Use of Genetic Technologies in Formation of Specialized Professional

Selection Programs in the Health Care System as a Factor in Ensuring

the Sustainable Development of Society and Regions in the Context

of the COVID19 Pandemic

V. D. Ruzanova

, E. V. Ruzanova

and V. I. Belyakov

Samara National Research University (Samara University), Samara, Russia

Keywords: Covid19 Pandemic, Coronavirus Infection, Health Care Professional, Health Care System, Professional

Selection Program, Genetic Technologies, Genetic Markers, Circadian Biorhythms, Professional Standards.

Abstract: The article indicates that the most important factor in ensuring sustainable socio-economic development of

society as a whole and of each individual region is the state of labor resources, and in this regard, the question

is raised of the need to apply anti-pandemic approaches at different levels of organization of the life of modern

society and, above all, in the healthcare sector. It is concluded that the epidemic of the new coronavirus

infection is an unprecedented challenge to the national health systems, checking the degree of their

preparedness and the speed of response to the current emergency. The importance of taking proactive complex

measures to create more favorable conditions for performance of professional duties by health care

professionals in the case of a large-scale spread of dangerous infections is emphasized. In this regard, it is

recognized that it is necessary to revise various aspects of occupational safety and health, to strengthen

measures to prevent violations of their somatic and mental health, and to form a system of special legislation

that defines working conditions and guarantees the rights of health care professionals in the case of a

pandemic. To solve the problem of optimizing the work and rest of health care professionals in a pandemic,

preventing burnout syndrome, it is offered to use, among other things, genetic technologies. It is proved that

the proper performance of professional duties in the context of a pandemic of new infectious diseases is

determined not only by the necessary competencies formed during the period of training and the work itself,

but also, to a large extent, by human genetic data. The necessity of development and legal consolidation of

modern standards of professional selection and appropriate rotation of health care professionals on the basis

of genetic information about the characteristics of the immune status, the stability of circadian biological

rhythms, resistance to stress factors, and etc. is justified. The importance of scientific discussion of the

establishment of basic genetic markers, on the basis of which professional selection and personnel

management programs in the health care system shall be implemented in a pandemic, is emphasized. The key

directions of the formation and implementation of these programs for the professional selection and

management of medical personnel using genetic technologies are determined.

1 INTRODUCTION

An outbreak of a new coronavirus infection SARS-

CoV2, first registered in December 2019 in Wuhan,

China, quickly spread throughout the world in a short

period of time and led to the development of the

COVID19 pandemic (Lu, Zhao, Li, Niu, Yang, Wu,

https://orcid.org/0000-0003-4381-5237

https://orcid.org/0000-0001-9014-0557

https://orcid.org/0000-0002-4317-4890

2020), (Carvalho, Krammer, Iwasaki, 2021). Until

now, a large-scale circulation of various variants of

SARS-CoV2 continues (Richardson, Hirsch,

Narisimhan, Crawford, McGinn, Davidson, 2020),

(Planas, Veyer, Baidaliuk, Baidaliuk, Staropoli,

Guivel-Benhassine, Rajah, 2021), which provides

chronic stress to the national health systems, social

Ruzanova, V., Ruzanova, E. and Belyakov, V.

Use of Genetic Technologies in Formation of Specialized Professional Selection Programs in the Health Care System as a Factor in Ensuring the Sustainable Development of Society and

Regions in the Context of the COVID19 Pandemic.

DOI: 10.5220/0011111500003439

In Proceedings of the 2nd International Scientiﬁc and Practical Conference "COVID-19: Implementation of the Sustainable Development Goals" (RTCOV 2021), pages 113-118

ISBN: 978-989-758-617-0

113

sphere and economies of almost all countries. As of

August 26, 2021, 213,967,020 cases of COVID19

were confirmed and 4,464,245 deaths were

registered.

