scholarly journals COVID transmission and contact tracing using WHO risk assement tool among frontline healthcare workers : Insights from a South Indian tertiary care centre

2021 ◽  
Author(s):  
Merlin Moni ◽  
Kiran G Kulirankal ◽  
Preetha Prasanna ◽  
Ann Mary ◽  
Elizabeth Mary Thomas ◽  
...  
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Low Risk ◽  
Contact Tracing ◽  
Tertiary Care Centre ◽  
South Indian ◽  
Shared Space ◽  
Frontline Healthcare Workers

AbstractBackgroundThe high exposure risk to COVID among frontline heathcare workers was a major challenge to healthcare systems across the globe that warranted close monitoring through risk assessment and contact tracing strategies. The objective of our study was to characterize exposure risk factors for transmission and subsequent COVID positivity among the frontlinehealthcare workers in our institution during the pandemic period.MethodsThe retrospective observational study conducted over a period of 6 months from June 2020 to November 2020 at a 1300-bedded South Indian tertiary care centre included frontline healthcare workers who were assessed for their identified encounter with COVID positive individual using a modified WHO COVID risk assessment tool. Additional risk attributes of exposure characterized among COVID positive healthcare workers comprised of shared space, cluster related transmissions and multiple instances of exposure to COVID.ResultsAmong a total of 4744 contacts with COVID positive individuals assessed for risk stratification during the study period, 942 (19.8%) were high risk and 3802 (80.2%) were low risk exposures respectively. 106 (2.2%) turned COVID positive during the surveillance period of 14 days. Frontline workers working in COVID areas had significant low COVID rates as compared to other areas (N=1, 0.9%). The average monthly COVID positivity rates being 1.66%, the attack rates among high risk and low risk contacts among the total HCWs screened were 5% (46/942) and 1.57% (60/3802) respectively. Shared space (70%) and IPC breaches (66%) were found to be highly prevalent in the COVID positive cohort, along with maskless encounters (43%) and multiple exposure (39%). The attack rate among the 6 identified COVID cluster groups (5.5%) were found to be higher than the attack rate (2.2%) noted among the total contacts screened and no significant association was observed between risk categories in the clusters.DiscussionOur study highlights higher risk of COVID positivity among high risk contacts as compared to low risk contacts. However, the high COVID positivity rate in low risk group among cluster transmissions and its lack of association with risk assessment highlight the suboptimal utility of the risk assessment strategy among cluster groups.

scholarly journals Pilot evaluation of risk assessment and enhanced protocols regarding contacts at an international professional golf event

2021 ◽  
Vol 7 (3) ◽  
pp. e001127
Author(s):  
Patrick G Robinson ◽  
Andrew Murray ◽  
Volker Sheer ◽  
Graeme Close ◽  
Denis F Kinane
Keyword(s):  
Risk Assessment ◽  
Pilot Study ◽  
High Risk ◽  
Disease Transmission ◽  
Low Risk ◽  
Contact Tracing ◽  
Sporting Events ◽  
Medical Surveillance ◽  
Rt Pcr ◽  
Antigen Testing

ObjectivesThe aim of this study was to assess whether a risk assessment and managed risk approach to contact tracing was practical and feasible at the Gran Canaria Lopesan Open 2021 and could inform further pilot work regarding disease transmission during elite sporting events.MethodsThis prospective cohort study included all international attendees. All participants required a minimum of one negative reverse transcriptase PCR (RT-PCR) test prior to travelling to each tournament. High-risk contacts were isolated for 10 days. Moderate-risk contacts received education regarding enhanced medical surveillance, had daily rapid antigen testing for 5 days, with RT-PCR day 5, mandated mask use and access to outside space for work purposes only. Low-risk contacts received rapid antigen testing every 48 hours and PCR testing on day 5.ResultsA total of 550 persons were accredited and were required to undergo RT-PCR testing before the event. Two of these tests were positive (0.36%). Of these, case 1 had 1 high, 23 moderate and 48 low-risk contacts. Case 2 did not have any significant travel history within 2 days of positive test and had one high-risk contact. There were no further positive tests on site in the wider cohort of attendees, from a total of 872 RT-PCR and 198 rapid antigen tests.ConclusionsThis pilot study showed it is practical, feasible and well accepted to provide enhanced (daily) virus testing and risk-mitigating measures at a professional golf event. Further study is required to assess the efficacy of these interventions; however, no transmission was found in this pilot study.

