scholarly journals Quantification of occupational and community risk factors for SARS-CoV-2 seropositivity among healthcare workers in a large U.S. healthcare system

2020 ◽  
Author(s):  
Julia M. Baker ◽  
Kristin N. Nelson ◽  
Elizabeth Overton ◽  
Benjamin A. Lopman ◽  
Timothy L. Lash ◽  
...  
Keyword(s):  
Risk Factors ◽  
Healthcare Worker ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Occupational Risk Factors ◽  
Community Risk ◽  
Community Risk Factors ◽  
Zip Code ◽  
Pcr Test

AbstractBackgroundQuantifying occupational risk factors for SARS-CoV-2 infection among healthcare workers can inform efforts to improve healthcare worker and patient safety and reduce transmission. This study aimed to quantify demographic, occupational, and community risk factors for SARS-CoV-2 seropositivity among healthcare workers in a large metropolitan healthcare system.MethodsWe analyzed data from a cross-sectional survey conducted from April through June of 2020 linking risk factors for occupational and community exposure to COVID-19 with SARS-CoV-2 seropositivity. A multivariable logistic regression model was fit to quantify risk factors for infection. Participants were employees and medical staff members who elected to participate in SARS-CoV-2 serology testing offered to all healthcare workers as part of a quality initiative, and who completed a survey on exposure to COVID-19 and use of personal protective equipment. Exposures of interest included known demographic risk factors for COVID-19, residential zip code incidence of COVID-19, occupational exposure to PCR test-positive healthcare workers or patients, and use of personal protective equipment. The primary outcome of interest was SARS-CoV-2 seropositivity.ResultsSARS-CoV-2 seropositivity was estimated to be 5.7% (95% CI: 5.2%-6.1%) among 10,275 healthcare workers. Community contact with a person known or suspected to have COVID-19 (aOR=1.9, 95% CI:1.4-2.5) and zip code level COVID-19 incidence (aOR: 1.4, 95% CI: 1.0-2.0) increased the odds of infection. Black individuals were at high risk (aOR=2.0, 95% CI:1.6-2.4). Overall, occupational risk factors accounted for 27% (95% CI: 25%-30%) of the risk among healthcare workers and included contact with a PCR test-positive healthcare worker (aOR=1.2, 95% CI:1.0-1.6).ConclusionsCommunity risk factors, including contact with a COVID-19 positive individual and residential COVID-19 incidence, are more strongly associated with SARS-CoV-2 seropositivity among healthcare workers than exposure in the workplace.

scholarly journals Examining the cost-effectiveness of personal protective equipment for formal healthcare workers in Kenya during the COVID-19 pandemic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jacob Kazungu ◽  
Kenneth Munge ◽  
Kalin Werner ◽  
Nicholas Risko ◽  
Andres I. Vecino-Ortiz ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Incremental Cost ◽  
Healthcare Worker ◽  
Personal Protective Equipment ◽  
Return On Investment ◽  
Healthcare Workers ◽  
Health Economic Evaluation ◽  
Response Strategy ◽  
Decision Analytic Model ◽  
Protective Equipment

Abstract Background Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the incremental cost per healthcare worker death averted, and 2) the incremental cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results Kenya would need to invest $3.12 million (95% CI: 2.65–3.59) to adequately protect healthcare workers against COVID-19. This investment would avert 416 (IQR: 330–517) and 30,041 (IQR: 7243 – 102,480) healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a healthcare system ROI of $170.64 million (IQR: 138–209) – equivalent to an 11.04 times return. Conclusion Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

scholarly journals Examining the Cost-effectiveness of Personal Protective Equipment for Formal Healthcare Workers in Kenya during the COVID-19 Pandemic

2021 ◽  
Author(s):  
Jacob Kazungu ◽  
Kenneth Munge ◽  
Kalin Werner ◽  
Nicholas Risko ◽  
Andres Vecino Ortiz ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Healthcare Worker ◽  
Personal Protective Equipment ◽  
Return On Investment ◽  
Healthcare Workers ◽  
Health Economic Evaluation ◽  
Response Strategy ◽  
Decision Analytic Model ◽  
Protective Equipment ◽  
The Cost

