scholarly journals High-risk exposure without personal protective equipment and infection with SARS-CoV-2 in healthcare workers: results of the CoV-CONTACT prospective cohort

2020 ◽  
Author(s):  
Sarah Tubiana ◽  
Charles Burdet ◽  
Nadhira Houhou ◽  
Michael Thy ◽  
Pauline Manchon ◽  
...  
Keyword(s):  
High Risk ◽  
Personal Protective Equipment ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Risk Exposure ◽  
Protective Equipment ◽  
Risk Of Infection ◽  
Rt Pcr ◽  
Specific Symptom ◽  
Increased Risk

Objective: We aimed to estimate the risk of infection in Healthcare workers (HCWs) following a high-risk exposure without personal protective equipment (PPE). Methods: We conducted a prospective cohort in HCWs who had a high-risk exposure to SARS-CoV-2-infected subject without PPE. Daily symptoms were self-reported for 30 days, nasopharyngeal swabs for SARS-CoV-2 RT-PCR were performed at inclusion and at days 3, 5, 7 and 12, SARS-CoV-2 serology was assessed at inclusion and at day 30. Confirmed infection was defined by positive RT-PCR or seroconversion, and possible infection by one general and one specific symptom for two consecutive days. Results: Between February 5th and May 30th, 2020, 154 HCWs were enrolled within 14 days following one high-risk exposure to either a hospital patient (70/154; 46.1%) and/or a colleague (95/154; 62.5%). At day 30, 25.0% had a confirmed infection (37/148; 95%CI, 18.4%; 32.9%), and 43.9% (65/148; 95%CI, 35.9%; 52.3%) had a confirmed or possible infection. Factors independently associated with confirmed or possible SARS-CoV-2 infection were being a pharmacist or administrative assistant rather than being from medical staff (adjusted OR (aOR)=3.8, CI95%=1.3;11.2, p=0.01), and exposure to a SARS-CoV-2-infected patient rather than exposure to a SARS-CoV-2-infected colleague (aOR=2.6, CI95%=1.2;5.9, p=0.02). Among the 26 HCWs with a SARS-CoV-2-positive nasopharyngeal swab, 7 (26.9%) had no symptom at the time of the RT-PCR positivity. Conclusions: The proportion of HCWs with confirmed or possible SARS-CoV-2 infection was high. There were less occurrences of high-risk exposure with patients than with colleagues, but those were associated with an increased risk of infection.

scholarly journals Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study

2020 ◽  
Author(s):  
Long H. Nguyen ◽  
David A. Drew ◽  
Amit D. Joshi ◽  
Chuan-Guo Guo ◽  
Wenjie Ma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Personal Protective Equipment ◽  
Prospective Cohort ◽  
Healthcare Workers ◽  
Positive Test ◽  
Protective Equipment ◽  
Increased Risk ◽  
Frontline Healthcare Workers ◽  
General Community

