scholarly journals Healthcare worker risk of COVID-19: A 20-month analysis of protective measures from vaccination and beyond

2021 ◽  
Author(s):  
Annalee Yassi ◽  
Stephen Barker ◽  
Karen Lockhart ◽  
Jennifer M. Grant ◽  
Arnold Ikedichi Okpani ◽  
...  
Keyword(s):  
Public Health ◽  
Occupational Health ◽  
Infection Control ◽  
Medical Staff ◽  
Cox Regression ◽  
Vaccine Effectiveness ◽  
Health System Strengthening ◽  
Infection Rates ◽  
Protective Measures ◽  
Vaccination Rates

Background: As the COVID-19 pandemic continues and new variants such as Omicron emerge, we aimed to re-evaluate vaccine effectiveness as well as impacts of rigorously implemented infection control, public health and occupational health measures in protecting healthcare workers (HCWs). Methods: Following a cohort of 21,242 HCWs in Vancouver, British Columbia, Canada, for 20 months since the pandemic started, we used Cox regression and test-negative design to examine differences in SARS-COV-2 infection rates compared to community counterparts, and within the HCW workforce, assessing the role of occupation, testing accessibility, vaccination rates, and vaccine effectiveness over time. Results: Nurses, allied health professionals and medical staff in this jurisdiction had a significantly lower rate of infection compared to their age-group community counterparts, at 47.4, 41.8, and 55.3% reduction respectively; controlling for vaccine-attributable reductions, the protective impact was still substantial, at 33.4, 28.0, and 36.5% respectively. Licensed practical nurses and care aides had the highest risk of infection among HCWs, more than double that of medical staff. However, even considering differences in vaccination rates, no increase in SARS-CoV-2 infection was found compared to community rates, with combined protective measures beyond vaccination associated with a 17.7% reduced SARS-COV-2 rate in the VCH workforce overall. There was also no evidence of waning immunity within at least 200 days after second dose. Conclusion: Rigorously implemented occupational health, public health and infection control measures results in a well-protected healthcare workforce with infection rates at or below rates in community counterparts. Greater accessibility of vaccination worldwide is essential; however, as implementing measures to protect this workforce globally also requires considerable health system strengthening in many jurisdictions, we caution against overly focusing on vaccination to the exclusion of other crucial elements for wider protection of HCWs, especially in facing ongoing mutations which may escape current vaccines.

scholarly journals Infection control, occupational and public health measures including mRNA-based vaccination against SARS-CoV-2 infections to protect healthcare workers from variants of concern: A 14-month observational study using surveillance data

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0254920
Author(s):  
Annalee Yassi ◽  
Jennifer M. Grant ◽  
Karen Lockhart ◽  
Stephen Barker ◽  
Stacy Sprague ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Healthcare Workers ◽  
Cox Regression ◽  
Vaccine Coverage ◽  
Severe Disease ◽  
Surveillance Data ◽  
Control Measures ◽  
Vaccine Uptake ◽  
Occupational Infection

Background We evaluated measures to protect healthcare workers (HCWs) in Vancouver, Canada, where variants of concern (VOC) went from <1% VOC in February 2021 to >92% in mid-May. Canada has amongst the longest periods between vaccine doses worldwide, despite Vancouver having the highest P.1 variant rate outside Brazil. Methods With surveillance data since the pandemic began, we tracked laboratory-confirmed SARS-CoV-2 infections, positivity rates, and vaccine uptake in all 25,558 HCWs in Vancouver Coastal Health, by occupation and subsector, and compared to the general population. Cox regression modelling adjusted for age and calendar-time calculated vaccine effectiveness (VE) against SARS-CoV-2 in fully vaccinated (≥ 7 days post-second dose), partially vaccinated infection (after 14 days) and unvaccinated HCWs; we also compared with unvaccinated community members of the same age-range. Findings Only 3.3% of our HCWs became infected, mirroring community rates, with peak positivity of 9.1%, compared to 11.8% in the community. As vaccine coverage increased, SARS-CoV-2 infections declined significantly in HCWs, despite a surge with predominantly VOC; unvaccinated HCWs had an infection rate of 1.3/10,000 person-days compared to 0.89 for HCWs post first dose, and 0.30 for fully vaccinated HCWs. VE compared to unvaccinated HCWs was 37.2% (95% CI: 16.6–52.7%) 14 days post-first dose, 79.2% (CI: 64.6–87.8%) 7 days post-second dose; one dose provided significant protection against infection until at least day 42. Compared with community infection rates, VE after one dose was 54.7% (CI: 44.8–62.9%); and 84.8% (CI: 75.2–90.7%) when fully vaccinated. Interpretation Rigorous droplet-contact precautions with N95s for aerosol-generating procedures are effective in preventing occupational infection in HCWs, with one dose of mRNA vaccination further reducing infection risk despite VOC and transmissibility concerns. Delaying second doses to allow more widespread vaccination against severe disease, with strict public health, occupational health and infection control measures, has been effective in protecting the healthcare workforce.