The complex course and multi-organ nature of

COVID19, the lack of effective treatments for this

disease so far, the ability of a new virus to undergo

mutational changes, an increasing rate of spread and

an increase in the damaging activity of new SARS-

CoV2 variants and, as a result, a violation of the

socio-economic infrastructure that developed during

the pre-pandemic period most countries – all these

circumstances actualize the search for effective ways

and mechanisms to counter a pandemic of a new

infectious disease. Wherein, the need to apply anti-

pandemic approaches at different levels of

organization of the life of modern society is clearly

traced. Undoubtedly, these approaches shall, among

other things, be based on modern scientific

achievements and include artificial intelligence

systems for collecting, analyzing and storing a large

array of various data, genetic technologies,

innovative communication programs under

conditions of social distancing, the latest means of

predicting the course of a pandemic, and etc. No less

important is an active discussion of the problem of

applicability of innovative technologies from the

standpoint of modern law and bioethics.

The most important factor in ensuring sustainable

socio-economic development of society as a whole

and of each individual region is the state of labor

resources. In this regard, attention shall be paid to

optimizing the functioning of those services whose

work is aimed at preserving human life and health.

These include, first of all, the health care system, the

importance of which during a pandemic can hardly be

overestimated. In the light of the foregoing, the issues

of conducting the correct personnel policy in this area

come to the fore, within formation of which it is

necessary to consider that the proper performance of

the professional duties by health care professionals is

determined not only by the necessary competencies,

but also, to a large extent, by the genetic data of a

person.

The foregoing confirms the relevance of the

problem of forming specialized programs for

recruiting workers in the field of medicine in

emergency epidemiological conditions using genetic

technologies. Wherein, development of such

programs shall be based on the results of

interdisciplinary scientific research that can assess

various aspects of the COVID19 pandemic (from

biomedical to bioethical and legal ones) and indicate

integrated approaches to successfully address

personnel policy issues in the healthcare system in

emergency conditions of society.

2 STUDY METHODS

The purpose of this cross-scientific study is to

establish the possibility and necessity of using genetic

technologies in preparation of specialized

professional selection programs in the healthcare

sector in the context of the COVID-19 pandemic. In

support of the conclusions made in the paper, data on

the prevalence of COVID-19 from official sources, as

well as the data given in the doctrine, obtained as a

result of experimental observations, generalization of

clinical material, analysis of relevant genetic

information, and etc., were used.

When considering the importance of considering

the genetic data that determine some psychotypical

characteristics of a person, restructuring the activity

of physiological systems, as well as the problem of

influence of night work on the cognitive functions of

health care professionals, a complex of physiological

research methods was used: registration of the

electrical activity of the heart and individual

indicators of the cardiac cycle (Cardiocode analyzer),

daily monitoring of blood circulation parameters

(Kardiotechnika-04-8M analyzer). Male students (n =

42) at the age of 20-28 years of medical university

took part in the study on a voluntary basis in

compliance with the bioethics norms. Among them

were students combining educational activities with

work as nursing staff (n = 8).

In addition, a systematic analysis of the latter was

carried out in order to substantiate the offer for

improving the Russian legislation defining working

conditions and guaranteeing the rights of health care

professionals in a pandemic.

The doctrinal basis for writing this paper was the

works of scientists conducting studies in the field of

assessing the medical and biological aspects of the

new coronavirus, the physiology of adaptation

processes, circadian biorhythmology, and law.

In the course of the study, both general scientific

and specific scientific methods of cognition were

used: dialectical, systemic, intersectoral, and natural

science ones.

3 STUDY RESULTS

An analysis of the results of the latest studies

(Pouwels, K.B., House, T., Pritchard, E., Robotham,

RTCOV 2021 - II International Scientiﬁc and Practical Conference " COVID-19: Implementation of the Sustainable Development Goals

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114

J.V., Birrell, P.J., Gelman, A. et al., 2021), (Nafilyan,

V., Pawelek, P., Ayoubkhani, D., Rhodes, S.,

Pembrey, L., Matz, M. et al., 2021) shows a positive

relationship between the incidence of diseases and

deaths from a new coronavirus infection with certain

professions. So, doctors of intensive care units and

nurses caring for patients with COVID19, workers of

nursing homes are among the main risk group for this

disease (Burdorf, L., Porru, F., Rugulies, R., 2020),

(Chadeau-Hyam, M., Bodinier, B., Elliott, J.,

Whitaker, M.D., Tzoulaki, I., Vermeulen, R. et al.,

2020; Sim, M.R., 2020), (Mutambudzi, M.,

Niedzwiedz, C., Macdonald, E.B., Leyland, A., Mair,

F,. Anderson, J. et al., 2021).

