scholarly journals Access to personal protective equipment in exposed healthcare workers and COVID-19 illness, severity, symptoms and duration: a population-based case-control study in six countries

2021 ◽  
Vol 6 (1) ◽  
pp. e004611
Author(s):  
Hyunju Kim ◽  
Sheila Hegde ◽  
Christine LaFiura ◽  
Madhunika Raghavan ◽  
Nancy Sun ◽  
...  
Keyword(s):  
At Risk ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Close Contact ◽  
Severe Disease ◽  
Protective Equipment ◽  
Symptom Duration ◽  
Medical Specialties ◽  
Limited Access ◽  
Increased Risk

BackgroundDespite the widespread implementation of personal protective equipment (PPE) in the COVID-19 pandemic, there are surprisingly few studies of its impact. To assess the risk, severity and duration of COVID-19 in relation to access to PPE in at-risk healthcare workers (HCWs).MethodsFrom 17 July to 25 September 2020, at-risk physicians and nurses registered as a provider in the Survey Healthcare Globus network in six countries (the UK, Germany, France, Italy, Spain and USA) were identified based on adult medical specialties with frequent and close contact with patients with COVID-19. Exposed HCWs completed a detailed questionnaire including demographics, medical, social and lifestyle factors. COVID-19 cases were defined as COVID-19 symptoms (fever, cough, fatigue, loss of taste or smell) and asymptomatic COVID-19 test positive cases.ResultsAmong 2884 exposed HCWs (94% medical doctors and 6% nurses or physician assistants), there were 514 reports of COVID-19 illness and 54 asymptomatic COVID-19 test positive cases. COVID-19 risk was significantly associated with close contact with COVID-19 cases both inside and outside the workplace, number of work shifts and hours worked per week. Limited access to PPE compared with access to a fresh mask, gown and gloves and face shield with each patient encounter was associated with a 2.2-fold to 22-fold increased risk of reporting COVID-19 symptoms (p<0.0001), a pattern consistent across all six countries. Further, limited access to PPE was associated with symptom duration greater than 2 weeks and the presence of moderate to severe symptoms such as difficulty breathing, abnormal chest X-ray, low oxygen saturations, respiratory distress and acute lung injury.ConclusionIn six countries, less access to PPE was strongly associated with both increased risk of reporting COVID-19 illness as well as more prolonged and severe disease course in frontline HCWs.

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.

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 The high level of adherence of personal protective equipment in health care workers efficiently protects them from COVID-19 infection

Work ◽  
2021 ◽  
pp. 1-6
Author(s):  
Malihe Zangoue ◽  
Hamidreza Safari ◽  
Simon G. Royce ◽  
Alireza Zangooie ◽  
Hadis Rezapour ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Close Contact ◽  
Cross Sectional Study ◽  
Protective Equipment ◽  
Cross Sectional ◽  
Igm Antibodies ◽  
First Case ◽  
Referral Hospitals ◽  
High Level

BACKGROUND: The first case of coronavirus disease 2019 (COVID-19) was reported in December 2019 in Wuhan, China. Healthcare workers (HCWs) are at high risk of acquiring and spreading the COVID-19 infection; using personal protective equipment (PPE) reduces the risk of COVID-19 infection in HCWs. OBJECTIVE: Our study aimed to investigate the seroprevalence of COVID-19 IgG, IgM antibodies among HCWs as well as identifying the factors associated with this seroprevalence. METHODS: This cross-sectional study was performed from July to August 2020 on healthcare workers at two COVID-19 referral hospitals of Birjand University of Medical Sciences. The level of COVID-19 IgG and IgM antibodies in sera was measured by commercial qualitative ELISA kits. RESULTS: In total, 192 individuals participated in the study: physicians (31.25%), nurses (30.2%). 84.2%of participants had contact with confirmed COVID-19 cases and among them 42.9 %of had close contact with COVID-19 patients for more than 3 months, and 31%reported close contact with more than 50 confirmed COVID-19 cases. Mask and gloves were the most frequently used personal protective equipment (PPE) with 92.4%and 77.2%of usage. CONCLUSIONS: The results of the current study showed high level of adherence to the use of PPE among HCWs as well as very low prevalence of seropositivity for of COVID-19 antibodies, hence confirming the effectiveness of PPE in protecting HCWs among COVVID-19 and possibly any other similar infections.

scholarly journals Viral Genomics to Inform Infection-control Response in Occupational Coronavirus Disease 2019 (COVID-19) Transmission

2020 ◽  
Author(s):  
Naomi C A Whyler ◽  
Norelle L Sherry ◽  
Courtney R Lane ◽  
Torsten Seemann ◽  
Patiyan Andersson ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Genomic Sequencing ◽  
Protective Equipment ◽  
Viral Genomics ◽  
Subsequent Response ◽  
Increased Risk ◽  
Control Response

Abstract Healthcare workers are at increased risk of occupational transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report 2 instances of healthcare workers contracting SARS-CoV-2 despite no known breach of personal protective equipment. Additional specific equipment cleaning was initiated. Viral genomic sequencing supported this transmission hypothesis and our subsequent response.