scholarly journals Infection control, occupational and public health measures including mRNA-based vaccination against SARS-CoV-2 infections to protect healthcare workers from variants of concern: a 14-month observational study using surveillance data

2021 ◽  
Author(s):  
Annalee Yassi ◽  
Jennifer M. Grant ◽  
Karen Lockhart ◽  
Stephen Barker ◽  
Stacy Sprague ◽  
...  
Keyword(s):  
Public Health ◽  
Infection Control ◽  
Healthcare Workers ◽  
Cox Regression ◽  
Vaccine Coverage ◽  
Severe Disease ◽  
Surveillance Data ◽  
Control Measures ◽  
Vaccine Uptake ◽  
Occupational Infection

Background: We evaluated measures to protect healthcare workers (HCWs) in Vancouver, Canada, where variants of concern (VOC) went from <1% in February 2021 to >92% in mid-May. Canada has amongst the longest periods between vaccine doses worldwide, despite Vancouver having the highest P.1 variant rate outside Brazil. Methods: With surveillance data since the pandemic began, we tracked laboratory-confirmed SARS-CoV-2 infections, positivity rates, and vaccine uptake in all 25,558 HCWs in Vancouver Coastal Health, by occupation and subsector, and compared to the general population. We employed Cox regression modelling adjusted for age and calendar-time to calculate vaccine effectiveness (VE) against SARS-CoV-2 in fully vaccinated (≥ 7 days post-second dose), partially vaccinated (14 days post vaccine) and unvaccinated HCWs; we also compared with unvaccinated community members of the same age-range. Findings: Only 3.3% of our HCWs became infected, mirroring community rates, with peak positivity of 9.1%, compared to 11.8% in the community. As vaccine coverage increased, SARS-CoV-2 infections declined significantly in HCWs, despite a surge with predominantly VOC; unvaccinated HCWs had an infection rate of 1.3/10,000 person-days compared to 0.89 for HCWs post first dose, and 0.30 for fully vaccinated HCWs. VE compared to unvaccinated HCWs was 37.2% (95% CI: 16.6-52.7%) 14 days post-first dose, 79.2% (CI: 64.6-87.8%) 7 days post-second dose; one dose provided significant protection against infection until at least day 42. Compared with community infection rates, VE after one dose was 54.7% (CI: 44.8-62.9%); and 84.8% (CI: 75.2-90.7%) when fully vaccinated. Interpretation: Predominantly droplet-contact precautions, with N95s required for aerosol generating medical procedures and available as needed according to point-of-care risk assessment, has been a highly effective approach to preventing occupational infection in HCWs, with one dose of mRNA vaccination further reducing infection risk despite VOC and transmissibility concerns. Delaying second doses to allow more widespread vaccination against severe disease, with strict public health, occupational health and infection control measures, has been effective in protecting the healthcare workforce.

