Perspectives on COVID-19 testing policies and practices: a qualitative study with scientific advisors and NHS health care workers in England

Abstract Background As COVID-19 death rates have risen and health-care systems have experienced increased demand, national testing strategies have come under scrutiny. Utilising qualitative interview data from a larger COVID-19 study, this paper provides insights into influences on and the enactment of national COVID-19 testing strategies for health care workers (HCWs) in English NHS settings during wave one of the COVID-19 pandemic (March–August 2020). Through the findings we aim to inform learning about COVID-19 testing policies and practices; and to inform future pandemic diagnostic preparedness. Methods A remote qualitative, semi-structured longitudinal interview method was employed with a purposive snowball sample of senior scientific advisors to the UK Government on COVID-19, and HCWs employed in NHS primary and secondary health care settings in England. Twenty-four interviews from 13 participants were selected from the larger project dataset using a key term search, as not all of the transcripts contained references to testing. Framework analysis was informed by the non-adoption, abandonment, scale-up, spread, and sustainability of patient-facing health and care technologies implementation framework (NASSS) and by normalisation process theory (NPT). Results Our account highlights tensions between the communication and implementation of national testing developments; scientific advisor and HCW perceptions about infectiousness; and uncertainties about the responsibility for testing and its implications at the local level. Conclusions Consideration must be given to the implications of mass NHS staff testing, including the accuracy of information communicated to HCWs; how HCWs interpret, manage, and act on testing guidance; and the influence these have on health care organisations and services.

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Title page Title Perspectives on COVID-19 testing policies and practices: a qualitative study with scientific advisors and NHS health care workers in England

10.21203/rs.3.rs-454781/v1 ◽

2021 ◽

Author(s):

Anne-Marie Martindale ◽

Caitlin Pilbeam ◽

Hayley Mableson ◽

Sarah Tonkin-Crine ◽

Paul Atkinson ◽

...

Keyword(s):

Health Care ◽

Health Care Workers ◽

Local Level ◽

Scale Up ◽

Normalisation Process Theory ◽

Framework Analysis ◽

Implementation Framework ◽

Testing Strategies ◽

Care Workers ◽

National Testing

Abstract Background As COVID-19 death rates have risen and health-care systems have experienced increased demand, national testing strategies have come under scrutiny. Utilising qualitative interview data from a larger COVID-19 study, this paper provides insights into influences on and the enactment of national COVID-19 testing strategies for health care workers (HCWs) in English NHS settings during wave one of the COVID-19 pandemic (March-August 2020). We aim to inform COVID-19 learning and future pandemic diagnostic preparedness.Methods A remote qualitative, semi-structured longitudinal interview method was employed with a purposive snowball sample of senior scientific advisors to the UK Government on COVID-19, and HCWs employed in NHS primary and secondary health care settings in England. 24 interviews from 13 participants were selected from the larger project dataset. Framework analysis was informed by the non-adoption, abandonment, scale-up, spread, and sustainability of patient-facing health and care technologies implementation framework (NASSS) and by normalisation process theory (NPT).Results Our account highlights tensions between the communication and implementation of national testing developments; scientific advisor and HCW perceptions about infectiousness; and uncertainties about the responsibility for testing and its implications at the local level.Conclusions Consideration must be given to the implications of mass NHS staff testing, including the accuracy of information communicated to HCWs; how HCWs interpret, manage, and act on testing guidance; and the influence these have on health care organisations and services.

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Influenza vaccination of health care workers: Policies and practices of hospitals in a community setting

American Journal of Infection Control ◽

10.1016/j.ajic.2007.02.010 ◽

2007 ◽

Vol 35 (7) ◽

pp. 441-447 ◽

Cited By ~ 17

Author(s):

Julie A. Gazmararian ◽

Margaret Coleman ◽

Mila Prill ◽

Alan R. Hinman ◽

Bruce S. Ribner ◽

...

Keyword(s):

Health Care ◽

Influenza Vaccination ◽

Health Care Workers ◽

Community Setting ◽

Care Workers ◽

Policies And Practices

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Quadmester-wise comparison of disease transmission dynamics of COVID-19 among health care workers in Kannur district, Kerala

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20211778 ◽

2021 ◽

Vol 8 (5) ◽

pp. 2481

Author(s):

Ameena Subair Raheela ◽

Sajish Chandran ◽

Deepak Rajan ◽

Preetha Muduvana

Keyword(s):

Health Care ◽

Health Care Workers ◽

Disease Transmission ◽

Local Level ◽

Control Measures ◽

Transmission Dynamics ◽

Work Place ◽

Cross Sectional ◽

Indirect Contact ◽

Care Workers

Background: Health-care workers (HCWs) may get infected by direct or indirect contact with infected patients or other HCWs or from the community as well, depending on the phase through which pandemic progresses. Knowledge about the disease transmission dynamics as the pandemic advances is a need so that appropriate monitoring, prevention and control measures for HCWs can be implemented at local level. The main objective of this study was quadmester-wise comparison of disease transmission dynamics of COVID-19 among HCWs in Kannur district.Methods: A cross-sectional study was carried out among HCWs reported positive for SARS-CoV-2 in Kannur district, Kerala. COVID-19 positive HCWs reported in the district were consolidated and contacted over phone and details were collected using a semi-structured questionnaire. Data were entered into microsoft excel and analysed using statistical package for social sciences (SPSS) trial version. Chi-square test was used to compare differences observed in the two groups and binary logistic regression was done to pick out the significant predictors of variability in disease transmission among the two groups.Results: Total respondents in the first and second quadmester were 243 and 1665, respectively. Factors like gender, clinical features, source of infection, family as source and type of duty taken were found to be statistically significant for the disease transmission dynamics among HCWs.Conclusions: As the pandemic advances, irrespective of the type of work place, self-reporting and regular testing of HCWs will help to check HCWs from getting infected and spreading the disease.