scholarly journals Ensuring safety and availability of healthcare workers in the era of COVID-19: An experience from the Eastern State of India

2020 ◽  
Vol 72 ◽  
pp. 58-64 ◽  
Author(s):  
Neeraj Agarwal ◽  
Bijit Biswas ◽  
Rathish Nair
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Health Workers ◽  
Low Risk ◽  
Contact Tracing ◽  
Risk Exposure ◽  
Risk Of Infection ◽  
Healthcare Settings ◽  
Contact Investigation ◽  
Tracing Algorithm

Objectives: The objective of this study was to design a contact tracing algorithm and contact investigation form for healthcare workers deployed in rendering essential health-care services in limitedly resourced healthcare settings during the COVID era. Material and Methods: It was an observational study, longitudinal in design. Based on the existing evidence as of April 15, 2020, we have designed a contact tracing algorithm and contact investigation form to determine the risk of infection among healthcare workers. Later, we have tested the developed contact tracing algorithm and contact investigation from among 28 suspected contacts of a confirmed COVID-19 case admitted in all India Institute of Medical Sciences Patna, Bihar, India. Results: Using the designed contact investigation form, all the 28 suspected contacts of the confirmed COVID-19 case were interviewed, among which only 7(25%) were found to be having high-risk exposure. All persons with high-risk exposure were home quarantined for 5 days, along with their direct contacts. Eventually, all high-risk contacts were tested negative on the 5th day after exposure and immediately joined their duties after that. Those who were at low risk of infection continued to work and self-monitor for COVID compatible symptoms for 14 days. Eventually, none of the low-risk exposure persons developed COVID compatible symptoms, therefore deferred testing. Conclusion: The contact tracing approach designed in the current study is a balanced one where we tried to balance health workers safety without compromising their availability for duty. This approach can also be implemented in other healthcare settings in the era of COVID-19.

scholarly journals Risk stratification as a tool to rationalize quarantine among health care workers exposed to COVID-19 cases – Evidence from a tertiary healthcare centre in India

2020 ◽  
Author(s):  
Ravneet Kaur ◽  
Shashi Kant ◽  
Mohan Bairwa ◽  
Arvind Kumar ◽  
Shivram Dhakad ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Risk Stratification ◽  
Health Care Workers ◽  
Healthcare Workers ◽  
Healthcare Services ◽  
Low Risk ◽  
Contact Tracing ◽  
List Type ◽  
Care Workers