Promoting respiratory infection control practices in primary care: Primary care/public health collaboration

2005 ◽  
Author(s):  
William Hogg ◽  
Patricia Houston ◽  
Carmel Martin ◽  
Raphael Saginur ◽  
Adriana Newbury ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Infection Control ◽  
Respiratory Infection

Strengthening of occupational health promotion by the German Prevention Health Care Act

2019 ◽  
pp. 188-190
Author(s):  
Diana Hart
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Promotion ◽  
Primary Prevention ◽  
Occupational Health ◽  
Life Expectancy ◽  
Prevention And Control ◽  
Occupational Health Promotion ◽  
And Control

All countries are faced with the problem of the prevention and control of non-communicable diseases (NCD): implement prevention strategies eff ectively, keep up the momentum with long term benefi ts at the individual and the population level, at the same time tackling hea lth inequalities. Th e aff ordability of therapy and care including innovative therapies is going to be one of the key public health priorities in the years to come. Germany has taken in the prevention and control of NCDs. Germany’s health system has a long history of guaranteeing access to high-quality treatment through universal health care coverage. Th r ough their membership people are entitled to prevention and care services maintaining and restoring their health as well as long term follow-up. Like in many other countries general life expectancy has been increasing steadily in Germany. Currently, the average life expectancy is 83 and 79 years in women and men, respectively. Th e other side of the coin is that population aging is strongly associated with a growing burden of disease from NCDs. Already over 70 percent of all deaths in Germany are caused by four disease entities: cardiovascular disease, cancer, chronic respiratory disease and diabetes. Th ese diseases all share four common risk factors: smoking, alcohol abuse, lack of physical activity and overweight. At the same time, more and more people become long term survivors of disease due to improved therapy and care. Th e German Government and public health decision makers are aware of the need for action and have responded by initiating and implementing a wide spectrum of activities. One instrument by strengthening primary prevention is the Prevention Health Care Act. Its overarching aim is to prevent NCDs before they can manifest themselves by strengthening primary prevention and health promotion in diff erent sett ings. One of the main emphasis of the Prevention Health Care Act is the occupational health promotion at the workplace.

Occupational and Environmental Health

2017 ◽  
Keyword(s):  
Public Health ◽  
Occupational Health ◽  
Environmental Health ◽  
Health And Safety ◽  
Practical Experience ◽  
Global Perspective ◽  
Clear Understanding ◽  
Practical Case ◽  
Environmental Sciences ◽  
Wide Range

This thoroughly updated seventh edition is a comprehensive, clearly written, and practical textbook that includes information on both occupational health and environmental health, providing the necessary foundation for recognizing and preventing work-related and environmentally induced diseases and injuries. National and international experts share their knowledge and practical experience in addressing a wide range of issues and evolving challenges in their fields. A multidisciplinary approach makes this an ideal textbook for students and practitioners in public health, occupational and environmental medicine, occupational health nursing, epidemiology, toxicology, occupational and environmental hygiene, safety, ergonomics, environmental sciences, and other fields. Comprehensive coverage provides a clear understanding of occupational and environmental health and its relationships to public health, environmental sciences, and government policy. Practical case studies demonstrate how to apply the basic principles of occupational and environmental health to real-world challenges. Numerous tables, graphs, and photographs reinforce key concepts. Annotated Further Reading sections at the end of chapters provide avenues for obtaining further infomation. This new edition of the book is thoroughly updated and also contains new chapters on climate change, children’s environmental health, liver disorders, kidney disorders, and a global perspective on occupational health and safety.

scholarly journals Impact of reduction of susceptibility to SARS-CoV-2 on epidemic dynamics in four early-seeded metropolitan regions

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thomas J. Barrett ◽  
Karen C. Patterson ◽  
Timothy M. James ◽  
Peter Krüger
Keyword(s):  
Public Health ◽  
Growth Phase ◽  
Chronic Phase ◽  
Health Interventions ◽  
Resource Utilisation ◽  
Policy Planning ◽  
Infection Rates ◽  
Public Health Interventions ◽  
Metropolitan Regions ◽  
Epidemic Dynamics

