scholarly journals Incidence of COVID-19 infection amongst the high risk versus low risk health care workers: an audit from a tertiary cancer care centre

2021 ◽  
Vol 8 (7) ◽  
pp. 3474
Author(s):  
Nitin Shetty ◽  
Nivedita Chakrabarty ◽  
Amit Joshi ◽  
Amar Patil ◽  
Suyash Kulkarni ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Cancer Care ◽  
Low Risk ◽  
Care Centre ◽  
Protective Measures ◽  
Care Workers ◽  
Significant Difference ◽  
Treatment Research

Background: Theoretically, health care workers (HCW) are at increased risk of getting infected with COVID-19 compared to the general population. Limited data exists regarding the actual incidence of COVID-19 infection amongst the high risk and low risk HCW of the same hospital. We present an audit from our tertiary cancer care centre comparing the COVID-19 infection rate between the high risk and low risk HCW, all of whom had been provided with adequate protective measures and health education.Methods: This is a retrospective observational study from 01 April 2020 to 30 September 2020, in which all the 970 HCW of Advanced Centre for Treatment, Research and Education in Cancer were divided into high risk and low risk groups. High risk HCW included all the medical and non-medical staff directly involved with the care of COVID-19 patients, and rest were low risk HCW. Adequate protective measures and classes for infection prevention were provided to all the HCW. We calculated the incidence of COVID-19 infection in both these groups based on the positive real time-polymerase chain reaction (RT-PCR) result and also looked for any significant difference in incidence between these two groups.Results: The incidence of COVID-19 infection amongst the high risk HCW was 13% and that of low risk HCW was 14%.Conclusions: We found no significant difference in COVID-19 infection between the high risk and low risk HCW. Thus, along with protective measures, behavior modifications induced by working in high risk areas, prevented the high risk HCW from getting increased COVID-19 infection compared to the low risk HCW.

scholarly journals Acroischemia in a Patient with Tracheostomy in COVID-19: A Case Report

2020 ◽  
pp. 39-43
Author(s):  
Bhagyashree Sagane ◽  
Shivakumar Divity ◽  
Yogesh G. Dabholkar
Keyword(s):  
Health Care ◽  
Case Report ◽  
High Risk ◽  
Health Care Workers ◽  
Medical Community ◽  
Aerosol Exposure ◽  
Care Workers ◽  
Significant Difference ◽  
Global Health Care ◽  
High Index Of Suspicion

As a part of global health care system we are now facing an unprecedented increase in the number of COVID positive patients. While the SARS-CoV2 continues to expand its reach, newer information gets reported every day. The phenomenon of acro-ischemia in patients testing positive for SARS-CoV2 has started gathering attention within the medical community. Also, with increased need for tracheostomy HCWs (health care workers) are constantly at a high risk of aerosol exposure. We report a case of a critically ill, late detected, COVID positive male, with dermatological signs who landed in a tracheostomy. We aim to highlight the importance of high index of suspicion and early detection that would make a significant difference.

scholarly journals 447. COVID-19 Prevalence Among COVID-19 Exposed Health Care Workers at a Tertiary Care Center in San Bernardino County, Ca

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S291-S292
Author(s):  
Kathleen Louise Valenzuela ◽  
Jennifer Veltman ◽  
April Wilson
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Antibody Test ◽  
Igg Antibodies ◽  
Antibody Testing ◽  
Protective Measures ◽  
Positive Antibody ◽  
Care Workers ◽  
San Bernardino

