scholarly journals 504. Transmission of SARS-CoV-2 to Household Members of COVID Positive Healthcare Workers

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Mehreen Arshad ◽  
Sebastian Otero ◽  
Leena B Mithal
Keyword(s):  
Stress Level ◽  
Healthcare Workers ◽  
Preventive Measures ◽  
Physical Contact ◽  
Transmission Risk ◽  
Infection Prevention And Control ◽  
Intimate Contact ◽  
Mild Disease ◽  
Increased Risk ◽  
Survey Responses

Abstract Background Healthcare workers (HCW) are at increased risk of SARS-CoV-2 infection. Infection prevention and control methods to prevent HCWs from bringing the virus home are lacking. We aimed to describe the various isolation practices of COVID positive (+) physicians and advanced practice providers to mitigate transmission risk to family members (FM) and understand HCW stress during this pandemic. Methods Survey responses were collected from 5/19/2020 - 6/12/2020 using a convenience sampling of HCW. Solicitations were done through email, listservs, institutional websites, and Facebook groups without geographic restriction. We collected data on demographics, details about HCW illness, health of FM, preventive measures taken, and HCW stress. Results The survey has so far been completed by 51 COVID+ respondents with FM in the home (Table 1). Half (55%) work in outpatient, 31% inpatient, and 8% in ER setting. Most HCW (83%) were diagnosed by PCR test; others were presumptive positive due to symptoms and exposure (14%). 64% had mild disease and 33% had moderate disease. Most common preventive measures were immediate showering after reaching home (59%) and changing clothes prior to going home (35%); 22% took no precautions. About 55% of FM developed symptoms of COVID. There were no significant differences between preventive measures taken by HCW whose FM remained asymptomatic. However, we noted that HCW whose FM remained symptom-free were more likely to sleep in a separate room (17% vs. 7%), refrain from physical contact with FM (22% vs.14%) and intimate contact with partners (22% vs. 11%). Over 88% reported increased stress level, many identifying health concerns and safety (26%) and impact on FM (28%) as the greatest source of stress. There was no difference in reported stress level between HCW whose FM became infected and those who were not. HCW with symptom-free FM were more concerned about transmission to their partner (p = 0.02). Table 1 Table 2 Conclusion This is the first survey of its kind which, although limited by total respondents, indicates that HCW are taking a variety of approaches to prevent transmission of SARS-CoV-2 to their FM. We did not find a significant impact of individual preventive measures on the risk of transmission. Regardless of the FM illness, most HCW have increased stress due to impact of COVID. Disclosures All Authors: No reported disclosures

scholarly journals Safer primary healthcare facilities are needed to protect healthcare workers and maintain essential services: lessons learned from a multicountry COVID-19 emergency response initiative

2021 ◽  
Vol 6 (6) ◽  
pp. e005833
Author(s):  
Leena N Patel ◽  
Samantha Kozikott ◽  
Rodrigue Ilboudo ◽  
Moreen Kamateeka ◽  
Mohammed Lamorde ◽  
...  
Keyword(s):  
Health Facility ◽  
Healthcare Workers ◽  
National Level ◽  
Lessons Learned ◽  
Health Facilities ◽  
Infection Prevention And Control ◽  
Health Facility Level ◽  
Ensure Patient Safety ◽  
Increased Risk ◽  
Facility Level