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Optimal strategies to screen health care workers for COVID-19 in the US: a cost-effectiveness analysis

Cost Effectiveness and Resource Allocation ◽

10.1186/s12962-021-00336-x ◽

2022 ◽

Vol 20 (1) ◽

Author(s):

Sigal Maya ◽

Guntas Padda ◽

Victoria Close ◽

Trevor Wilson ◽

Fareeda Ahmed ◽

...

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Health Care Workers ◽

Cost Effective ◽

Health Care Settings ◽

Testing Strategies ◽

Effectiveness Analysis ◽

Care Workers ◽

Antigen Testing ◽

Quality Adjusted Life

Abstract Background Transmission of SARS-CoV-2 in health care facilities poses a challenge against pandemic control. Health care workers (HCWs) have frequent and high-risk interactions with COVID-19 patients. We undertook a cost-effectiveness analysis to determine optimal testing strategies for screening HCWs to inform strategic decision-making in health care settings. Methods We modeled the number of new infections, quality-adjusted life years lost, and net costs related to six testing strategies including no test. We applied our model to four strata of HCWs, defined by the presence and timing of symptoms. We conducted sensitivity analyses to account for uncertainty in inputs. Results When screening recently symptomatic HCWs, conducting only a PCR test is preferable; it saves costs and improves health outcomes in the first week post-symptom onset, and costs $83,000 per quality-adjusted life year gained in the second week post-symptom onset. When screening HCWs in the late clinical disease stage, none of the testing approaches is cost-effective and thus no testing is preferable, yielding $11 and 0.003 new infections per 10 HCWs. For screening asymptomatic HCWs, antigen testing is preferable to PCR testing due to its lower cost. Conclusions Both PCR and antigen testing are beneficial strategies to identify infected HCWs and reduce transmission of SARS-CoV-2 in health care settings. IgG tests’ value depends on test timing and immunity characteristics, however it is not cost-effective in a low prevalence setting. As the context of the pandemic evolves, our study provides insight to health-care decision makers to keep the health care workforce safe and transmissions low.

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Occupational health policies and practices related to tuberculosis in health care workers in KwaZulu-Natal, South Africa

Public Health Action ◽

10.5588/pha.12.0098 ◽

2013 ◽

Vol 3 (2) ◽

pp. 141-145 ◽

Cited By ~ 8

Author(s):

C. Tudor ◽

M. Van der Walt ◽

M. N. Hill ◽

J. E. Farley

Keyword(s):

South Africa ◽

Health Care ◽

Occupational Health ◽

Health Care Workers ◽

Health Policies ◽

Care Workers ◽

Kwazulu Natal ◽

Policies And Practices

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Optimal strategies to screen health care workers for COVID-19 in the US: a cost-effectiveness analysis

10.21203/rs.3.rs-887590/v1 ◽

2021 ◽

Author(s):

Sigal Maya ◽

Guntas Padda ◽

Victoria Close ◽

Trevor Wilson ◽

Fareeda Ahmed ◽

...

Keyword(s):

Health Care ◽

Cost Effectiveness ◽

Health Care Workers ◽

Cost Effective ◽

Health Care Settings ◽

Testing Strategies ◽

Effectiveness Analysis ◽

Care Workers ◽

Antigen Testing ◽

Quality Adjusted Life

Abstract Background: Transmission of SARS-CoV-2 in health care facilities poses a challenge against pandemic control. Health care workers (HCWs) have frequent and high-risk interactions with COVID-19 patients. We undertook a cost-effectiveness analysis to determine optimal testing strategies for screening HCWs to inform strategic decision-making in health care settings. Methods: We modeled the number of new infections, quality-adjusted life years lost, and net costs related to six testing strategies including no tests. We applied our model to four strata of HCWs, defined by the presence and timing of symptoms. We conducted sensitivity analyses to account for uncertainty in inputs. Results: When screening recently symptomatic HCWs, conducting only a PCR test is preferable; it saves costs and improves health outcomes in the first week post-symptom onset, and costs $83,000 per quality-adjusted life year gained in the second week post-symptom onset. When screening HCWs in the late clinical disease stage, none of the testing approaches is cost-effective and thus no testing is preferable, yielding $11 and 0.003 new infections per 10 HCWs. For screening asymptomatic HCWs, antigen testing is preferable to PCR testing due to its lower cost. Conclusions: Both PCR and antigen testing are beneficial strategies to identify infected HCWs and reduce transmission of SARS-CoV-2 in health care settings. IgG testing clinical value depends on test timing and immunity characteristics, however is not cost-effective in a low prevalence setting. As the context of the pandemic evolves, our study provides insight to health-care decision makers to keep the health care workforce safe and transmissions low.

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