Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

Abstract

Objective: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). In this study, we evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their infection control or occupational health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May and October 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0 to day 7 after exposure and standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for (1) clinical coronavirus disease 2019 (COVID-19) diagnosis from day 8–14 after exposure, and for (2) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9, 10, and 14 after exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled, the mean age was 31 years (SD, ±9), and 24 (80%) were female. Moreover, 3 were diagnosed with COVID-19 by day 14 after exposure (secondary attack rate, 10.0%), and all cases were detected using the 7-day infection control strategy: the NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95% CI, 93.1%–100.0%). Conclusions: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. Ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, and here we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

An early return-to-work program for COVID-19 close contacts in healthcare during the Omicron wave in Japan

“…Our data showed 14% of HCWs had a secondary attack, which was consistent with previous studies [ 5 , 6 ]. Sahoo et al reported that 3.8% of HCWs with high-risk contacts tested positive for COVID-19.…”

“…A prospective study including 2761 close contacts observed no secondary attack cases of COVID-19 among participants initially exposed to the index case after six days of symptom onset [ 9 ]. Benea et al reported that all secondary attack cases of COVID-19 infection among HCWs following high-risk exposures to SARS-CoV-2 were diagnosed within six days of the last exposure [ 5 ]. The National Institute of Infectious Diseases demonstrated that the number of cases from which live virus was recovered was low six days after diagnosis among asymptomatic COVID-19 patients [ 10 ].…”

COVID-19 Prevention and Control Measures in Workplace Settings: A Rapid Review and Meta-Analysis

“…Fifteen studies were performed in the United States (USA) [28,36,38,41,45,49,51,52,55,69,72,[78][79][80][81]. Other included studies were performed in India [32], France [72], Canada [29,63], Italy [22,42,44,57,60,62,74], the United King-dom (UK) [35,40,50,53,58,65,75,76], Belgium [21,39], Korea [30,31,54,56], Taiwan [73], Germany [33,37,59,67,68,71] China [48], Finland [25], Spain [26], Japan …”

“…Kong and Yan added a unique component to their intervention: inventory monitoring protocols to ensure adequate PPE supply at all times [48]. Other widely used measures in combined interventions were universal, asymptomatic testing [29,42,48,56,62,71], symptomatic testing [29,46,47,67,68], and social distancing [22,47,48,67,68]. Five studies conducted employee education and/or training [22,34,44,48,67].…”

An Early Return-to-Work Program for COVID-19 Close Contacts in Healthcare During the Omicron Wave in Japan

“…A prospective study including 2761 close contacts observed no secondary attack cases of COVID-19 among participants initially exposed to the index case after six days of symptom onset (9). Benea et al reported that all secondary attack cases of COVID-19 infection among HCWs following high-risk exposures to SARS-CoV-2 were diagnosed within six days of the last exposure (5). The National Institute of Infectious Diseases demonstrated that the number of from which live virus was recovered cases decreased six days after diagnosis among asymptomatic COVID-19 patients (10).…”