AbstractAs we enter a chronic phase of the SARS-CoV-2 pandemic, with uncontrolled infection rates in many places, relative regional susceptibilities are a critical unknown for policy planning. Tests for SARS-CoV-2 infection or antibodies are indicative but unreliable measures of exposure. Here instead, for four highly-affected countries, we determine population susceptibilities by directly comparing country-wide observed epidemic dynamics data with that of their main metropolitan regions. We find significant susceptibility reductions in the metropolitan regions as a result of earlier seeding, with a relatively longer phase of exponential growth before the introduction of public health interventions. During the post-growth phase, the lower susceptibility of these regions contributed to the decline in cases, independent of intervention effects. Forward projections indicate that non-metropolitan regions will be more affected during recurrent epidemic waves compared with the initially heavier-hit metropolitan regions. Our findings have consequences for disease forecasts and resource utilisation.

scholarly journals Improvement of the module for occupational diseases in the structure of occupational health record

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Iancheva ◽  
T Kundurzhiev ◽  
N Tzacheva ◽  
L Hristova
Keyword(s):  
Public Health ◽  
Occupational Health ◽  
Health Services ◽  
Occupational Disease ◽  
Occupational Diseases ◽  
National Level ◽  
Working Environment ◽  
Occupational Health Services ◽  
Health Record ◽  
Disease Module

Abstract The study is based on the National Science Program 'eHealth in Bulgaria (e-Health)', funded by the Ministry of Education and Science. Partnership Contract No. D-01-200/16.11.2018 Issue Occupational health is closely linked to public health and health system. In Bulgaria there are many software products related to the registration and reporting of occupational health. Description of the Problem It is necessary to study all the determinants of occupational health, including the risks of diseases and accidents in the occupational environment, social and individual factors. The establishment of electronic systems for registering and monitoring both the health status of each worker and the possible hazards in the work environment is associated with the introduction and use of the occupational health record of each worker. Results The methodology for improving the module for occupational diseases in the structure of the occupational health record in Bulgaria has been developed. The classifications are in compliance with the legislation in the country and the requirements of the developing Eurostat methodology for European statistics on occupational diseases are applied. The occupational health record will serve both employers and physicians working in Occupational Health Services. Lessons The occupational disease module in the structure of the occupational health record will contribute to the statistical comparability of occupational disease data at regional and national level. Not only will the registration of the harmful factors of the working environment and the diseases related to the work process, but also the introduction of timely measures to ensure good occupational and public health. Key messages Through the occupational disease module, the structure of the occupational health record introduces the possibility of taking adequate measures to ensure good occupational health. The occupational health record will serve both employers and physicians working in Occupational Health Services.

scholarly journals The Effect of Vaccination Rates on the Infection of COVID-19 under the Vaccination Rate below the Herd Immunity Threshold

2021 ◽  
Vol 18 (14) ◽  
pp. 7491
Author(s):  
Yi-Tui Chen
Keyword(s):  
Infection Rate ◽  
Herd Immunity ◽  
The United States ◽  
Vaccination Rate ◽  
Infection Rates ◽  
Vaccination Rates ◽  
The United Kingdom ◽  
The World ◽  
Almost All ◽  
The Impact

Although vaccination is carried out worldwide, the vaccination rate varies greatly. As of 24 May 2021, in some countries, the proportion of the population fully vaccinated against COVID-19 has exceeded 50%, but in many countries, this proportion is still very low, less than 1%. This article aims to explore the impact of vaccination on the spread of the COVID-19 pandemic. As the herd immunity of almost all countries in the world has not been reached, several countries were selected as sample cases by employing the following criteria: more than 60 vaccine doses per 100 people and a population of more than one million people. In the end, a total of eight countries/regions were selected, including Israel, the UAE, Chile, the United Kingdom, the United States, Hungary, and Qatar. The results find that vaccination has a major impact on reducing infection rates in all countries. However, the infection rate after vaccination showed two trends. One is an inverted U-shaped trend, and the other is an L-shaped trend. For those countries with an inverted U-shaped trend, the infection rate begins to decline when the vaccination rate reaches 1.46–50.91 doses per 100 people.

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