In the context of the fight against the COVID-19

pandemic, healthcare workers are exposed to various

kinds of risks and traumatic situations, which include

the following: SARS-CoV2 infection while providing

medical care to patients; physical overwork and

emotional exhaustion; irregular working hours;

discrimination in society and family, and etc.

The Interim Recommendations of the

International Labor Organization (ILO) and the

World Health Organization (WHO) "COVID-19:

Occupational Health and Safety of Health Workers",

released on February 2, 2021, provide an update on

health and safety measures for health workers and

activities of the occupational health services within

the new coronavirus pandemic.

In addition to reviewing various aspects of

occupational safety and health in the case of a large-

scale spread of dangerous infections, it is necessary to

strengthen measures to prevent violations of the

somatic and mental health of health workers. This

shall consider the current classification of risk levels.

Otherwise, insufficient and untimely measures in the

field of arranging the work of health care

professionals can lead to an unpredictable increase in

morbidity, a decrease in labor productivity and the

quality of care in pandemic conditions. This, in turn,

can lead not only to a collapse in the health care

system, but to a dangerous overstrain of the socio-

economic sphere of society.

An important aspect of the problem under

consideration is provision of an individual approach

to prevent overwork and disruption of professional

adaptation of health care professionals in the context

of a pandemic. Such a personalized approach can be

associated with use of modern technologies for the

analysis of genetic information revealing the adaptive

potential of a person.

Considering the high degree of tension in the

mechanisms of regulation of the activity of the

cardiovascular system in emergency situations, it is

relevant to consider the genetic markers of the risk of

diseases of the heart and blood vessels. Wherein, it is

advisable to correlate these risks with the behavioral

characteristics of a person. According to the concept

of behavioral types, the prevalence of coronary heart

disease, atherosclerosis, myocardial infarction,

arterial hypertension,-cerebrovascular disorders are

higher in representatives with type A behavior

(Denollet, J., De Potter, B., 1992), (Kucherenko,

K.N., Belyakov, V.I., 2018). Health care workers

with type A behavior can be a potential risk group for

occurrence of functional and organic disorders of the

cardiovascular system, as well as professional

maladjustment due to a high predisposition to

emotional burnout.

The above-mentioned features of representatives

with type A behavior are in good agreement with the

results obtained in the framework of this study.

Analysis of the dynamics of the parameters of the

activity of the cardiovascular system during the day

revealed higher average daily values of systolic and

diastolic blood pressure, pulse rate, and presence of a

greater number of acrophases for these indicators in

type A representatives. Calculation of the Kerdo

vegetative index in this group of subjects revealed the

dominance of sympatho-adrenal mechanisms of

blood circulation regulation. Under the conditions of

motor functional tests, subjects with type A showed

hypertensive and dystonic types of reactions.

There is data (Melentyev, I.A., Vershinin, A.A..

Kolesnikova, E.A., Melentyev, N.A. Malygina, I.V.

Kostomarova, V.P. Zaitse, A.S., 2006) about a greater

distribution of the DD genotype for the ACE

(Angiotensin Converting Enzyme) gene among

individuals with characteristic type A behavior.

Meanwhile, this genotype is associated with a

relatively high predisposition to myocardial

infarction and other diseases of the cardiovascular

system. Considering the peculiarities of the genotype

(namely, the ACE gene) in the programs for the

selection of medical personnel for work in emergency

conditions will make it possible to prevent diseases of

the cardiovascular system and recommend, first of all,

persons who are not prone to type A behavior to

perform work with high and extremely high risk.

Based on the analysis of genetic information, it is

also possible to determine the individual-typological

characteristics of a person, for example, those

associated with the regulation of circadian biological

rhythms and resistance to occupational

desynchronosis. The need and timeliness of a

comprehensive accounting of such data is determined

by intense hours-long work shifts, work on a shift

schedule, unplanned attendance due to the illness of

Use of Genetic Technologies in Formation of Specialized Professional Selection Programs in the Health Care System as a Factor in Ensuring

the Sustainable Development of Society and Regions in the Context of the COVID19 Pandemic

115

colleagues in the context of a pandemic of infectious

diseases.