BackgroundData for frontline healthcare workers (HCWs) and risk of SARS-CoV-2 infection are limited and whether personal protective equipment (PPE) mitigates this risk is unknown. We evaluated risk for COVID-19 among frontline HCWs compared to the general community and the influence of PPE.MethodsWe performed a prospective cohort study of the general community, including frontline HCWs, who reported information through the COVID Symptom Study smartphone application beginning on March 24 (United Kingdom, U.K.) and March 29 (United States, U.S.) through April 23, 2020. We used Cox proportional hazards modeling to estimate multivariate-adjusted hazard ratios (aHRs) of a positive COVID-19 test.FindingsAmong 2,035,395 community individuals and 99,795 frontline HCWs, we documented 5,545 incident reports of a positive COVID-19 test over 34,435,272 person-days. Compared with the general community, frontline HCWs had an aHR of 11·6 (95% CI: 10·9 to 12·3) for reporting a positive test. The corresponding aHR was 3·40 (95% CI: 3·37 to 3·43) using an inverse probability weighted Cox model adjusting for the likelihood of receiving a test. A symptom-based classifier of predicted COVID-19 yielded similar risk estimates. Compared with HCWs reporting adequate PPE, the aHRs for reporting a positive test were 1·46 (95% CI: 1·21 to 1·76) for those reporting PPE reuse and 1·31 (95% CI: 1·10 to 1·56) for reporting inadequate PPE. Compared with HCWs reporting adequate PPE who did not care for COVID-19 patients, HCWs caring for patients with documented COVID-19 had aHRs for a positive test of 4·83 (95% CI: 3·99 to 5·85) if they had adequate PPE, 5·06 (95% CI: 3·90 to 6·57) for reused PPE, and 5·91 (95% CI: 4·53 to 7·71) for inadequate PPE.InterpretationFrontline HCWs had a significantly increased risk of COVID-19 infection, highest among HCWs who reused PPE or had inadequate access to PPE. However, adequate supplies of PPE did not completely mitigate high-risk exposures.FundingZoe Global Ltd., Wellcome Trust, EPSRC, NIHR, UK Research and Innovation, Alzheimer’s Society, NIH, NIOSH, Massachusetts Consortium on Pathogen ReadinessRESEARCH IN CONTEXTEvidence before this studyThe prolonged course of the coronavirus disease 2019 (COVID-19) pandemic, coupled with sustained challenges supplying adequate personal protective equipment (PPE) for frontline healthcare workers (HCW), have strained global healthcare systems in an unprecedented fashion. Despite growing awareness of this problem, there are few data to inform policy makers on the risk of COVID-19 among HCWs and the impact of PPE on their disease burden. Prior reports of HCW infections are based on cross sectional data with limited individual-level information on risk factors for infection. A PubMed search for articles published between January 1, 2020 and May 5, 2020 using the terms “covid-19”, “healthcare workers”, and “personal protective equipment,” yielded no population-scale investigations exploring this topic.Added value of this studyIn a prospective study of 2,135,190 individuals, frontline HCWs may have up to a 12-fold increased risk of reporting a positive COVID-19 test. Compared with those who reported adequate availability of PPE, frontline HCWs with inadequate PPE had a 31% increase in risk. However, adequate availability of PPE did not completely reduce risk among HCWs caring for COVID-19 patients.Implications of all the available evidenceBeyond ensuring adequate availability of PPE, additional efforts to protect HCWs from COVID-19 are needed, particularly as lockdown is lifted in many regions of the world.

scholarly journals Seroprevalence of the SARS-CoV-2 antibody in healthcare workers: a multicentre cross-sectional study in 10 Colombian cities

2021 ◽  
pp. oemed-2021-107487
Author(s):  
Jeadran Nevardo Malagón-Rojas ◽  
Marcela Mercado-Reyes ◽  
Yezith G Toloza-Pérez ◽  
Eliana L Parra Barrera ◽  
Marien Palma ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Strong Association ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Risk Of Infection ◽  
Sectional Study ◽  
Cross Sectional ◽  
Increased Risk ◽  
Significant Difference ◽  
Automated Immunoassay

BackgroundHealthcare workers are at increased risk of infection due to occupational exposure to SARS-CoV-2-infected patients. The objective of this study was to determine the seroprevalence of SARS-CoV-2 in healthcare workers in Colombia.MethodsThis study is a cross-sectional study focused on estimating the seroprevalence of SARS-CoV-2 antibodies in healthcare workers from 65 hospitals in 10 cities in Colombia during the second semester of 2020. The seroprevalence was determined using an automated immunoassay (Abbott SARS-CoV-2 CLIA IgG). The study included a survey to establish the sociodemographic variables and the risk of infection. A multivariate model was used to evaluate the association between the results of seroprevalence and risk factors.ResultsThe global seroprevalence of antibodies against SARS-CoV-2 was 35% (95% Bayesian CI 33% to 37%). All the personnel reported the use of protective equipment. General services personnel and nurses presented the highest ratios of seroprevalence among the healthcare workers. Low socioeconomic strata have shown a strong association with seropositivity.ConclusionThis study estimates the prevalence of SARS-CoV-2 infection among healthcare workers. Even though all the personnel reported the use of protective equipment, the seroprevalence in the general services personnel and nurses was high. Also, a significant difference by cities was observed.