Abstract Background: Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods: We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the cost per healthcare worker death averted, and 2) the cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results: Kenya would need to invest $3.12 million to adequately protect healthcare workers against COVID-19. This investment would avert 416 and 30,041 healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a societal ROI of $170.64 million – equivalent to an 11.04 times return. Conclusion: Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

scholarly journals Determining the source of transmission of SARS-CoV-2 infection in a healthcare worker

2020 ◽  
Author(s):  
Nasia Safdar ◽  
Gage K. Moreno ◽  
Katarina M. Braun ◽  
Thomas C. Friedrich ◽  
David H. O’Connor
Keyword(s):  
Infection Control ◽  
Healthcare Worker ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Total Population ◽  
Protective Equipment ◽  
Hospital Infection Control ◽  
Risk Of Exposure ◽  
N95 Respirators ◽  
Cumulative Prevalence

BackgroundHealthcare workers (HCWs) are at the frontlines of the COVID-19 pandemic and are at risk of exposure to SARS-CoV-2 infection from their interactions with patients and in the community (1, 2). Limited availability of recommended personal protective equipment (PPE), in particular N95 respirators, has fueled concerns about whether HCWs are adequately protected from exposure while caring for patients. Understanding the source of SARS-CoV-2 infection in a HCW – the community or the healthcare system – is critical for understanding the effectiveness of hospital infection control and PPE practices. In Dane County, Wisconsin, community prevalence of SARS-CoV-2 is relatively low (cumulative prevalence of ~0.06% – positive cases / total population in Dane county as of April 17). Although SARS-CoV-2 infections in HCWs are often presumed to be acquired during the course of patient care, there are few reports unambiguously identifying the source of acquisition.ObjectiveTo determine the source of transmission of SARS-CoV-2 in a healthcare worker.

scholarly journals Perioperative challenges in managing a patient with COVID-19 undergoing debridement for massive scalp myiasis

2021 ◽  
Vol 14 (2) ◽  
pp. e241189
Author(s):  
Shiu Yin Lo ◽  
Ming Kai Teah ◽  
Yan Zheng Ho ◽  
Tat Boon Yeap
Keyword(s):  
Real Time ◽  
Personal Protective Equipment ◽  
Real Time Pcr ◽  
Healthcare Workers ◽  
Patient Management ◽  
Cross Infection ◽  
Nasopharyngeal Swab ◽  
Protective Equipment ◽  
Test Result ◽  
Pcr Test

A young man presented to our centre needing an urgent debridement of his postcraniotomy wound due to massive myiasis during the COVID-19 pandemic in October 2020. Prior to the surgery, his nasopharyngeal swab real-time PCR test result was unknown. One day later, it returned as SARS-CoV-2 positive. All healthcare workers who were involved in the patient management avoided cross infection as they wore appropriate personal protective equipment. This article depicts the importance of adequate preparations when handling potentially infectious patients and the perioperative issues associated with it.

Risk factors for SARS-CoV-2 infection in health care workers and prevention measures

2021 ◽  
Vol 61 (1) ◽  
pp. 34-39
Author(s):  
Nadezhda I. Shulakova ◽  
Aleksey V. Tutelyan ◽  
Olga A. Kvasova ◽  
Vasiliy G. Akimkin ◽  
Alexander V. Konyukhov
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Health Care Workers ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Central Research ◽  
Prevention Measures ◽  
Frequent Contact ◽  
Care Workers

Introduction. Currently, the number of confirmed cases of COVID-19 among healthcare workers continues to increase both in Russia and in other countries. Due to their professional activities' specifics, medical workers - frequent contact with sick people are most at risk of contracting SARS-CoV-2. The study aims to research the risk factors for infection of medical workers with SARS-CoV-2 to prevent infection and the spread of COVID-19 in medical institutions, considering the use of personal protective equipment. Materials and methods. Specialists of the Central Research Institute of Epidemiology of Rospotrebnadzor conducted an anonymous questionnaire with the subsequent analysis of the results obtained to study and assess risk factors for infection of SARS-CoV-2 medical workers, their attitude to the use of personal protective equipment, non-specific prophylaxis. Results. The authors present a literature review on the problem of infection and morbidity of COVID-19 medical workers, who are known to be at high risk of infection due to frequent contact with the sick. We analyzed data that exposure to higher concentrations of the virus, especially from critically ill patients, can affect the disease's severity in health care workers. The authors conducted an anonymous survey to study the risk factors for infection of health care workers with SARS-CoV-2 and their attitude to the use of personal protective equipment. Based on the obtained data, identified the main ways of infection of medical staff, options of the disease, and their severity, and revealed that providers responsible for selecting and using PPE. Conclusion. Assessing potential risk factors for the spread of coronavirus infection among healthcare workers is essential to prevent healthcare workers' infection and the spread of COVID-19 in healthcare settings.

