Introduction This study examines the frequency, associated factors, and characteristics of healthcare personnel coronavirus disease 2019 (COVID-19) cases in a healthcare department that comprises a tertiary hospital and its associated 12 primary healthcare centers. Methods This study included healthcare personnel that showed symptoms or were in contact with a COVID-19 case patient from March 2 to April 19, 2020. Their evolution and characteristics (age, sex, professional category, type of contact) were recorded. Correlations between the different characteristics and risk of developing COVID-19 and severe COVID-19 were analyzed using chi-square tests. Their magnitudes were quantified with ORs, AORs, and their 95% CIs using a logistic regression model. Results Of the 3,900 healthcare professionals in the department, 1,791 (45.9%) showed symptoms or were part of a contact tracing study. The prevalence of those with symptoms was 20.1% (784/3,900; 95% CI=18.8%, 21.4%), with COVID-19 was 4.0% (156/3,900; 95% CI=3.4%, 4.6%), and with severe COVID-19 was 0.5% (18/3,900; 95% CI=0.2%, 0.7%). The frequency of COVID-19 in symptomatic healthcare personnel with a non-protected exposure was 22.8% (112/491) and 13.7% (40/293) in those with a protected exposure (AOR=2.2, 95% CI=1.2, 3.9). The service in which the healthcare personnel performed their activity was not significantly associated with being diagnosed with COVID-19. A total of 26.3% (10/38) of male healthcare personnel with COVID-19 required hospitalization, compared with 6.8% (8/118) among female healthcare personnel (OR=4.9, 95% CI=1.8, 13.6). Conclusions A surveillance and monitoring program centered around healthcare personnel enables an understanding of the risk factors that lead to COVID-19 among this population. This knowledge allows the refinement of the strategies for disease control and prevention in healthcare personnel during the COVID-19 pandemic.

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On behalf of COVID19-ALC research group, Effectiveness of a SARS-CoV-2 infection-prevention model in elective surgery patients, a prospective study: Does Universal Screening Make Sense?.

Objetivo: Estimar la prevalencia de anticuerpos IgG frente a SARS-CoV-2 en profesionales sanitarios (PS) de un Departamento Sanitario (DS). Métodos: Estudio de prevalencia. Se determinó la presencia de anticuerpos IgG frente a SARS-CoV-2 en los PS del DS. La determinación se realizó mediante la técnica de ELISA. El trabajo de campo se realizó del 24/04/2020 al 08/05/2020. Se recogió edad, sexo, estamento (facultativo, enfermería, etc.) y área de trabajo (atención primaria, urgencias, etc.). Se calculó la prevalencia de anticuerpos IgG frente a SARS-CoV-2 con su intervalo de confianza al 95% (IC95%). Para estudiar la asociación entre las características de los PS y la presencia de IgG se utilizó la prueba de la Ji Cuadrado y para cuantificar la magnitud de asociación se calculó la Odds Ratio (IC95%). Resultados: De los 4813 PS del DS participaron 4179 (87,1%). De éstos el 73,3% (3065) eran mujeres y el 26,7% (1114) hombres. La prevalencia global de presencia de anticuerpos IgG frente a SARS-CoV-2 fue del 6,6% (IC95%:5,8%-7,3%). Hubo diferencias estadísticamente significativas según estamento, oscilando del 8,7% (IC95%:6,9%-10,6%) en facultativos a un 3,2% (IC95%:1,0%-8,0%) en otro personal no sanitario. El resto de características no se asociaron de forma significativa a la presencia de anticuerpos frente a SARS-CoV-2. Conclusión: La frecuencia de infección por SARS-CoV-2 en PS es similar a la estimada para la población general en grandes ciudades en España, lo que orienta sobre la efectividad del programa de prevención y control de infecciones dirigido a los profesionales sanitarios en este Departamento Sanitario.