In the experimental part of this study, we analyzed

the effect of night shift work on attention function and

parameters of electrical activity of the cerebral cortex

in junior medical personnel. It was found that a 12-

hour working day and absence of night sleep

negatively affect the function of attention (there is a

decrease in its stability and concentration). A key

feature of the pattern of electrical activity of the brain

in medical students working at night was a significant

change in the frequency component of the delta

rhythm for various functional tests. Further studies

are necessary to indicate specific violations of the

functioning of individual neurotransmitter systems,

the physiological activity of various areas of the

cerebral cortex. In this case, it is necessary to consider

the genetically specified features of the course of

circadian biorhythms. We believe that the

peculiarities of a person's chronotype can also be

reflected in specialized genetic passports.

Experimental observations and extensive clinical

material indicate that a violation of the flow of

circadian biological rhythms poses a certain threat to

the immune system and cellular defense mechanisms.

As new data (Zheng, L., Wang, X., Zhou , C., Liu, Q.,

Li , S., Sun, Q. et al., 2020) on the prevalence of

COVID-19 show, there is a significant number of

cases (including deaths) among doctors and auxiliary

medical personnel. The results of the studies (Zhanq,

R., Wang, X., Ni, L., Di, X., Ma, B., Niu, S. et al.,

2020) indicate a direct connection between the

severity of COVID-19 and the deficiency and

dysregulation of immunity.

With the integrated use of modern programs for

professional selection and management of the

rotation of medical personnel, genetic markers of the

immune status shall also be analyzed. Variations of

several of these genes are currently being discussed

(Debnath, М., Banerjee, М., Berk, М., 2020). The

paper (Anastassopoulou, C., Gkizarioti, Z., Patrinos,

G.P., Tsakris, A., 2020) provides generalized

information on presence of a relationship between

certain alleles of genes with the susceptibility and

severity of COVID-19. As a result of polygenomic

studies (Pathak, G.A., Singh, K., Miller-Fleming,

T.W., Wendt, F.R., Ehsan, N., Hou, K. et al., 2021),

data were obtained on the relationship of 27 genes

involved in the regulation of inflammation and

hemocoagulation with the risk of hospitalization

when infected with SARS-CoV2. Genomic regions

associated with key mechanisms of antiviral

immunity and the activity of proinflammatory

cytokines in COVID-19 have been identified (Pairo-

Castineira, E., Clohisey, S., Klaric, L., Klaric, L.,

Bretherick, A.D., Rawlik, K., Pasko, D. et al.,2021;

Radzikowska, U., Ding, M., Tan, G., Zhakparov, D.,

Peng, Y., Wawrzyniak, P. et al., 2020).

As such, genetic analysis based on variations in

specific genes can provide reliable information about

the risk, severity and outcome of new multiple organ

disease, COVID-19.

4 DISCUSSION OF RESULTS

The epidemic of the new coronavirus infection

presents an unprecedented challenge to national

health systems with test of their preparedness and

how quickly they can respond to this emergency. The

references (SHarapova, A.I., Antonova, N.L., 2020)

correctly emphasize that since the modernization of

the healthcare sector is one of the main tasks of any

state, in the field of medicine, the solution of

personnel management issues and the rational use of

human potential are of paramount importance.

A comprehensive consideration of the problem of

staffing the medical sector in the context of the large-

scale and rapid spread of dangerous infectious

diseases such as the COVID-19 pandemic indicates

the need to use innovative approaches, namely, based

on taking into account human genetics. This will

allow for more efficient selection and optimal rotation

of health care professionals in a pandemic. Namely,

with an established individual low level of

immunological protection, a tendency to develop

dysregulation in the immune system, as well as a low

speed of making effective decisions in stressful

situations with a large number of infected people, it is

possible to recommend performing professional

duties not related to contacts with patients and visitors

to medical institutions (work in the field of

telemedicine, remote interviewing of patients, and

etc.). For a more thorough professional selection, we

consider it expedient to widely introduce the so-called

specialized genetic passports, the development of

which requires use of DNA technologies (Ruzanova,

V.D., Belyakov, V.I., 2020; Ruzanova, V.D.,

Inyushkin, A.A., Kryukova, E.S., Povarov, I.S.,

Belyakov, V.I., 2020).

WHO and ILO provide clear guidelines for

management of health care workers in emergencies.

Namely, it is indicated that five eight-hour or four

ten-hour shifts per week are relatively well tolerated.