scholarly journals 824 UK CoPACK Study: Health Care Workers Knowledge and Confidence in Using Personal Protective Equipment (PPE) And Related Anxiety Levels During The COVID-19 Pandemic

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Ismael ◽  
G Manoharan ◽  
K Al-Kaisi ◽  
A George ◽  
S Abas ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Risk Of Infection ◽  
Confidence Levels ◽  
Validated Questionnaire ◽  
Care Workers ◽  
Increased Risk ◽  
National Guidance ◽  
Psychometric Tool ◽  
Anxiety Levels

Abstract Aim The COVID-19 pandemic has resulted in significant pressures on the NHS. Healthcare workers (HCWs) are at increased risk of infection. Personal protective equipment (PPE) lowers the risk of infection transmission. However, during the early phases of the pandemic, the information available regarding COVD-19 and the use of PPE has been unclear, with constantly changing guidelines. The aim of this study was to determine the knowledge and confidence about PPE usage among HCWs, in addition to measuring their anxiety levels during the COVID pandemic. Method A validated questionnaire was distributed among HCWs in as many UK hospitals as possible, during April 2020. The questionnaire consisted of 13 questions regarding demographics, knowledge on PPE guidance, HCW training and confidence levels in PPE usage and finally anxiety levels measured using the GAD-7 psychometric tool. Results 1055 responses were received. Nurses (49%), Healthcare Assistants (HCA - 20%), Doctors (17%), Physios (8%) and other (6%). 99% of respondents indicated they were familiar with PPE guidance, but only 1.6% answered all 3 questions on PPE guidance accurately. 86.4% of respondents received mask-fitting checks. 79.7% received donning-doffing training. Despite this, only 46.8% were confident on their familiarity with PPE. 32.5% felt that their hospital communication regarding PPE policy during COVID-19 pandemic was poor or very poor. 30% HCWs experienced severe anxiety. Conclusions National guidance and local training on PPE usage during the COVID-19 pandemic has been unsatisfactory, leading to higher anxiety among HCWs. Improved information delivery and training are essential in preparation for the second wave and future pandemics.

scholarly journals Health Care Acquired COVID-19 is Less Symptomatic than Community Acquired Disease Among Healthcare Workers

2021 ◽  
pp. 1-28
Author(s):  
Jeffrey J Fletcher ◽  
Eric C Feucht ◽  
Peter Y Hahn ◽  
Theresa N McGoff ◽  
Del J Dehart ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Healthcare System ◽  
Healthcare Workers ◽  
Risk Exposure ◽  
Work Exposure ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
Low Exposure ◽  
Asymptomatic Disease

ABSTRACT Objective: We hypothesized healthcare workers (HCW) with high-risk exposures outside the healthcare system would have less asymptomatic coronavirus 2019 (COVID-19) disease and more symptoms than those without such exposures. Design: A longitudinal point prevalence study during August 17- September 4 2020 and December 2nd - 23rd. Setting: Community based teaching health system Participants: All HCS were invited to participate. Among HCW who acquired COVID-19, logistic regression models were used to evaluate the adjusted odds of asymptomatic disease using high-risk exposure outside the healthcare system as the explanatory variable. The number of symptoms between exposure groups was evaluated with the Wilcoxon rank-sum test. The risk of seropositivity among all HCS by work exposure was evaluated during both periods. Interventions: Survey and serological testing Result: Seroprevalence increased from 1.9% (95% CI 1.2% - 2.6%) to 13.7% (95% CI 11.9% - 15.5%) during the study. Only during Period 2 did HCW with the highest work exposure (versus low exposure) have an increased risk of seropositivity (RD 7% [95% CI 1% -13%]). Participants who had a high-risk exposure outside of work (compared to those without) had a decreased probability of asymptomatic disease (OR 0.38 [95% CI 0.16 – 0.86]) and demonstrated more symptoms (median of 3 [IQR 5] vs 1 [IQR 2]; P = 0.001). Conclusions Health care acquired COVID-19 increases the probability of asymptomatic or mild COVID-19 disease compared to community acquired disease. This suggests infection prevention strategies (including masks and eye protection) may be mitigating inoculum and supports the variolation theory in COVID-19.

