Impact of COVID-19 RT-PCR testing of asymptomatic health care workers on absenteeism and hospital transmission during the pandemic

Mendes, Elisa Donalísio Teixeira; Neto, Danilo Glauco Pereira Villagelin; Ferreira, Giulia Magalhães; Valença, Ian Nunes; Lima, Maria Patelli Juliani Souza; Freitas, Maria Fernanda Marciano Barros de; Donalísio, Maria Rita; Melo, Márcio Cristiano de; Lázari, Carolina S.; Goes, Jacqueline; Morales, Ingra; Jardim, Ana Carolina Gomes; Santos, Pamela Andrade dos; Franco, Lucas Augusto Moysés; Sabino, Ester C.; Costa, Sílvia Figueiredo

doi:10.1016/j.ajic.2022.10.014

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…Nineteen articles reporting original data on COVID-19-associated absenteeism among HCP were identified [3,[14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31]. The characteristics of these articles and their main findings are shown in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…Absenteeism rates among HCP soared upon implementation of this strategy; however, 3-4 weeks later there was a significant reduction of HCP with COVID-19, a reversal of the absenteeism trend, and a reduction trend of virus transmission to hospitalized patients, despite the peak of virus transmission in the community [26]. The overall positivity prevalence was 17.3% (74 out of 429 HCP), while the duration of sick absence increased by 473% in 2020 compared with 2019 [26]. Therefore, routine screening of asymptomatic HCP proved to be a key strategy for the prevention of virus transmission [26].…”

Section: Impact Of Infection Control Strategies On Hcp Absenteeismmentioning

confidence: 97%

“…Studies from the first COVID-19 pandemic wave indicated considerable absenteeism rates among HCP [3,[14][15][16]18,[26][27][28]. A retrospective study based on sickness data from a general hospital in London revealed 39% (128 out of 328) of frontline physicians had at least one episode of sickness absence (138 episodes in total) from 16 March through 26 April 2020, summing to a total of 1240 days of absence [16].…”

Section: Absenteeism In the First Year Of The Covid-19 Pandemicmentioning

confidence: 99%

“…The impact of intensified routine PCR testing of asymptomatic HCP on absenteeism and SARS-CoV-2 transmission was investigated with real-life data and phylogenetic analyses in a hospital in Brazil from March through August 2020 [26]. Absenteeism rates among HCP soared upon implementation of this strategy; however, 3-4 weeks later there was a significant reduction of HCP with COVID-19, a reversal of the absenteeism trend, and a reduction trend of virus transmission to hospitalized patients, despite the peak of virus transmission in the community [26]. The overall positivity prevalence was 17.3% (74 out of 429 HCP), while the duration of sick absence increased by 473% in 2020 compared with 2019 [26].…”

Section: Impact Of Infection Control Strategies On Hcp Absenteeismmentioning

confidence: 99%

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Absenteeism of Healthcare Personnel in the COVID-19 Era: A Systematic Review of the Literature and Implications for the Post-Pandemic Seasons

Maltezou,

Ledda,

Sipsas

2023

Healthcare

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This systematic review aimed to assess COVID-19-associated absenteeism among healthcare personnel (HCP). PubMed was searched on 4 February 2023. Inclusion criteria were the presentation of original data on COVID-19-associated absenteeism among HCP. Exclusion criteria were absenteeism associated with burnout, mental health illness, post-COVID syndrome, or child-care. Nineteen articles were identified; fifteen concerned almost exclusively the first pandemic year. Hospitals accounted for most data. There was heterogeneity across studies in terms of presentation of absenteeism data. Before COVID-19 vaccines became available, COVID-19 was a major driver of HCP absenteeism with excess costs, while the mean duration of absenteeism ranged from 5.82 to 33 days per episode of absence. Determinant factors of absenteeism rates were department of employment, high-risk exposure, age, profession, and work experience of HCP, suspected COVID-19, SARS-CoV-2 testing, SARS-CoV-2 positivity, and return-to-work strategy. Two studies demonstrated that COVID-19 vaccination significantly reduced the burden of absenteeism. Routine testing of asymptomatic HCP and use of personal protective equipment also significantly ameliorated absenteeism. In conclusion, COVID-19 has been a major driver of HCP absenteeism. Research is needed to assess how COVID-19 will impact HCP in the next years, considering the new SARS-CoV-2 variants, the co-circulation of other respiratory viruses, and the newer COVID-19 vaccines. Networks are needed to survey morbidity and absenteeism among HCP in real-time and guide vaccination policies.