Longer shifts are a risk of overwork. In the evening

and at night, short shifts are more physiological.

When drawing up a work schedule, it is preferable to

alternate individual shifts in a forward direction (first

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morning shift, then day shift, then evening one).

When choosing a professional workload, one shall

take into account its complexity and duration. So,

twelve-hour shifts are more optimal for performing

"light" work (for example, for working with

documents). On the contrary, heavy workloads shall

be carried out in shorter work shifts.

Particular attention shall be paid to consideration

of issues related to provision of rest, physical and

emotional recovery of health care professionals. It is

recommended that certain rules be established

regarding the length of the work period and the time

of rest and recovery.

As you know, Russian labor legislation classifies

health care professionals as special subjects of labor

law, establishing reduced working hours (no more

than 39 hours per week) and additional paid vacations

(Article 350 of the Labor Code of the Russian

Federation). We shall note that the regulatory

provisions in this area apply both to all health care

professionals and to their individual categories,

depending on the type of work performed and

services provided, as well as a number of other factors

(Manasyan, R.V., Sapozhnikova, N.I., 2021). Due to

the spread of COVID-19 in Russia, a whole package

of regulatory legal acts of various levels and

clarifications from authorized bodies aimed at

protecting and stimulating the work of health workers

was adopted urgently. So, for health care

professionals a shortened 36-hour working week and

special social payments with use of increasing

coefficients have been established, additional

insurance guarantees have been introduced in the

form of a one-time insurance payment, cases of

infection of health care professionals with

coronavirus infection are classified as occupational

diseases. However, today this is clearly not enough,

since formation of an integral system of special

legislation is required that determines the working

conditions and guarantees the rights of health care

professionals during a pandemic on the basis of a

differentiated approach to determining their legal

status, depending on the function performed and other

criteria.

Based on the analysis of various sources of

information and our own experimental data, it can be

concluded that the proper fulfillment of professional

duties by health care professionals in the context of

the COVID-19 pandemic (possibly future new

infectious diseases) is determined not only by the

necessary competencies formed during the training

and the work itself, but also to a significant extent, by

the genetic data of a person. This actualizes the need

for development and appropriate legal consolidation

of modern standards of professional selection and the

necessary rotation of health care professionals based

on genetic information about the characteristics of the

immune status, the stability of circadian biological

rhythms, resistance to stress factors, and etc. In this

regard, we consider it timely for a more active

discussion among a wide range of specialists to

determine the basic genetic markers, on the basis of

which professional selection and personnel

management programs in the health care system shall

be implemented in a pandemic.

5 CONCLUSIONS

In order to achieve a "workable" state of labor

resources in a pandemic as the most important factor

in ensuring sustainable socio-economic development

of society as a whole and each individual region, we

offer to highlight three key areas for formation and

implementation of programs for professional

selection and management of medical personnel

using genetic technologies:

1. Creation of the genetic base of "professional

markers", revealing, namely, the peculiarities of the

functioning of the mechanisms of innate and adaptive

immunity. This will make it possible to more reliably

determine the susceptibility, severity of the course

and possible outcomes of infectious diseases. It is

relevant to use such a genetic base when scheduling

the work of doctors and auxiliary medical personnel,

which is determined by the special importance of

circadian biological rhythms for the adaptive

capabilities of a person, his/her effective and safe

labor activity.

2. Development of an individual program of

preventive examinations based on genetic data,

analysis of the risk of health disorders and occurrence

of occupational desynchronosis in a pandemic of

infectious diseases.

3. Improvement and effective application of legal

support mechanisms, legal registration of such

programs, as well as discussion of the bioethical side

of the problem of genetisation of the personal and

professional sphere of a person.

We also consider it necessary to form an integral

system of special legislation that defines working

conditions and guarantees the rights of health care

professionals during a pandemic on the basis of a

differentiated approach to determining their legal

status, depending on the function performed and other

criteria.

Use of Genetic Technologies in Formation of Specialized Professional Selection Programs in the Health Care System as a Factor in Ensuring

the Sustainable Development of Society and Regions in the Context of the COVID19 Pandemic

117

The study was carried out with the financial

support of the Russian Foundation for Basic Research

within the framework of scientific project No. 18-29-

14073.

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