Healthcare workers (HCWs) are at increased risk of infection from SARS-CoV-2 and other disease pathogens, which take a disproportionate toll on HCWs, with substantial cost to health systems. Improved infection prevention and control (IPC) programmes can protect HCWs, especially in resource-limited settings where the health workforce is scarcest, and ensure patient safety and continuity of essential health services. In response to the COVID-19 pandemic, we collaborated with ministries of health and development partners to implement an emergency initiative for HCWs at the primary health facility level in 22 African countries. Between April 2020 and January 2021, the initiative trained 42 058 front-line HCWs from 8444 health facilities, supported longitudinal supervision and monitoring visits guided by a standardised monitoring tool, and provided resources including personal protective equipment (PPE). We documented significant short-term improvements in IPC performance, but gaps remain. Suspected HCW infections peaked at 41.5% among HCWs screened at monitored facilities in July 2020 during the first wave of the pandemic in Africa. Disease-specific emergency responses are not the optimal approach. Comprehensive, sustainable IPC programmes are needed. IPC needs to be incorporated into all HCW training programmes and combined with supportive supervision and mentorship. Strengthened data systems on IPC are needed to guide improvements at the health facility level and to inform policy development at the national level, along with investments in infrastructure and sustainable supplies of PPE. Multimodal strategies to improve IPC are critical to make health facilities safer and to protect HCWs and the communities they serve.

scholarly journals Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol

2021 ◽  
Vol 18 (1) ◽  
pp. 323
Author(s):  
Oladele Vincent Adeniyi ◽  
David Stead ◽  
Mandisa Singata-Madliki ◽  
Joanne Batting ◽  
Leo Hyera ◽  
...  
Keyword(s):  
Cohort Study ◽  
Infection Rate ◽  
Healthcare Workers ◽  
Health Facilities ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Eastern Cape ◽  
Rt Pcr ◽  
Cross Sectional ◽  
Increased Risk

Healthcare workers (HCWs) are at increased risk of infection by the virulent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Though data exist on the positivity rate of the SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test as well as COVID-19-related deaths amongst HCWs in South Africa, the overall infection rate remains underestimated by these indicators. It is also unclear whether the humoral immune response after SARS-CoV-2 infection offers durable protection against reinfection. This study will assess the SARS-CoV-2 seroprevalence amongst HCWs in the Eastern Cape (EC) and examine the longitudinal changes (rate of decay) in the antibody levels after infection in this cohort. Using a multi-stage cluster sampling of healthcare workers in selected health facilities in the EC, a cross-sectional study of 2250 participants will be recruited. In order to assess the community infection rate, 750 antenatal women in the same settings will be recruited. Relevant demographic and clinical characteristics will be obtained by a self-administered questionnaire. A chemiluminescent microparticle immunoassay (CMIA) will be used for the qualitative detection of IgG antibodies against SARS-CoV-2 nucleocapsid protein. A nested cohort study will be conducted by performing eight-weekly antibody assays (X2) from 201 participants who tested positive for both SARS-CoV-2 RT-PCR and serology. Logistic regression models will be fitted to identify the independent risk factors for SARS-CoV-2 infection. The cumulative SARS-CoV-2 infection rate and infection fatality rate among the frontline HCWs will be estimated. In addition, the study will highlight the overall effectiveness of infection prevention and control measures (IPC) per exposure sites/wards at the selected health facilities. Findings will inform the South African Department of Health’s policies on how to protect HCWs better as the country prepares for the second wave of the SARS-CoV pandemic.

scholarly journals Management of clozapine treatment during the COVID-19 pandemic

2020 ◽  
Vol 10 ◽  
pp. 204512532092816 ◽  
Author(s):  
Siobhan Gee ◽  
Fiona Gaughran ◽  
James MacCabe ◽  
Sukhi Shergill ◽  
Eromona Whiskey ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Signs And Symptoms ◽  
Physical Contact ◽  
Full Blood Count ◽  
Risk Of Infection ◽  
Clozapine Treatment ◽  
Neutropenic Sepsis ◽  
Blood Assay ◽  
Blood Monitoring ◽  
Increased Risk