AbstractBackgroundQuarantine of healthcare workers (HCWs) exposed to COVID -19 confirmed cases is a well-known strategy for limiting the transmission of infection. However, there is need of evidence-based guidelines for quarantine of HCWs in COVID -19.MethodsWe describe our experience of contact tracing and risk stratification of 3853 HCWs who were exposed to confirmed COVID-19 cases in a tertiary health care institution in India. We developed an algorithm, on the basis of risk stratification, to rationalize quarantine among HCWs. Risk stratification was based on the duration of exposure, distance from the patient, and appropriateness of personal protection equipment (PPE) usage. Only high-risk contacts were quarantined for 14 days. They underwent testing for COVID-19 after five days of exposure, while low-risk contacts continued their work with adherence to physical distancing, hand hygiene, and appropriate use of PPE. The low-risk contacts were encouraged to monitor for symptoms and report for COVID-19 screening if fever, cough, or shortness of breath occurred. We followed up all contacts for 14 days from the last exposure and observed for symptoms of COVID-19 and test positivity.Results and interpretationOut of total 3853 contacts, 560 (14.5%) were categorized as high-risk contacts, and 40 of them were detected positive for COVID-19, with a test positivity rate of 7.1% (95% CI = 5.2 – 9.6). Overall, 118 (3.1%) of all contacts tested positive. Our strategy prevented 3215 HCWs from being quarantined and saved 45,010 person-days of health workforce until June 8, 2020, in the institution.We conclude that exposure-based risk stratification and quarantine of HCWs is a viable strategy to prevent unnecessary quarantine, in a healthcare institution.SummaryWhat is already known about this subject?Quarantine of HCWs is a well-known strategy for community and HCWs to prevent the transmission of COVID-19.Though success stories of prompt contact tracing and quarantine to control COVID-19 are available from countries like South Korea, Singapore, and Hong Kong, there is a scarcity of evidence that could guide targeted quarantine of HCWs exposed to COVID -19 in India.What does this study add?Only 14.5% HCWs exposed to COVID-19 cases were stratified “high risk” contacts, and the most common reason for high-risk contacts was non-formal workplace interactions such as having meals together.The overall test positivity rate among the high-risk contacts was 7.1%, while it was higher in symptomatic high-risk contacts as compared to those who were asymptomatic (10.2% vs. 6.3%).How might this impact on clinical practice?Contact tracing and risk stratification can be used to minimize unnecessary quarantine of COVID-19 exposed health care workers and prevent the depletion of healthcare workers amidst the pandemic to continue the healthcare services optimally.

scholarly journals Multidimensional dynamic healthcare personnel (HCP)-centric model from a low-income and middle-income country to support and protect COVID-19 warriors: a large prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043837
Author(s):  
Usha Dutta ◽  
Anurag Sachan ◽  
Madhumita Premkumar ◽  
Tulika Gupta ◽  
Swapnajeet Sahoo ◽  
...  
Keyword(s):  
High Risk ◽  
Low Income ◽  
Tertiary Care ◽  
Low Risk ◽  
Transmission Risk ◽  
Healthcare Personnel ◽  
Risk Zone ◽  
Increased Risk ◽  
Medium Risk ◽  
Risk Zones

ObjectivesHealthcare personnel (HCP) are at an increased risk of acquiring COVID-19 infection especially in resource-restricted healthcare settings, and return to homes unfit for self-isolation, making them apprehensive about COVID-19 duty and transmission risk to their families. We aimed at implementing a novel multidimensional HCP-centric evidence-based, dynamic policy with the objectives to reduce risk of HCP infection, ensure welfare and safety of the HCP and to improve willingness to accept and return to duty.SettingOur tertiary care university hospital, with 12 600 HCP, was divided into high-risk, medium-risk and low-risk zones. In the high-risk and medium-risk zones, we organised training, logistic support, postduty HCP welfare and collected feedback, and sent them home after they tested negative for COVID-19. We supervised use of appropriate personal protective equipment (PPE) and kept communication paperless.ParticipantsWe recruited willing low-risk HCP, aged <50 years, with no comorbidities to work in COVID-19 zones. Social distancing, hand hygiene and universal masking were advocated in the low-risk zone.ResultsBetween 31 March and 20 July 2020, we clinically screened 5553 outpatients, of whom 3012 (54.2%) were COVID-19 suspects managed in the medium-risk zone. Among them, 346 (11.4%) tested COVID-19 positive (57.2% male) and were managed in the high-risk zone with 19 (5.4%) deaths. One (0.08%) of the 1224 HCP in high-risk zone, 6 (0.62%) of 960 HCP in medium-risk zone and 23 (0.18%) of the 12 600 HCP in the low-risk zone tested positive at the end of shift. All the 30 COVID-19-positive HCP have since recovered. This HCP-centric policy resulted in low transmission rates (<1%), ensured satisfaction with training (92%), PPE (90.8%), medical and psychosocial support (79%) and improved acceptance of COVID-19 duty with 54.7% volunteering for re-deployment.ConclusionA multidimensional HCP-centric policy was effective in ensuring safety, satisfaction and welfare of HCP in a resource-poor setting and resulted in a willing workforce to fight the pandemic.

