scholarly journals Importance of mitigation measures for hospital transmission of SARS-CoV-2 at the onset of the epidemic: the experience of Brescia, Northern Italy

Infection ◽  
2021 ◽  
Author(s):  
Valentina Marchese ◽  
Beatrice Formenti ◽  
Gloria Cola ◽  
Natalia Gregori ◽  
Elisa Albini ◽  
...  

Abstract Purpose Since the first Italian case of SARS-CoV-2 was detected in Lombardy (Northern Italy)  Italy quickly became one of the worst-affected European countries, with a severe impact on health-care workers (HCWs). In the first epidemic, HCWs accounted for 12% of all national COVID-19 cases. We evaluated the burden of COVID-19 among HCWs and other non-health-care workers (nHCWs) in a large Italian hospital. Methods From March 1st to May 31st 2020, we performed a retrospective study at ASST Civil Hospital, in the Province of Brescia, Lombardy. The study population included all hospital personnel (n = 9265), categorized by professional status. Results A SARS-CoV-2 test was performed in 3572 workers (38.5%), with a positive result in 552 (5.9% of all hospital personnel). The temporal trend of SARS-CoV-2 cases in hospital staff broadly reflected that in the community, with a great majority of infections occurred during March 2020 (87.7%). From April onward, a steep decrease of positive cases was observed among hospital personnel, while in the community the decrease was much slower. Medical doctors (8.9%) and nurses (8.5%) were the most affected professional categories with a significantly higher risk of SARS-CoV-2 infection (OR 1.436 and OR 1.410, respectively p < 0.0001). HCWs in COVID-19 units presented a significantly higher risk of infection compared to HCWs in non-COVID units (p < 0.001). Conclusion HCWs were severely affected by the COVID-19 epidemic, probably associated with an overwhelming burden of work and lack of preparedness in prevention of nosocomial transmission of the infection. The rapid decrease of COVID-19 spread in the hospital, registered before the one in the community, suggests that the adopted preventive measures were effective.

Infection ◽  
1992 ◽  
Vol 20 (4) ◽  
pp. 224-226 ◽  
Author(s):  
C. Campello ◽  
Silvia Majori ◽  
A. Poli ◽  
Patrizia Pacini ◽  
L. Nicolardi ◽  
...  

2021 ◽  
Vol 7 (3) ◽  
pp. 243-248
Author(s):  
Krina B Patel ◽  
Savfeena M. Nagani ◽  
Aanal T. Patel ◽  
Nirav Bapat

“MASK-NE”-Mask associated Acne, is a common form of acne during COVID-19 pandemic. It is type of acne mechanica seen when external factor occludes the skin, leads to irritation, inflammation and starts/aggravates all grades of acne.We conducted a cross-sectional study among 773 participants, using a Self-administered, aim oriented, questionnaire which includes demographic data, acne related history, type and duration of wearing mask & other mask related skin problems in COVID-19 pandemic during 15 October to 15December,2020.: Among 773 participants, age ranged 18-45 years with mean 30.69 (SD: 61.30) and M:F was 1:1.78. After starting of Pandemic, occurrence of new development of mask associated Acne/ Maskne was higher among Health Care Workers (HCW) (34.98%) as compared to non- Health Care Workers (non-HCWs) (17.36%). Moreover, more number of HCWs had aggravation of their pre-existing acne and/or development of new of acne during pandemic (81.2%) than non-HCWs (61%). Wearing N95 type of mask showed the highest aggravation (82%) of Maskne as compare to wearing Surgical mask (75.5%) and wearing cloth (cotton) mask (65.6%).Wearing a face mask for 4 to 8 hours/day and &#62;8 hours/day showed increase in the aggravation of Maskne as compared to wearing a facemask &#60;4 hrs/day.Though wearing face masks can be the best strategy against COVID-19 infection, HAZARD OF THIS SAFETY is not negligible especially in front-line workers-doctors, nurses, pharmacist, policemen, hospital staff who are at higher risk due to several factors including type of mask use, duration of mask use etc.


2021 ◽  
Vol 27 (2) ◽  
pp. 148-163
Author(s):  
Fatemeh Mohammadzadeh ◽  
◽  
Ali Delshad Noghabi ◽  
Javad Bazeli ◽  
Hamidreza Karimi ◽  
...  