Clozapine is the only available treatment for refractory schizophrenia but its use involves frequent physical contact with healthcare workers for the purpose of mandatory blood monitoring. During the COVID-19 pandemic, patients taking clozapine will be self-isolating to reduce the risk of infection, not least because these patients are at high risk of serious illness and fatality because of high rates of diabetes, obesity and pulmonary disease and an increased risk of pneumonia. Problems may also arise because both clozapine-induced myocarditis and neutropenic sepsis share signs and symptoms with COVID-19 (fever, chest pain, dyspnoea, etc.). We recommend decreasing the frequency of physical contacts by extending the blood monitoring interval to 12 weeks in those patients taking clozapine for more than 1 year. To distinguish COVID-19 from clozapine-related physical adverse effects, we suggest an urgent antigen test alongside a full blood count. In those taking clozapine who develop COVID-19, we suggest continuing with clozapine whenever possible (even during ventilation), reducing the dose if necessary in line with blood assay results. Blood monitoring should continue but clozapine should only cease if there is a significant fall in neutrophils (COVID-19 is linked to lymphopenia but not neutropenia). To protect against the likelihood and severity of respiratory infection, we recommend the use of vitamin D in all clozapine patients. Initiation of clozapine is likely to remain problematic while the risk of infection remains, given the degree of physical contact required to assure safety.

scholarly journals Self-reported COVID-19 among physicians: An Egyptian online study during the pandemic

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 785
Author(s):  
Hala Samir Abou-ElWafa ◽  
Abdel-Hady El-Gilany ◽  
Ahmed A. Albadry
Keyword(s):  
Healthcare Workers ◽  
Preventive Measures ◽  
Risk Of Infection ◽  
Vulnerable Group ◽  
Factors Associated ◽  
Online Study ◽  
Increased Risk ◽  
Laboratory Investigations ◽  
Survey Monkey ◽  
Frontline Healthcare Workers

Abstract:  Background: COVID-19 causes a critical occupational risk to frontline healthcare workers (HCWs) who respond to the pandemic, as they are placed in environments with an increased risk of infection exposure. It is a public health priority to understand how transmission occurs to protect this vulnerable group of HCWs. This study was conducted to estimate the incidence of self-reported COVID-19 infection among physicians and its possible associated factors. Methods: An online national survey using Survey Monkey was initiated to collect sociodemographic e.g. age and sex, occupational e.g. place and duration of work, and clinical data e.g. COVID symptoms and laboratory investigations, and to describe affected physicians' diagnoses. Results: The self-reported incidence of COVID-19 infection was found to be 65.4% among studied physicians. The significant independent predictors of COVID-19 infection were  smoking, working as a frontline physician, having contact with a COVID-19 case, and working for less than ten years [ARR (95% CI): 3.0(1.6-5.7), 2.3(1.4-3.8), 2.1(1.2-3.6), and 1.8(1.2-2.9); respectively]. Conclusions: The incidence of COVID-19 infection among Egyptian physicians is relatively high. Smoking, being a frontline physician, having contact with a COVID-19 case, and working for less than 10 years are all factors associated with an increased risk of infection. There should be strict application of preventive measures, periodic screening for COVID-19 for early detection and isolation of infected HCWs together with effective vaccination.

scholarly journals Performance Evaluation: Four Chemiluminescent SARS-Cov-2 Immunoassays and Rapid-Card Test in Mild Disease and Seroprevalence of SARS CoV-2 in Frontline Healthcare Workers

2021 ◽  
pp. 9-22
Author(s):  
Rasika Setia ◽  
Mitu Dogra ◽  
Anil Handoo ◽  
Gokhula Prasath Thangavel ◽  
Ramesh Yadav ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Modern Medicine ◽  
Clinical Diagnostics ◽  
Clinical Samples ◽  
New Delhi ◽  
Mild Disease ◽  
Increased Risk ◽  
Sample Testing ◽  
And Performance ◽  
Ortho Clinical Diagnostics