scholarly journals SARS-CoV-2 Seroprevalence in Healthcare Workers in Germany: A Follow-Up Study

2021 ◽  
Vol 18 (9) ◽  
pp. 4540
Author(s):  
Johannes Korth ◽  
Benjamin Wilde ◽  
Sebastian Dolff ◽  
Jasmin Frisch ◽  
Michael Jahn ◽  
...  
Keyword(s):  
High Risk ◽  
Healthcare Workers ◽  
Risk Group ◽  
Close Contact ◽  
Virus Transmission ◽  
High Risk Group ◽  
Low Risk ◽  
University Hospital ◽  
Intermediate Risk ◽  
Igg Antibody

SARS-CoV-2 is a worldwide challenge for the medical sector. Healthcare workers (HCW) are a cohort vulnerable to SARS-CoV-2 infection due to frequent and close contact with COVID-19 patients. However, they are also well trained and equipped with protective gear. The SARS-CoV-2 IgG antibody status was assessed at three different time points in 450 HCW of the University Hospital Essen in Germany. HCW were stratified according to contact frequencies with COVID-19 patients in (I) a high-risk group with daily contacts with known COVID-19 patients (n = 338), (II) an intermediate-risk group with daily contacts with non-COVID-19 patients (n = 78), and (III) a low-risk group without patient contacts (n = 34). The overall seroprevalence increased from 2.2% in March–May to 4.0% in June–July to 5.1% in October–December. The SARS-CoV-2 IgG detection rate was not significantly different between the high-risk group (1.8%; 3.8%; 5.5%), the intermediate-risk group (5.1%; 6.3%; 6.1%), and the low-risk group (0%, 0%, 0%). The overall SARS-CoV-2 seroprevalence remained low in HCW in western Germany one year after the outbreak of COVID-19 in Germany, and hygiene standards seemed to be effective in preventing patient-to-staff virus transmission.

scholarly journals RISK ASSESSMENT PERUSAHAAN EXPORT SEPATU PADA BAGIAN LINE UPPER PT. X

2015 ◽  
Vol 4 (1) ◽  
pp. 22
Author(s):  
Novita Dewi Vebriyana Dankis ◽  
Mulyono Mulyono
Keyword(s):  
Risk Assessment ◽  
High Risk ◽  
Risk Control ◽  
Consumer Products ◽  
Hazard Identification ◽  
Low Risk ◽  
Residual Risk ◽  
Control Measures ◽  
On Line ◽  
Punch Hole

ABSTRACTRevolution in the industry sector has been rapidly grown to fill up all the needs of the consumer products. One involves  supporting advanced machinery such as “Cutting, Skiving, Stitching, Emboss Logo, Roving, Punch Hole, Juki, BrushingEdge, Hammer Over Lapping and Two Molding”. In the factory production process, there are various types of high-risk activities, especially on line upper. The main of this research is to study the risk assessment on export companies line the upper part of the shoes export company using Job Safety Analysis. This research was conducted observational crosssectional design. Observations made to the hazards and control measures. Interviews were conducted to 12 employees. Variables in this research is production activity, hazard identification, risk assessment, risk control and residual risk. The results of hazard identification has been done, there are 91 known potential hazards, for risk assessment found 7 high risk and low risk 5. Machine classified as high risk on the risk assessment is roving machine, whereas low-risk is two molding machine. Control efforts on the upper line in accordance with the hierarchy of controlling a number of 91 controls, whereas for the residual risk still remains as much as 30 residual risk. Control has been applied quite well by pressing the consequences of hazards and risk management.Keywords: risk assessment, controlling, residual risk

scholarly journals AUDIT of patients referred for DXA scanning in a south Indian Tertiary care centre

2013 ◽  
pp. 1-1
Author(s):  
Thomas Paul ◽  
Mahesh Mruthyunjaya ◽  
Asha Shyamasunder ◽  
Dukhabandu Naik ◽  
Simon Rajaratnam ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
South Indian
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