Aims: The emergence of COVID-19 disease has created significant stress and anxiety for health care workers. This study aimed to investigate the stressors and coping strategies in the staff of Allameh Bohlool Hospital in Gonabad City, Iran, during the outbreak of the COVID-19 disease. Methods & Materials: This cross-sectional study was performed on 252 employees of Allameh Bohlool Hospital in Gonabad from March 2020 to April 2020. Study tools included a brief form of coping styles (Brief-COPE) and a researcher-made questionnaire of stressors due to the emergence of COVID-19 among health care workers. The obtained data were analyzed using linear regression and ordinal regression models at the significance level of 0.05. Findings: About 74.2%, 69.4%, 52.7%, 52.7%, and 99.2% of the hospital staff had moderate to high stress in the domains of internal, family-social, workplace-related, infection control, and government measures, respectively. The degree of using adaptive and maladaptive coping styles used by staff were 52.0% and 23.8% at the moderate to the high level, respectively. Maladaptive coping styles had a positive and significant relationship with stress intensity so that for each unit increase in maladaptive coping score, the odds of experiencing higher levels of stress increased 1.24 to 1.45 times (P<0.001). Also, the odds of experiencing higher levels of stress in those who had sports activities was 24% to 76% lower (P=0.003). Conclusion: The findings of the present study indicated a high level of stress among hospital staff. Also, the use of maladaptive coping styles and sports activities had a significant positive and negative relationship with stress intensity, respectively. Therefore, designing effective interventions focusing on reducing maladaptive coping patterns among hospital staff and encouraging people to engage in sports activities can help manage stress as much as possible due to the outbreak of COVID-19 disease.


PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1738 ◽  
Author(s):  
Vidya Pathak ◽  
Zinta Harrington ◽  
Claudia C. Dobler

Background.Healthcare workers have an increased risk of latent tuberculosis infection (LTBI), but previous studies suggested that they might be reluctant to accept preventive tuberculosis (TB) treatment. We aimed to examine doctors’ and nurses’ experience of TB screening and to explore their attitudes towards preventive TB treatment.Methods.We conducted a survey among randomly selected healthcare workers at a tertiary hospital in Sydney, Australia, using a paper-based questionnaire.Results.A total of 1,304 questionnaires were distributed and 311 (24%) responses were received. The majority of hospital staff supported preventive TB treatment in health care workers with evidence of latent TB infection (LTBI) in general (74%, 164/223) and for them personally (81%, 198/244) while 80 and 53 healthcare workers respectively had no opinion on the topic. Staff working in respiratory medicine were significantly less likely to support preventive TB treatment in health care workers in general or for them personally if they would have evidence of LTBI compared to other specialties (p= 0.001). Only 13% (14/106) of respondents with evidence of LTBI indicated that they had been offered preventive TB treatment. Twenty-one percent (64/306) of respondents indicated that they did not know the difference between active and latent TB. Among staff who had undergone testing for LTBI, only 33% (75/230) felt adequately informed about the meaning of their test results.Discussion.Hospital staff in general had positive attitudes towards preventive TB treatment, but actual treatment rates were low and perceived knowledge about LTBI was insufficient among a significant proportion of staff. The gap between high support for preventive TB treatment among staff and low treatment rates needs to be addressed. Better education on the concept of LTBI and the meaning of screening test results is required.


2000 ◽  
Vol 38 (4) ◽  
pp. 1536-1538 ◽  
Author(s):  
Sergio L. Vargas ◽  
Carolina A. Ponce ◽  
Francis Gigliotti ◽  
Ana V. Ulloa ◽  
Susana Prieto ◽  
...  

The transmission of Pneumocystis carinii from person to person was studied by detecting P. carinii-specific DNA in prospectively obtained noninvasive deep-nasal-swab samples from a child with a documented P. carinii pneumonia (PCP), his mother, two contact health care workers, and 30 hospital staff members who did not enter the patient's room (controls). Nested-DNA amplification was done by using oligonucleotide primers designed for the gene encoding the mitochondrial large subunit rRNA of rat P. carinii(P. carinii f. sp. carinii) that amplifies all forms of P. carinii and internal primers specific for humanP. carinii (f. sp. hominis). P. carinii f. sp. hominis DNA was detected in samples from the patient and all of his contacts versus none of the 30 hospital staff members. The results, as previously shown in murine models ofP. carinii pneumonia, document that person-to-person transmission of P. carinii is possible. This observation suggests that immunocompromised patients not on PCP prophylaxis should not enter the room of a patient with PCP, and it also raises the question as to whether healthy contacts can transmit the disease to immunocompromised patients at risk.


10.2196/19712 ◽  
2020 ◽  
Vol 8 (12) ◽  
pp. e19712
Author(s):  
May Oo Lwin ◽  
Jiahui Lu ◽  
Anita Sheldenkar ◽  
Chitra Panchapakesan ◽  
Yi-Roe Tan ◽  
...  