Abstract Background We studied the prevalence of positive SARS-CoV2 antibody and positive SARS-CoV2 antigen among high risk health care workers at Loma Linda University Health System (LLUHS) who voluntarily obtained SARS-CoV2 antibody testing, and if indicated, antigen testing. The study determined that there is a significant decrease in the prevalence of SARS-CoV2 antigen among employees at LLUH compared to the community. Methods Employee Health and Occupational Medicine offered antibody testing to employees who were considered high risk, primarily working in the Coronavirus Disease 19 (COVID-19) designated units. We tested 658 subjects’ serum for the presence of IgM and IgG antibodies via the Nirmidas Qualitative SARS-CoV2 test. 29 subjects with a positive antibody test were subsequently tested for the presence of serum SARS-CoV2 antigen via PCR. Results There were 31 subjects who tested positive for IgM or IgG antibodies. 11 subjects had positive IgM with negative IgG. 3 subjects had negative IgM with positive IgG. 15 patients had positive IgM and positive IgG. 2 subjects had positive IgM with negative IgG, were subsequently retested, and then found to have positive IgM and positive IgG. Of those 31 subjects with a positive antibody test, 2 were not tested for the COVID-19 antigen, 1 had an inconclusive test, 23 tested negative, and 5 tested positive. Of those 5 positive for the antigen, 2 had symptoms and 3 did not report symptoms or did not use the symptom questionnaire. The community prevalence of positive SARS-CoV2 antigen in San Bernardino is 0.37%, as of June 16. The prevalence of positive SARS-CoV2 antigen among LLUH employees is 0.03% and the prevalence of positive antibody is 0.18%. The value of z is -7.3206, p is < .00001. Thus, the result is significant at p < .01. Conclusion The results of this testing supports the efficacy of the early protective measures that LLUHS implemented in preparation for the pandemic. Such protective measures include: mandated face masks, symptoms screening, testing for SARS-CoV2 antibody or antigen on patients admitted, a dedicated COVID-19 section of the emergency department as well as inpatient units, etc. Given the statistical significance of this study, the protective bundle can be used as a template for preventative measures for future pandemics. Disclosures All Authors: No reported disclosures

scholarly journals Prevalence of SARS CoV-2 infection among Health Care Workers of a hybrid tertiary COVID 19 hospital in Kerala

2021 ◽  
Author(s):  
Jessy S J ◽  
Shamha Beegum ◽  
Genga Gopakumar ◽  
Bindu G ◽  
Chntha S ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Health Care Workers ◽  
Risk Group ◽  
Previous History ◽  
High Risk Group ◽  
Low Risk ◽  
Risk Category ◽  
Care Workers ◽  
History Of

Back ground and objectives- This study was undertaken to estimate the prevalence of SARS-CoV-2 infection among Health care workers [HCWs] of a hybrid COVID treatment hospital in Kerala. Methods- The study was conducted during 3rd week of January 2021. Among 3550 HCWs, 979 subjects were selected by stratified random sampling and grouped into high risk and low risk category based on job setting. Demographic details and clinical information regarding previous history of COVID 19 were collected at the time of SARS-CoV-2 IgG testing. Results: From 979 subjects, the data with respect to 940 health care workers were analysed. SARS-CoV-2 IgG was detected in 19.1% of HCWs. Seroprevalence among high risk group was 20.3% and that in low risk group was 7.4% [p=0.005]. In high-risk group, seropositivity was noted in 30.54 % of nurses, 19% hospital attenders, 18.9% resident doctors and 6.4% consultant doctors. In those with past history of SARS-CoV-2 infection, seropositivity was 75.4%. In those who were COVID positive during July2020, 33.3% were still IgG reactive. Interpretation and conclusion- The study reported 19.1% SARS CoV-2 IgG reactivity among health care workers in our hospital. Seropositivity was significantly higher in high risk group compared to low risk group. Antibody decay kinetics in our study is comparable to that in published literature. Infection control challenges in hybrid hospitals account for higher seropositivity in this study compared to overall seroprevalence among HCWs in Kerala.

scholarly journals Management of ear, nose, and throat out patient department in COVID-19 pandemic, experience: a descriptive study

2020 ◽  
Vol 6 (11) ◽  
pp. 1996
Author(s):  
Shashidhar S. Suligavi ◽  
Saif N. Saiyad ◽  
Sangappa S. Doddamani ◽  
Mallikarjun Patil ◽  
Archana Mathri ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Infection Control ◽  
Health Care Workers ◽  
Control Strategies ◽  
Clinical Care ◽  
Protective Measures ◽  
Medical College ◽  
Care Workers ◽  
Protective Strategies

<p><strong>Background:</strong> Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health care workers (HCWs) are particularly at high risk of becoming infected while treating patients as many in-office procedures and Aerosol Generating Medical Procedures (AGMP). Based on a review of the literature and various guidelines, recommendations are made to mitigate the risk to health care workers from becoming infected with SARS-CoV-2 while providing clinical care. During the COVID-19 pandemic, all elective and non-time sensitive Otolaryngology procedures should be deferred to mitigate the risk of transmission of infection to HCWs. Objective of the study was to describe outpatient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ENT department in S Nijalingappa Medical College.</p><p><strong>Methods</strong>: Personal protective equipment (PPE) use and infection control strategies implemented for ENT outpatients in S. N. Medical College, Bagalkot.</p><p><strong>Results:</strong> After implementation of infection control strategies for outpatient clinics, no health care workers were infected in the ENT OPD.<strong></strong></p><p><strong>Conclusion:</strong> Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection to otolaryngologists.</p>

