stands
at second position among the most COVID‑19 affected
countries.[4] With all these information it is quite natural to
build mental anxiety to the physicists working at different
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Gazi and Sarkar: The fear psychosis: Medical physicist

Table  1: Possible direct and indirect source points of coronavirus infectious disease 2019 infection to physicist
Source points  (direct/indirect)
Common computer mouse, keyboards, commonly used
door handles, devices, and switches
Linear accelerator accessories, especially couch
Indexer lock and source transfer tube of brachytherapy
machine
Unconscious touches with any HCW wearing PPE
during patients treatment
HCW: Health care workers, PPE: Personal protective equipment
Possible reasons of getting infected
Virus may propagate by touching such
accessories by a carrier (HCW)
The infected items may transfer the virus to
others while handling them for treatment
Brachytherapy patient attending nurse may
infect those items
Primar y HCW in direct contact with
patients. As a result, they may be get
infected during setup and treatment
Recommendations
Sanitise hands/stuffs frequently by themselves
and by housekeeping as well
Minimise the physicist super vision and
maximise the physical distance; audio‑video
telecommunication may be used

hospitals besides ensuring safety for themselves, other Financial support and sponsorship
HCW, and patients. Nil.

DISCUSSION AND RECOMMENDATIONS Conflicts of interest

There are no conflicts of interest.
Table 1 shows direct and indirect possible source points and
recommendations to prevent COVID‑19. REFERENCES

1. WHO, Director‑General’s Opening Remarks at the Media Briefing

Telecommunication
Deployment of telecommunication, if social and economic
condition favours can be largely used to minimise the high
risk from transfer and infection of COVID‑2019 among
different HCW as well as to maintain a smooth workflow of
the different treatment steps.
CONCLUSION
Although the infection risk is lowered than 1% as in March
2021, risk of infection still persists for healthcare workers
with a second wave starting in different countries with a
mutated form of virus.[4]
Few precautions can be taken like, suspected patients must
be sent to triage for evaluation, if possible a screening CT or
rapid COVID‑19 test, nonetheless these add to the treatment
cost. The patient must wear a sealed mask during the
simulation process, with clinicians, therapists, and medical
physicist touching them with gloves if PPE is not possible.
Higher precaution should be taken while performing the task
related to aerosol generation such as mouth bite insertion
or coaching for deep inspiration breath‑hold.
Further, anyone in the department gets infected, required
a quarantine. Several radiotherapy departments have
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scenario will lead to unplanned treatment interruption for
cancer treatment with the compromised success of the
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Gazi and Sarkar: The fear psychosis: Medical physicist

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Current Medicine Research and Practice / Volume 11 / Issue 3 / May-June 2021 155

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