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 Availability of personal protective equipment and satisfaction of healthcare professionals during COVID-19 pandemic in Ethiopia

2020 ◽  
Author(s):  
Wakgari Deressa ◽  
Alemayehu Worku ◽  
Workeabeba Abebe ◽  
Muluken Gizaw ◽  
Wondwosson Amogne
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Healthcare Professionals ◽  
Public Hospitals ◽  
The Self ◽  
Memorial Hospital ◽  
Protective Equipment ◽  
Satisfaction Level ◽  
Medical College ◽  
Increased Risk

AbstractHealthcare 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). This study assessed the availability of PPE and satisfaction of HCPs in six public hospitals in Addis Ababa, Ethiopia. A cross-sectional study was conducted from 9th to 26th June 2020. The study hospitals included: Tikur Anbessa Specialized Hospital, Zewditu Memorial Hospital, Ghandi Memorial Hospital, Menelik II Hospital, Yekatit 12 Hospital Medical College and St. Paul Hospital Millennium Medical College. 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 the satisfaction level of healthcare workers with regard to the availability and use of proper PPE during the current COVID-19 pandemic. A total of 1,134 (92.3%) valid questionnaires from a possible 1,228 were included in the analysis. 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%). An overall shortage of PPE was reported in all study hospitals. The majority (77%) of the healthcare professionals reported that their hospital did not have adequate PPE. A critical shortage of N95 respirator was particularly reported, the self-reported availability of N95 increased from 13% to 24% before and during COVID-19, respectively. The self-reported use of N95 increased from 9% to 21% before and during COVID-19, respectively. Almost 72% of the respondents were dissatisfied with the availability of PPE in their hospital. The independent predictors of the respondents’ satisfaction level about PPE were male gender (adjusted OR=1.39, 95% CI:1.05-1.85), healthcare workers who reported that PPE was adequately available in the hospital (adjusted OR=7.53, 95% CI:5.08-11.16), and preparedness to provide care to COVID-19 cases (adjusted OR=1.65, 95% CI:1.22-2.12). A critical shortage of appropriate PPE both before and during COVID-19 was identified. The high level of dissatisfaction with the availability of PPE might potentially lead to a lower level of preparedness and readiness to fight against COVID-19. Therefore, urgent efforts are needed to adequately supply the healthcare facilities with appropriate PPE to alleviate the challenges.

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.

scholarly journals Fit Testing Retrofitted Full-Face Snorkel Masks as a Form of Novel Personal Protective Equipment During the COVID-19 Pandemic

2021 ◽  
pp. 1-16
Author(s):  
Stephanie Toigo ◽  
Michel Jacques ◽  
Tarek Razek ◽  
Ewa Rajda ◽  
Sidney Omelon ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Health Centre ◽  
Disease Outbreaks ◽  
Protective Equipment ◽  
Test Results ◽  
Passing Rate ◽  
Fit Testing ◽  
Full Face ◽  
Medical Grade

ABSTRACT Objective: Bottlenecks in the personal protective equipment (PPE) supply chain have contributed to shortages of PPE during the COVID-19 pandemic, resulting in fractures in the functionality of healthcare systems. This study was conducted with the aim of determining the effectiveness of retrofitted commercial snorkel masks as an alternative respirator for healthcare workers during infectious disease outbreaks. Methods: A retrospective analysis was performed, analyzing qualitative and quantitative fit test results of the retrofitted Aria Ocean Reef® full-face snorkeling mask on healthcare workers at the McGill University Health Centre between April-June 2020. Historical fit test results, using medical-grade respirators, for healthcare workers were also analyzed. Results: During the study period, 71 participants volunteered for fit testing, 60.6% of which were nurses. The overall fit test passing rate using the snorkel mask was 83.1%. Of the participants who did not previously pass fit testing with medical-grade respirators, 80% achieved a passing fit test with the snorkel respirator. Conclusions: The results suggest that this novel respirator may be an effective and feasible alternative solution to address PPE shortages, while still providing healthcare workers with ample protection. Additional robust testing will be required to ensure that respirator fit is maintained, after numerous rounds of disinfection.

scholarly journals Acoustic voice characteristics with and without wearing a facemask

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Duy Duong Nguyen ◽  
Patricia McCabe ◽  
Donna Thomas ◽  
Alison Purcell ◽  
Maree Doble ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Mask Condition ◽  
Connected Speech ◽  
Significant Attenuation ◽  
Cepstral Peak Prominence ◽  
Vocal Intensity ◽  
Significant Change ◽  
The Voice

AbstractFacemasks are essential for healthcare workers but characteristics of the voice whilst wearing this personal protective equipment are not well understood. In the present study, we compared acoustic voice measures in recordings of sixteen adults producing standardised vocal tasks with and without wearing either a surgical mask or a KN95 mask. Data were analysed for mean spectral levels at 0–1 kHz and 1–8 kHz regions, an energy ratio between 0–1 and 1–8 kHz (LH1000), harmonics-to-noise ratio (HNR), smoothed cepstral peak prominence (CPPS), and vocal intensity. In connected speech there was significant attenuation of mean spectral level at 1–8 kHz region and there was no significant change in this measure at 0–1 kHz. Mean spectral levels of vowel did not change significantly in mask-wearing conditions. LH1000 for connected speech significantly increased whilst wearing either a surgical mask or KN95 mask but no significant change in this measure was found for vowel. HNR was higher in the mask-wearing conditions than the no-mask condition. CPPS and vocal intensity did not change in mask-wearing conditions. These findings implied an attenuation effects of wearing these types of masks on the voice spectra with surgical mask showing less impact than the KN95.

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