Hospital based contact tracing of COVID-19 patients and health care workers during the COVID-19 Pandemic in Eastern India (Preprint)

2021 ◽  
Author(s):  
Durgesh Prasad Sahoo ◽  
Arvind Kumar Singh ◽  
Dinesh Prasad Sahu ◽  
Somen Kumar Pradhan ◽  
Binod Kumar Patro ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Risk Stratification ◽  
Health Care Workers ◽  
Control Strategies ◽  
Routine Data ◽  
Low Risk ◽  
Contact Tracing ◽  
P Value ◽  
Care Workers

BACKGROUND Contact tracing and subsequent quarantining of Health Care Workers (HCWs) is essential to minimize further transmission of SARS-CoV2 infection. OBJECTIVE In this study, we have reported the yield of contact tracing of COVID-19 cases and risk stratification of HCWs exposed to them. METHODS This is an analysis of routine data collected for contact tracing of COVID-19 cases from 19th March to 31st August 2020 at All India Institute of Medical Sciences, Bhubaneswar, Odisha, India. COVID-19 cases were either admitted patients, out-patients, or HCWs in the hospital. HCWs who were exposed to COVID-19 cases were categorized as per the risk stratification guidelines into high-risk contacts and low-risk contacts RESULTS During contact tracing, 3411 HCWs were identified as exposed to 360 COVID-19 cases. Out of 360, 269 (74.7%) were either admitted or out-patients and 91(26.1%) were HCWs. After risk stratification 890 (26.1%) were categorized as high-risk contacts and 2521 (73.9%) were categorized as low-risk contacts. The test positivity rate of high-risk contact and low-risk contacts were 3.82% and 1.90%, respectively. The average number of high-risk contacts was significantly higher when the COVID-19 case was an admitted patient (6.6) rather than when the COVID-19 case was an HCW (4.0) or outpatient (0.2), p-value = 0.009. Similarly, the average number of high-risk contacts was higher when the COVID-19 case was admitted in non-COVID-19 area (15.8) as compared to COVID-19 area (0.27), p value < 0.001. There was significant decline in mean number of high-risk contacts over the study period. CONCLUSIONS Contact tracing and risk stratification was effective and helped in reducing the number of HCWs going for quarantine. There was also a decline in high-risk contacts during study period suggesting role of implementation of hospital based COVID-19 related infection control strategies. This contact tracing and risk stratification approach designed in the current study can also be implemented in other healthcare settings.

scholarly journals Hospital based contact tracing of COVID-19 patients and health care workers and risk stratification of exposed health care workers during the COVID-19 Pandemic in Eastern India

2020 ◽  
Author(s):  
Durgesh Prasad Sahoo ◽  
Arvind Kumar Singh ◽  
Dinesh Prasad Sahu ◽  
Somen Kumar Pradhan ◽  
Binod Kumar Patro ◽  
...  
Keyword(s):  
Health Care ◽  
High Risk ◽  
Risk Stratification ◽  
Health Care Workers ◽  
Secondary Analysis ◽  
Routine Data ◽  
Low Risk ◽  
Contact Tracing ◽  
P Value ◽  
Care Workers