scholarly journals The Synergistic Effect of Time of Exposure, Distance and No Use of Personal Protective Equipment in the Determination of SARS-CoV-2 Infection: Results of a Contact Tracing Follow-Up Study in Healthcare Workers

2021 ◽  
Vol 18 (18) ◽  
pp. 9456
Author(s):  
Giuseppe La Torre ◽  
Mattia Marte ◽  
Carlo Maria Previte ◽  
Lavinia Camilla Barone ◽  
Filippo Picchioni ◽  
...  
Keyword(s):  
Risk Factors ◽  
Synergistic Effect ◽  
Personal Protective Equipment ◽  
Contact Time ◽  
Healthcare Workers ◽  
Cox Regression ◽  
Univariate Analysis ◽  
Protective Equipment ◽  
Rt Pcr

The aim of this study is to assess the effect of contact time, contact distance and the use of personal protective equipment on the determination of SARS-CoV-2 infection in healthcare workers (HCWs). This study consists of an analysis of data gathered for safety reasons at the Sapienza Teaching Hospital Policlinico Umberto I in Rome through the surveillance system that was put into place after the worsening of the COVID-19 pandemic. The studied subjects consist of HCWs who were put under health surveillance, i.e., all employees who were in contact with subjects who were confirmed to have tested positive for SARS-CoV-2. The HCWs under surveillance were monitored for a period encompassing ten days after the date of contact, during which they undertook nasopharyngeal swab tests analysed through RT-PCR (RealStar® SARS-CoV-2 Altona Diagnostic–Germany). Descriptive and univariate analyses have been undertaken, considering the following as risk factors: (a) no personal protective equipment use (PPE); (b) Distance < 1 m between the positive and contact persons; (c) contact time > 15′. Finally, a Cox regression and an analysis of the level of synergism between factors, as specified by Rothman, were carried out. We analysed data from 1273 HCWs. Of these HCWs, 799 (62.8%) were females, with a sample average age of 47.8 years. Thirty-nine (3.1%) tested positive during surveillance. The overall incidence rate was 0.4 per 100 person-days. Time elapsed from the last exposure and a positive RT-PCR result ranged from 2 to 17 days (mean = 7, median = 6 days). In the univariate analysis, a distance <1 m and a contact time > 15′ proved to be risk factors for the SARS-CoV-2 infection, with a hazard ratio (HR) of 2.62 (95% CI: 1.11–6.19) and 3.59 (95% IC: 1.57–8.21), respectively. The synergism analysis found the highest synergism between the “no PPE use” x “Contact time”. The synergy index S remains strongly positive also in the analysis of the factors “no PPE use” x “Distance” and “Time of contact” x “Distance”. This study confirms the absolute need to implement safety protocols during the pandemic and to use the correct PPE within health facilities in order to prevent SARS-CoV-2 infection. The analysis shows that among the factors considered (contact time and distance, no use of PPE), there is a strong synergistic effect.

The incidence of COVID-19 medical workers. The issues of biosafety and occupational risk factors

2021 ◽  
Vol 20 (2) ◽  
pp. 4-11
Author(s):  
T. A. Platonova ◽  
A. A. Golubkova ◽  
A. V. Tutelyan ◽  
S. S. Smirnova
Keyword(s):  
Risk Factors ◽  
Personal Protective Equipment ◽  
Work Experience ◽  
Health Workers ◽  
Clinical Manifestations ◽  
Occupational Risk ◽  
Protective Equipment ◽  
Online Questionnaire ◽  
Occupational Risk Factors ◽  
Coronavirus Infection

