Coworkers are more likely than patients to transmit SARS-CoV-2 infection to healthcare personnel

Abstract

ObjectivesTo compare the impact of occupational exposures to SARS-CoV-2 positive patients and SARS-CoV-2 positive coworkers, by comparing the frequency of occupational exposure incidents and the rate of healthcare personnel (HCP) who developed a positive PCR test for SARS-COV-2 after occupational exposure to the two different types of infectious individuals.MethodsA retrospective analysis of all confirmed higher risk occupational exposure incidents that occurred in HCP from 20 March 2020 to 31 December 2020 at a large multisite US academic medical centre. Comparisons between groups for source type were performed using unpaired Student’s t-test for continuous variables and the χ2 test for categorical variables, regression analysis was conducted to assess the associations between source type and risk of positive COVID-19 test after occupational exposure.ResultsIn total, 2253 confirmed medium or high-risk occupational exposures occurred during the study period. 57% were exposures from coworker sources. Each source individual exposed a mean of 2.6 (95% CI 2.3 to 2.9) HCP; during postexposure surveillance, 4.5% of exposed HCP tested positive within 14 days. A coworker source on average exposed 2.2 (95% CI 2.01 to 2.4) other HCP and infected 0.14 (95% CI 0.1 to 0.17) HCP, while patient sources exposed a mean of 3.4 (95% CI 2.6 to 4.2) HCP but only infected 0.07 (95% CI 0.04 to 0.11) HCP. The multivariate analysis demonstrated that exposure to a coworker source carried a higher risk of testing positive compared with exposure to a patient source (OR 3.22; 95% CI 1.72 to 6.04).ConclusionOccupational exposures to coworker sources were not only more frequent but also associated with triple the risk of developing COVID-19 infection, compared with exposures to patient sources.

COVID-19 Infections and Predictors of Sickness Related Absences Among Healthcare Workers

“…15,16 These findings suggest that HCWs were infected from a community source, potentially spreading the infection to their colleagues at work, resulting in an increased risk for occupational exposure. 17 This hypothesis could only be confirmed by further assessments of the source of infection of HCWs.…”

Residential social vulnerability among healthcare personnel with and without severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection in Five US states, May–December 2020

“… 31 Providing adequate paid sick leave and health benefits to all HCP, especially those more vulnerable to community exposures, is also necessary to prevent viral transmission to other HCP and patients in the workplace. 32 Furthermore, given our findings that case status is associated with residing in census tracts with higher proportions of older adults, children, people living with disabilities and single-parent households (ie, the household characteristics SVI theme), healthcare facilities should consider childcare and eldercare policies that can support HCP that are differentially impacted by their household composition and care responsibilities. Finally, focusing interventions to prevent SARS-CoV-2 transmission and social policies to improve economic conditions in the most vulnerable neighborhoods would protect the healthcare workforce as well as the general population.…”

Lessons learned from the COVID-19 pandemic—what Occupational Safety and Health can bring to Public Health

“…Because employees interact, cohabit, commute to work together, they are potential carriers, vectors, or targets of the virus. Effective workplace prevention can reduce excess occupational risk for workers, their families, community contacts, and patients in healthcare [8][9][10][11]. Workplaces also serve as settings for education about prevention and vaccination, knowledge that workers can transfer to their communities.…”