AbstractIntroductionContact tracing and subsequent quarantining of Health Care Workers (HCWs) is essential to minimize further transmission of COVID-19 infection. In this study, we have reported the yield of Contact Tracing of COVID-19 Patients and HCWs and risk stratification of exposed HCWs.MethodologyThis is a secondary analysis of routine data collected for contact tracing from 19th March to 31st August 2020 at All India Institute of Medical Sciences, Bhubaneswar, Odisha, India. HCWs exposed to COVID-19 infections were categorized as per the risk stratification guidelines and the high-risk contacts were quarantined for 14 days and tested on 7th day from last day of exposure. The low risk contacts were encouraged to closely monitor their symptoms while continuing to work.ResultsOut of 3411 HCWs exposed to COVID 19 patients (n=269) and HCWs (n=91), 890 (26.1%) were high risk contacts and 2521 (73.9%) were low risk contacts. The test positivity rate of high-risk contact was 3.82% and for low risk contact was 1.90%. Average number of high-risk contacts was significantly higher; for admitted patients (6.6) as compared to HCWs (4.0) and outpatients (0.2), p value = 0.009; for patients admitted in non-COVID areas (15.8) as compared to COVID areas (0.27), p value < 0.001; and when clustering of cases was present (14.3) as compared to isolated cases (8.2); p value < 0.001. Trend analysis (15 days block period) showed a significant decline in number of mean numbers of high-risk contacts during the study period.ConclusionContact tracing and risk stratification was effective and helped in reducing the number of HCWs going for quarantine. There was also a decline in high-risk contacts during study period suggesting role of implementation of hospital based COVID related infection control strategies. This contact tracing and risk stratification approach designed in the current study can also be implemented in other healthcare settings.

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 Psychological impact of COVID-19 on Chinese health-care workers (Preprint)

2020 ◽  
Author(s):  
Jie Ni ◽  
Yihai Liu ◽  
Mingyue Wu ◽  
Yan Jiang ◽  
Yujie Zhou ◽  
...  
Keyword(s):  
Health Care ◽  
Medical Students ◽  
High Risk ◽  
Psychological Stress ◽  
Health Care Workers ◽  
Hospital Environment ◽  
Psychological Status ◽  
Epidemic Disease ◽  
Care Workers ◽  
Significant Difference

BACKGROUND The outbreak of the 2019-nCoV has dominated headlines throughout the world. The number of infections continue to rise, which has reached 30 thousand at the time of writing this editorial. Because of the high risk of nosocomial transmission, the medical health-care workers may be experiencing significant psychological stress. OBJECTIVE This descriptive study aimed to identify hospital staff’s psychosocial effects associated with working in a hospital environment during the 2019-nCoV outbreak. METHODS 57 frontline clinicians working in Wuhan First Hospital and 157 medical training students working in Jiangsu Provincial Peoples Hospital during this outbreak participated in our survey. The questionnaire we adopted included questions regarding the participants’ personal well-being, sociodemographic characteristics and the psychological status. RESULTS 2019-nCoV had psychological impacts both on formal workers and medical students. The psychological effects include sleep disorders, anxiety and depression. There is no significant difference between the group of formal workers and medical students, and nearly 50% of the respondents reported pandemic-related mental disorders. CONCLUSIONS Our study indicates that the high risk of 2019-nCoV exposure cause huge psychological stress on healthcare workers. This finding emphasizes the need of promoting psychological crisis intervention for medical personnel during this epidemic disease outbreak.

scholarly journals Measuring the Quality of Rural-Based, Government Health Care Workers in Nepal

2010 ◽  
Author(s):  
Stephen Knoble ◽  
Anil Pandit ◽  
Bibek Koirala ◽  
Laxmi Ghimire
Keyword(s):  
Health Care ◽  
Health Care Workers ◽  
Clinical Training ◽  
Health Workers ◽  
Clinical Skills ◽  
Clinical Teacher ◽  
Government Health ◽  
Care Workers ◽  
Key Skills ◽  
Significant Difference

A representative, cross-sectional clinical skills assessment of 163 mid-level, rural-based, government health care workers was conducted in four districts of Nepal in June 2007. All Health Assistants and Auxiliary Healthcare Workers within the target districts were scored using checklists of standardized key skills in clinical encounters with model patients or clinical models. Participant scores were reported as a mean percentage in adult medicine 28(%), pediatric medicine 56(%), maternity medicine 35(%), orthopedic medicine 45(%), clinical procedures 59(%), and management 46(%). This was measured against the government’s 60(%) standard on clinical skills. There was little significant difference between categories of health workers by district of posting or years of experience. There was a minor difference in skills by level of facility - workers in higher level facilities scored better across the domains. Reasons for poor performance in clinical skills were attributed to a lack of clinical in-service training programs, training only focusing on prevention and public health, and poor on-sight supervision. Poor pre-service schooling factors included heavy theory concentration in pathophysiology and inadequate clinical exposure opportunities. Recommendations for the improvement of clinical skills and decision-making include the institution of in-service competency-based training with a high emphasis on real patient exposure. Pre-service recommendations include implementation of a national certification program and an expansion of the current government clinical training sites and clinical teacher development programs.

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