Relevance. During the pandemic of the new coronavirus infection (COVID-19), one of the most vulnerable and actively involved in the epidemic process categories of the population were medical workers. The study of the incidence of COVID-19 among medical workers, risk factors for infection and safety measures is an important area of research in modern conditions. The aim of the study is to assess the prevalence of COVID-19 among employees of medical organizations and occupational risk factors for infection in order to develop proposals for corrective measures. Materials and methods. To study the incidence of COVID-19 among employees of medical organizations, an anonymous online questionnaire developed by the authors was used, which was posted on the Google platform and distributed during the first wave of the pandemic among employees of medical organizations in several regions of the Russian Federation through corporate e-mail or specialized online resources adapted for health workers. The survey involved 1,872 medical workers of different genders, ages, positions and work experience. Results and discussion. Among the survey participants, 161 employees have already had a new coronavirus infection. In the majority (64.0%) of them, the disease occurred in the form of acute respiratory infection, in 28.6% - interstitial pneumonia, in 7.4% only the fact of isolation of the SARSCoV-2 antigen without clinical manifestations of infection was documented. The most affected contingents were secondary and junior medical personnel, mainly hospital staff. The likelihood of infection in the workplace was increased by factors such as providing care to patients with confirmed COVID-19, participating in procedures related to aerosol generation, working with biomaterials of patients with COVID-19, contact with surfaces in the environment of a COVID-19 patient, ignorance of infectious safety issues due to lack of instruction before admission to work. When assessing the efficiency of personal protective equipment (PPE) when they are used in the process, it was found that the highest value for the prevention of infection COVID-19 had a PPE for face protection, respiratory and eye, and hand hygiene. At the same time, many employees are faced with the problem of an insufficient number of protective equipment in the workplace. When assessing the availability of SARS-CoV-2 testing to employees, it was found that only 77.4% of survey participants had the opportunity to be tested for coronavirus infection in a timely manner. Conclusion. Thus, for more effective protection of employees of medical organizations, it is necessary to have a sufficient number of personal protective equipment, especially for the face, respiratory organs and vision, the availability of hygienic hand treatment during work, regular instruction on infectious safety, using interactive forms of training, and the organization of screening examinations of previously unvaccinated and unvaccinated employees.

scholarly journals Stress and Associated Factors among Frontline Healthcare Workers in the COVID-19 Epicenter of Da Nang City, Vietnam

2021 ◽  
Vol 18 (14) ◽  
pp. 7378
Author(s):  
Nhan Phuc Thanh Nguyen ◽  
Duong Dinh Le ◽  
Robert Colebunders ◽  
Joseph Nelson Siewe Fodjo ◽  
Trung Dinh Tran ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Stress Component ◽  
Multivariable Analysis ◽  
Working Hours ◽  
Health Facilities ◽  
Protective Equipment ◽  
Laboratory Workers ◽  
Frontline Healthcare Workers ◽  
Second Wave

Frontline healthcare workers (HCWs) involved in the COVID-19 response have a higher risk of experiencing psychosocial distress amidst the pandemic. Between July and September 2020, a second wave of the COVID-19 pandemic appeared in Vietnam with Da Nang city being the epicenter. During the outbreak, HCWs were quarantined within the health facilities in a bid to limit the spread of COVID-19 to their respective communities. Using the stress component of the 21-item Depression, Anxiety and Stress Scale (DASS-21), we assessed the level of stress among HCWs in Da Nang city. Between 30 August and 15 September 2020, 746 frontline HCWs were recruited to fill in an online structured questionnaire. Overall, 44.6% of participants experienced increased stress and 18.9% severe or extremely severe stress. In multivariable analysis, increased stress was associated with longer working hours (OR = 1.012; 95% CI: 1.004–1.019), working in health facilities providing COVID-19 treatment (OR = 1.58, 95% CI: 1.04–2.39), having direct contact with patients or their bio-samples (physicians, nurses and laboratory workers; OR = 1.42, 95% CI: 1.02–1.99), low confidence in the available personal protective equipment (OR = 0.846; 95% CI: 0.744–0.962) and low knowledge on COVID-19 prevention and treatment (OR = 0.853; 95% CI: 0.739–0.986). In conclusion, many frontline HCWs experienced increased stress during the COVID-19 outbreak in Da Nang city. Reducing working time, providing essential personal protective equipment and enhancing the knowledge on COVID-19 will help to reduce this stress. Moreover, extra support is needed for HCWs who are directly exposed to COVID-19 patients.

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