Background Existing studies have suggested that internet-based participatory surveillance systems are a valid sentinel for influenza-like illness (ILI) surveillance. However, there is limited scientific knowledge on the effectiveness of mobile-based ILI surveillance systems. Previous studies also adopted a passive surveillance approach and have not fully investigated the effectiveness of the systems and their determinants. Objective The aim of this study was to assess the efficiency of a mobile-based surveillance system of ILI, termed FluMob, among health care workers using a targeted surveillance approach. Specifically, this study evaluated the effectiveness of the system for ILI surveillance pertaining to its participation engagement and surveillance power. In addition, we aimed to identify the factors that can moderate the effectiveness of the system. Methods The FluMob system was launched in two large hospitals in Singapore from April 2016 to March 2018. A total of 690 clinical and nonclinical hospital staff participated in the study for 18 months and were prompted via app notifications to submit a survey listing 18 acute respiratory symptoms (eg, fever, cough, sore throat) on a weekly basis. There was a period of study disruption due to maintenance of the system and the end of the participation incentive between May and July of 2017. Results On average, the individual submission rate was 41.4% (SD 24.3%), with a rate of 51.8% (SD 26.4%) before the study disruption and of 21.5% (SD 30.6%) after the disruption. Multivariable regression analysis showed that the adjusted individual submission rates were higher for participants who were older (<30 years, 31.4% vs 31-40 years, 40.2% [P<.001]; 41-50 years, 46.0% [P<.001]; >50 years, 39.9% [P=.01]), ethnic Chinese (Chinese, 44.4% vs non-Chinese, 34.7%; P<.001), and vaccinated against flu in the past year (vaccinated, 44.6% vs nonvaccinated, 34.4%; P<.001). In addition, the weekly ILI incidence was 1.07% on average. The Pearson correlation coefficient between ILI incidence estimated by FluMob and that reported by Singapore Ministry of Health was 0.04 (P=.75) with all data and was 0.38 (P=.006) including only data collected before the study disruption. Health care workers with higher risks of ILI and influenza such as women, non-Chinese, allied health staff, those who had children in their households, not vaccinated against influenza, and reported allergy demonstrated higher surveillance correlations. Conclusions Mobile-based ILI surveillance systems among health care workers can be effective. However, proper operation of the mobile system without major disruptions is vital for the engagement of participants and the persistence of surveillance power. Moreover, the effectiveness of the mobile surveillance system can be moderated by participants’ characteristics, which highlights the importance of targeted disease surveillance that can reduce the cost of recruitment and engagement.


1984 ◽  
Vol 5 (12) ◽  
pp. 583-584 ◽  
Author(s):  
William M. Valenti

From time to time, health care workers are restricted from patient contact because of proven or suspected infectious illness or because of incubating disease after an exposure. The CDC Guideline for Infection Control in Hospital Personnel addresses a number of infectious illnesses and exposures which may require some type of employee restriction from patient contact. However, the Guideline does not address the administrative aspects that accompany putting an employee on a leave of absence for infection control purposes. This process is often complicated and questions frequently arise as to how an employee should be paid for the time lost from work. In general, there is no uniform way to approach the problem of “absence to prevent contagion.” As with many areas of infection control and employee health, hospitals can choose one of several options. However, the employee should never be penalized for reporting an infectious illness or exposure, and administrators should encourage reporting of proven or suspected disease or exposures (eg, exposure to chickenpox).


2020 ◽  
Vol 56 (03) ◽  
pp. 149-153
Author(s):  
Parul Chawla Gupta ◽  
Praveen Kumar-M ◽  
Jagat Ram

AbstractEye care professionals are susceptible to contract COVID-19 infection due to the presence of the virus in tears and conjunctival secretions and, also, partly due to the proximity required during ophthalmic examination. Although infrequent, ocular features include conjunctivitis (predominant), chemosis, follicles, itching, dry eye, and tearing. In this article, we have outlined salient safety recommendations at outpatient, inpatient and operation theater level for both patients as well as health care workers. Some of them being, creation of special triage areas at ophthalmology clinic for the screening of patients, things to be avoided at each level, procedures to manage appointments, examination room modifications, operation theater protocols, a suggestion for prioritizing cases, and finally airflow and hospital staff management. These suggestions, along with local hospital-specific modifications, will help us to go a long way in the battle against COVID-19.


2020 ◽  
Vol 7 (9) ◽  
Author(s):  
Carmela Schwartz ◽  
Yonatan Oster ◽  
Carole Slama ◽  
Shmuel Benenson ◽  
Adiel Cohen ◽  
...  

Abstract Background During the coronavirus disease (COVID-19) epidemic, many health care workers (HCWs) have been exposed to infected persons, leading to suspension from work. We describe a dynamic response to exposures of HCWs at Hadassah Hospital, Jerusalem, to minimize the need for suspension from work. Methods We performed an epidemiological investigation following each exposure to a newly diagnosed COVID-19 patient or HCW; close contacts were suspended from work. During the course of the epidemic, we adjusted our isolation criteria according to the timing of exposure related to symptom onset, use of personal protective equipment, and duration of exposure. In parallel, we introduced universal masking and performed periodic severe acute respiratory syndrome coronavirus 2 screening for all hospital personnel. We analyzed the number of HCWs suspended weekly from work and those who subsequently acquired infection. Results In the 51 investigations conducted during March–May 2020, we interviewed 1095 HCWs and suspended 400 (37%) from work, most of them, 251 (63%), during the first 2 weeks of the outbreak. The median duration of exposure (interquartile range) was 30 (15–120) minutes. Only 5/400 (1.3%) developed infection, all in the first 2 weeks of the epidemic. After introduction of universal masking and despite loosening the isolation criteria, none of the exposed HCWs developed COVID-19. Conclusions Relatively short exposures of HCWs, even if only either the worker or the patient wears a mask, probably pose a very low risk for infection. This allowed us to perform strict follow-up of exposed HCWs in these exposures, combined with repeated testing, instead of suspension from work.


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