Introduction: The COVID-19 pandemic raised a host of challenges to modern medicine. Key amongst these were in diagnostics, as most SARS-CoV-2 assays had been rapidly developed and released under emergency-use authorization with limited validation on clinical samples and secondly, an increased risk of COVID-19 infection to healthcare workers (HCW). There are limited inter-assay comparisons to detect SARS-CoV-2 antibodies in cases with milder symptoms of COVID-19, necessary to evaluate whether assays can detect SARS-CoV-2 antibodies in patients with mild infection.  Aim: Therefore this study aimed to evaluate the performance of four chemiluminescence immunoassays and a rapid immunochromatographic assay in 100 rRT-PCR diagnosed-recovered frontline HCW with milder COVID-19 disease and secondly to evaluate the seroprevalence of SARS-CoV-2 infection in the asymptomatic frontline HCW at a multispeciality hospital in Delhi, India. Study Design: Serum and plasma samples were obtained from 100 rRT-PCR diagnosed-recovered frontline HCWs with mild disease working across the hospital, and performance of four common chemiluminescence immunoassays evaluated. Also samples of 505 asymptomatic, frontline HCWs working in hospital, who had not developed or shown any symptoms of COVID-19 infection to date was collected and the seroprevalence of infection was evaluated. Place and Duration of the Study: A study was conducted at BLK Superspeciality Hospital, New Delhi from September to October 2020. Methods: Four chemiluminescence immunoassays [Abbott SARS-CoV-2 IgG (Nucleocapsid), Roche Elecsys® Anti-SARS-CoV-2 Total (Nucleocapsid), Ortho-Clinical Diagnostics: VITROS Anti-SARS-CoV-2 IgG (Spike) and Anti-SARS-CoV-2 Total (Spike)] and a rapid assay [Medsource Ozone Biomedicals] were evaluated in 100 rRT-PCR diagnosed-recovered frontline HCW with mild disease. Also, seroprevalence was studied in 505 asymptomatic, frontline HCW.  Results: At manufacturers' thresholds, overall sensitivity for Abbott was 71%, Roche 96%, Ortho (both total and IgG(S) 99% and rapid card 56%. Seroprevalence in asymptomatic frontline HCW was found to be 17.6%, with positivity being higher in the HCW group not facing patients directly compared to direct patient caregivers (P = 0.0034). Conclusion: Assay performance depends on assay design (total IgM & IgG antibodies versus IgG alone), choice of antigen, and time of sample testing from the onset of disease. In our study, Ortho Vitros total-Ab; IgG (Spike), and Roche Elecsys total-Ab (Nucleocapsid) assays were found to have optimal sensitivity. A seroprevalence study in the frontline HCWs at our institute showed that seroprevalence was higher (17.6%) in HCWs in comparison to the community.

scholarly journals Scabies outbreak among healthcare workers in a German acute care hospital

2017 ◽  
Vol 18 (4) ◽  
pp. 189-192 ◽  
Author(s):  
Rasmus Leistner ◽  
Dirk Buchwald ◽  
Marc Beyer ◽  
Sandra Philipp
Keyword(s):  
Acute Care ◽  
Healthcare Workers ◽  
Multivariable Analysis ◽  
Acute Care Hospital ◽  
Index Patient ◽  
Physical Contact ◽  
P Value ◽  
Care Hospital ◽  
Increased Risk ◽  
Crusted Scabies

Background: This article reports on a scabies outbreak among healthcare workers (HCW) in an acute care hospital. The outbreak was associated with a patient suffering from a chronic skin disease that was later diagnosed as crusted scabies. Objective: The objective was to determine the outbreak drivers and define a prevention strategy against future outbreaks. Methods: All staff that had contact with the patient were treated with 5% permethrin ointment. An interdisciplinary outbreak investigation team was established. The team conducted a questionnaire-based case-control study. Findings: After the permethrin treatment, no further case was found. Twenty-seven HCWs who had contact with the index patient answered the questionnaire (response rate 73%). The outbreak questionnaire revealed 13 cases of secondary scabies among HCWs. In the multivariable analysis, a lack of glove use (odds ratio [OR], 9.8; P value = 0.036) and frequent close physical contact (OR, 8.151; P value = 0.038) were associated with increased risk of scabies acquisition. Discussion: The scabies outbreak was most likely driven by three factors: an index patient with crusted scabies; a delayed diagnosis of this patient; and close physical contact without gloves during his hospital stay. The use of disposable gloves for patients with unclear dermatological diagnosis have the potential to limit future scabies outbreaks.