Wound care during the COVID-19 pandemic: improving outcomes through the integration of telemedicine

2021 ◽  
Vol 30 (Sup2) ◽  
pp. S12-S17
Author(s):  
Alisha Oropallo ◽  
John Lantis ◽  
Alexander Martin ◽  
Ammar Al Rubaiay ◽  
Na Wang
Keyword(s):  
High Risk ◽  
Healthcare System ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Wound Care ◽  
Protective Equipment ◽  
Medical Resources ◽  
Social Distancing ◽  
Vulnerable Patients ◽  
Rapid Spread

COVID-19 is highly contagious and its rapid spread burdens the healthcare system. As the number of confirmed cases goes up, the shortage of medical resources has become a challenge. To avoid the collapse of the healthcare system during the fight with COVID-19, all healthcare workers, including wound care practitioners, should adapt to new roles and use any appropriate methods available to slow the spread of the virus. Integrating telemedicine into wound care during the outbreak helps maintain social distancing, preserve personal protective equipment and medical resources, and eliminate unnecessary exposure for both vulnerable patients and high-risk healthcare workers.

scholarly journals Availability and use of personal protective equipment and satisfaction of healthcare professionals during COVID-19 pandemic in Addis Ababa, Ethiopia

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Wakgari Deressa ◽  
Alemayehu Worku ◽  
Workeabeba Abebe ◽  
Muluken Gizaw ◽  
Wondwossen Amogne
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Public Hospitals ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Healthcare Facilities ◽  
Increased Risk

Abstract Background Healthcare professionals (HCPs) are at the frontline in the fight against COVID-19 and are at an increased risk of becoming infected with coronavirus. Risk of infection can be minimized by use of proper personal protective equipment (PPE). The aim of this study was to assess the availability and use of PPE, and satisfaction of HCPs with PPE in six public hospitals in Addis Ababa, Ethiopia. Methods A cross-sectional study was conducted among 1134 HCPs in June 2020. A systematic random sampling and consecutive sampling techniques were used to select the study participants. Data were collected using a self-administered questionnaire. Descriptive statistics were used to describe the data and Chi-square test was used to assess the association between the groups. Bivariate and multivariable logistic regression models were used to assess factors associated with satisfaction of healthcare workers. Results The mean (±SD) age of the participants was 30.26 ± 6.43 year and 52.6% were females. Nurses constituted about 40% of the overall sample, followed by physicians (22.2%), interns (10.8%), midwives (10.3%) and others (16.7%). The majority (77%) of the HCPs reported that their hospital did not have adequate PPE. A critical shortage of N95 respirators was particularly reported, it only increased from 13 to 24% before and during COVID-19, respectively. The use of N95 increased from 9 to 21% before and during COVID-19, respectively. Almost 72% of the respondents were dissatisfied with the availability and use of PPE in their hospital. The independent predictors of the respondents’ satisfaction level about PPE were healthcare workers who reported that PPE was adequately available in the hospital (adjusted OR = 7.65, 95% CI:5.09–11.51), and preparedness to provide care to COVID-19 cases (adjusted OR = 2.07, 95% CI:1.42–3.03). Conclusions A critical shortage of appropriate PPE and high level of dissatisfaction with the availability and use of PPE were identified. Therefore, urgent efforts are needed to adequately supply the healthcare facilities with appropriate PPE to alleviate the challenges.

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