Background Although recommendations to prevent COVID-19 healthcare-associated infections (HAIs) have been proposed, data on their effectivity are currently limited. Objective The aim was to evaluate the effectivity of a program of control and prevention of COVID-19 in an academic general hospital in Spain. Methods We captured the number of COVID-19 cases and the type of contact that occurred in hospitalized patients and healthcare personnel (HCP). To evaluate the impact of the continuous use of a surgical mask among HCP, the number of patients with COVID-19 HAIs and accumulated incidence of HCP with COVID-19 was compared between the preintervention and intervention periods. Results Two hundred fifty-two patients with COVID-19 have been admitted to the hospital. Seven of them had an HAI origin (6 in the preintervention period and 1 in the intervention period). One hundred forty-two HCP were infected with SARS-CoV-2. Of them, 22 (15.5%) were attributed to healthcare (2 in the emergency department and none in the critical care departments), and 120 (84.5%) were attributed to social relations in the workplace or during their non–work-related personal interactions. The accumulated incidence during the preintervention period was 22.3 for every 1000 HCP and 8.2 for every 1000 HCP during the intervention period. The relative risk was 0.37 (95% confidence interval, 0.25 to 0.55) and the attributable risk was −0.014 (95% confidence interval, −0.020 to −0.009). Conclusions A program of control and prevention of HAIs complemented with the recommendation for the continuous use of a surgical mask in the workplace and social environments of HCP effectively decreased the risk of COVID-19 HAIs in admitted patients and HCP.

Background: The objective is to know the evolution of the Degree of Compliance with Recommendations (DCR) on hand hygiene (HH) and its associated factors in the pediatric care areas (PCAs) of a tertiary hospital. Methods: Observational, cross-sectional study, repeated over time, with direct observation of the DCR on HH during the daily activity of health care workers. Over 13 years, 9226 HH opportunities were observed. Associations between DCR, PCA and other variables (eg, age, sex, and professional position) were examined using x 2 and adjusted odds ratios (aOR) with 95% confidence intervals (CI). Results: DCR on HH in 9 PCAs was 64.3% (95% CI, 63.3-65.3), and in the group of non-pediatric areas it was 49.6% (95% CI, 49.1-50.1). The areas with the highest degree of compliance were Oncology 72.8% (95% CI, 69.2-76.4), Neonatology 73.2% (95% CI, 71.3-75.1), and Neonatal intensive care unit 70.0% (95% CI, 67.5-72.6). These were the areas with the strongest association with HH compliance, with aOR:2.8 (95% CI, 2.2-3.6); aOR, 3.0 (95% CI, 2.6-3.6) aOR:2.6 (95% CI, 2.1-3.1), respectively. Other associated factors were the indications "after an activity," aOR, 1.6 (95% CI, 1.5-1.8) and the availability of pocket-size alcohol-based solution, aOR, 2.1(95% CI, 1.9-2.3). Conclusions: The DCR on HH in PCAs is higher than in other areas, although there is still margin for improvement. We have identified modifiable factors that have an independent association with HH compliance in PCAs. Focusing on modifiable factors will increase compliance with HH with the ultimate goal of reducing healthcare associated infections.

DISCLAIMER This paper was submitted to the Bulletin of the World Health Organization and was posted to the COVID-19 open site, according to the protocol for public health emergencies for international concern as described in Vasee Moorthy et al. (http://dx.doi.org/10.2471/BLT.20.251561).The information herein is available for unrestricted use, distribution and reproduction in any medium, provided that the original work is properly cited as indicated by the Creative Commons Attribution 3.0 Intergovernmental Organizations licence (CC BY IGO 3.0).

Objective Estimate IgG antibody prevalence against SARS-CoV-2 in healthcare personnel (HCP) of a healthcare department (HD). Method Prevalence study. The presence of IgG antibodies against SARS-CoV-2 was determined in HCP of the HD. Enzyme linked immunosorbent assays (ELISA) tests were used. Field work took place from April 24, 2020 to May 8, 2020. The age, sex, occupation (physician, nurse, etc.) and the work area (Primary Care, Emergency Room, etc.) were gathered. The IgG antibody prevalence was then calculated with its 95% confidence interval (95% CI). To study the association between HCP characteristics and the presence IgG the Chi Square test was used, and to study the magnitude of association, the Odds Ratio (95% CI) was calculated. Results Of the 4813 HCP in the HD, 4179 (87,1%) participated. Of these, 73,3% (3065) were women and 26,7% (1114) men. The global prevalence of IgG antibodies against SARS-CoV-2 was 6,6% (95% CI: 5,8–7,3). There were statistically significant differences depending on the occupation, from 8,7% (95% CI: 6,9-10,6) on medics down to 3,2% (95% CI: 1,0-8,0) on personnel not associated with health care. The other characteristics did not associate significantly to antibody presence against SARS-CoV-2. Conclusion The SARS-CoV-2 infection frequency in HCP is similar to the estimated in the general population for big cities in Spain. This highlights the effectiveness of the infection control and prevention programme in this healthcare department targeted at healthcare personnel.