scholarly journals National COVID-19 Hospital Admissions and Mortality among Healthcare Workers in South Africa, 2020-2021

2021 ◽  
Author(s):  
Nonhlanhla Tlotleng ◽  
Waasila Jassat ◽  
Cheryl Cohen ◽  
Felix Made ◽  
Tahira Kootbodien ◽  
...  
Keyword(s):  
South Africa ◽  
Hospital Mortality ◽  
Healthcare Workers ◽  
Hospital Admissions ◽  
Kidney Diseases ◽  
Public Hospitals ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Factors Associated ◽  
Increased Risk

Abstract Background: Healthcare workers (HCWs) in close contact with SARS-CoV-2-infected patients have an increased risk of infection compared to non-HCWs, but little is known about the clinical course and risks for mortality amongst HCWs in South Africa. In this study, we compared characteristics of hospitalised HCWs with non-HCWs with COVID-19 and assessed factors associated with COVID-19 mortality among HCWs.Methods: Data from 5 March 2020 to 30 April 2021 was obtained from DATCOV, the national surveillance programme monitoring COVID-19 admissions in private and public hospitals across South Africa. A logistic regression model was used to determine factors associated with COVID-19 HCW admissions and mortality. Results: There were a total 169,678 confirmed COVID-19 admissions reported on DATCOV, of which 6,364 (3.8%) were HCWs. Compared to non-HCWs, HCWs were less likely to be male [aOR 0.3, 95%CI (0.3-0.4)], and more likely to be younger, white or other race, have pre-existing obesity and asthma, and be admitted in the private sector, in Eastern Cape, Gauteng, Kwa-Zulu Natal, Limpopo, Northern Cape and North West provinces. Pre-wave 1 [aOR 3.0; 95%CI 2.4-3.7)], wave 1 [aOR 2.1; 95%CI (1.8-2.5)] and post-wave 1 [aOR 1.3; 95%CI (1.0-1.7)] were associated with increase in HCW admissions compared to wave 2. There was an increased risk for in-hospital mortality among HCWs in the older age group (40-49 [aOR 3.8; 95%CI (1.6-8.80)]; 50-59 [aOR 4.7; 95%CI (2.0-10.9)] and 60-65 years [aOR 9.8; 95%CI (4.2-23.0)] compared to HCWs less than 40 years, with comorbidities such as hypertension, diabetes, chronic kidney diseases, malignancy and TB. Mortality was decreased for HCWs who were coloured [aOR 0.5; 95%CI (0.3-0.8)], admitted in the public sector [aOR 0.7; 95%CI (0.5-0.9)] in pre-wave 1 [aOR 0.6; 95%CI (0.3-0.9)] compared to wave one period. Conclusion: In-hospital mortality in HCWs was associated with age, race, wave period, presence of comorbidites and sector. Policies should be put in place to remove older HCWs with comorbidities from direct patient care. Optimal management of comorbid conditions is advised and improvement of infection prevention and control measures in healthcare settings for those that come into direct contact with infected patients.

scholarly journals National COVID-19 Hospital Admissions and Mortality Among Healthcare Workers in South Africa, 2020-2021

2021 ◽  
Author(s):  
Nonhlanhla Tlotleng ◽  
Waasila Jassat ◽  
Cheryl Cohen ◽  
Felix Made ◽  
Tahira Kootbodien ◽  
...  
Keyword(s):  
South Africa ◽  
Hospital Mortality ◽  
Healthcare Workers ◽  
Hospital Admissions ◽  
Kidney Diseases ◽  
Public Hospitals ◽  
Control Measures ◽  
Infection Prevention And Control ◽  
Factors Associated ◽  
Increased Risk

Abstract Background: Healthcare workers (HCWs) in close contact with SARS-CoV-2-infected patients have an increased risk of infection compared to non-HCWs, but little is known about the clinical course and risks for mortality amongst HCWs in South Africa. In this study, we compared characteristics of hospitalised HCWs with non-HCWs with COVID-19 and assessed factors associated with COVID-19 mortality among HCWs. Methods: Data from 5 March 2020 to 30 April 2021 was obtained from DATCOV, the national surveillance programme monitoring COVID-19 admissions in private and public hospitals across South Africa. A logistic regression model was used to determine factors associated with COVID-19 HCW admissions and mortality.Results: There were a total 169,678 confirmed COVID-19 admissions reported on DATCOV, of which 6,364 (3.8%) were HCWs. Compared to non-HCWs, HCWs were less likely to be male [aOR 0.3, 95%CI (0.3-0.4)], and more likely to be younger, white or other race, have pre-existing obesity and asthma, and be admitted in the private sector, in Eastern Cape, Gauteng, Kwa-Zulu Natal, Limpopo, Northern Cape and North West provinces. Pre-wave 1 [aOR 3.0; 95%CI 2.4-3.7)], wave 1 [aOR 2.1; 95%CI (1.8-2.5)] and post-wave 1 [aOR 1.3; 95%CI (1.0-1.7)] were associated with increase in HCW admissions compared to wave 2. There was an increased risk for in-hospital mortality among HCWs in the older age group (40-49 [aOR 3.8; 95%CI (1.6-8.80)]; 50-59 [aOR 4.7; 95%CI (2.0-10.9)] and 60-65 years [aOR 9.8; 95%CI (4.2-23.0)] compared to HCWs less than 40 years, with comorbidities such as hypertension, diabetes, chronic kidney diseases, malignancy and TB. Mortality was decreased for HCWs who were coloured [aOR 0.5; 95%CI (0.3-0.8)], admitted in the public sector [aOR 0.7; 95%CI (0.5-0.9)] in pre-wave 1 [aOR 0.6; 95%CI (0.3-0.9)] compared to wave one period. Conclusion: In-hospital mortality in HCWs was associated with age, race, wave period, presence of comorbidites and sector. Policies should be put in place to remove older HCWs with comorbidities from direct patient care. Optimal management of comorbid conditions is advised and improvement of infection prevention and control measures in healthcare settings for those that come into direct contact with infected patients.

COVID-19 seroprevalence in primary and secondary healthcare workers (HCWs)

2021 ◽  
Author(s):  
Gregory P. Murphy ◽  
Catherine Garry ◽  
Susan Van Baarsel ◽  
Tina Coleman ◽  
Ben Shovlin ◽  
...  
Keyword(s):  
Primary Care ◽  
Secondary Care ◽  
Healthcare Workers ◽  
Contact Tracing ◽  
Infection Prevention And Control ◽  
Detectable Antibody ◽  
Increased Risk ◽  
Seroprevalence Data ◽  
Observational Cohort ◽  
And Control

Professional anxiety existed early in the coronavirus disease 2019 (COVID-19) pandemic with challenging infection prevention and control support. The aims of this study were to compare epidemiological features of healthcare workers (HCWs) within primary and secondary care with their serological evidence of infection. A prospective observational cohort of 1,916 HCWs completed a questionnaire, and their sera were assayed for detectable antibody to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleoprotein in the first wave of the pandemic. Datasets were compared between the two sub-cohorts in primary and secondary care and between the combined seropositive and seronegative cohorts. Curiosity of antibody status was high. Detectable antibody was 7% in the primary care and 5% in the secondary care workers at a time of 1.7% in the general community. Inappropriate personal protective equipment (PPE) was more common in primary care, and detectable antibody was twice as prevalent in HCWs who felt they did not have appropriate PPE. Contact tracing was perceived to be inadequate although it was more commonly performed in the seropositive cohort suggesting appropriate prioritisation. Both temperature and symptom checking alerts and work exclusion were significantly more prevalent in the seropositive cohort. The seroprevalence data support increased risk for HCWs, the importance of appropriate PPE and the usefulness of the daily temperature and symptom checks, particularly in primary care.

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