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Section: Resultsmentioning

confidence: 99%

Section: Impact Of Infection Control Strategies On Hcp Absenteeismmentioning

confidence: 97%

Section: Absenteeism In the First Year Of The Covid-19 Pandemicmentioning

confidence: 99%

Section: Impact Of Infection Control Strategies On Hcp Absenteeismmentioning

confidence: 99%

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Absenteeism of Healthcare Personnel in the COVID-19 Era: A Systematic Review of the Literature and Implications for the Post-Pandemic Seasons

Maltezou,

Ledda,

Sipsas

2023

Healthcare

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“…Similar observations have been reported elsewhere. For example, a hospital in the Canadian city of Campinas experienced a significantly reduced level of hospital absenteeism due to COVID-19 from March 2020 to September 2020 by using PCR tests for screening and then requiring the isolation of asymptomatic HCWs who had tested positive, resulting in a reduction in transmission of COVID-19 to hospitalised patients [32]. Using a computational model of SARS-CoV-2 transmission in a hospital in England, another study estimated that testing asymptomatic patients on admission would reduce the rate of nosocomial SARS-CoV-2 infection by 8.1% to 21.5% [33].…”

Section: Discussionmentioning

confidence: 99%

Assessing the impact of testing for COVID-19 using lateral flow devices in NHS acute trusts in England

Chen,

Hounsell,

Cantrell

et al. 2024

Preprint

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BackgroundTwice-weekly lateral flow device (LFD) testing was introduced for routine asymptomatic testing of healthcare workers (HCWs) in the National Health Service (NHS) in England in November 2020, with the primary aim of reducing nosocomial infections among staff and patients and a secondary aim of reducing absenteeism among HCWs. Here, we describe the burdens of HCW absenteeism and nosocomial infections in NHS acute trusts and the reported testing intensity of LFDs and associated costs from October 2020 to March 2022 and assess the impact of LFD testing on reducing these burdens.Methods and FindingsWe collected 16 million LFD testing results (total cost GBP 1.64 billion) reported in NHS acute trusts through England’s Pillar 1 and 2 testing programmes from 1 October 2020 to 30 March 2022. We estimated the prevalence of nosocomial COVID-19 infections in NHS acute trusts using data from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC). Testing data were linked with nosocomial infections and full-time equivalent (FTE) days lost by trust for NHS acute trusts.We used a mixed-effects linear model to examine the association between FTE days lost and LFD test coverage. The relationship between weekly prevalence of nosocomial infections and LFD test coverage in the previous week was modelled using logistic regression weighted by the number of new COVID-19 cases reported in the ISARIC dataset for that week. We adjusted both models for community prevalence of COVID-19 infections, average income deprivation score, prevalence of variants of concern and LFD test positivity.FTE days lost among HCWs varied considerably by trust type, staff group, geographical location of trusts, and progress of the pandemic in England. Increased LFD test coverage was associated with decreases in FTE days lost due to COVID-19 from November 2020 to July 2021, with no association observed from August 2021 to March 2022. Higher community prevalence levels were associated with significant increases in FTE days lost due to COVID-19 in all periods except the pre-vaccination period (last two months of 2020). The model predicted that changes in testing levels (50–150%) would have resulted in modest changes in FTE days lost due to COVID-19 for all time periods.We identified 3,794 nosocomial infections (if patients developed COVID-19 symptoms 7 days or more after their hospital admission) among 106,377 hospitalised COVID-19 patients in 136 NHS acute trusts. The proportion of nosocomial infections among new weekly cases in hospitalised patients was negatively associated with reported LFD testing levels. The strength of the association varied over time and was estimated to be highest during the Omicron period, although no effect of testing on HCW absenteeism was found. The observed HCW testing/reporting was estimated to be associated with a 16.8% (95% confidence interval 8.2%, 18.8%) reduction in nosocomial infections compared with a hypothetical testing scenario at 25% of actual levels, translating to a cost saving per quality-adjusted life-year (QALY) gained of GBP 18,500–46,400.ConclusionsLFD testing was an impactful public health intervention for reducing HCW absenteeism and nosocomial infections in NHS acute trusts and was cost effective in preventing nosocomial infections.Author SummaryWhy was this study done?In any pandemic response, mass diagnostic testing plays a key role.We sought to evaluate the burdens of healthcare worker absenteeism and nosocomial infections in NHS acute trusts, the reported testing intensity using lateral flow devices (LFDs) and associated costs, and the impact of LFD testing on reducing these burdens.What did the researchers do and find?We collected 16 million LFD testing results and full-time equivalent (FTE) days lost due to COVID-19, obtained from healthcare workers (HCWs) in NHS acute trusts in England between 1 October 2020 and 30 March 2022.We estimated the number of nosocomial COVID-19 infections in NHS acute trusts using data from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC).Testing data were linked with nosocomial infections and FTE days lost due to COVID-19 by trust for NHS acute trusts.We used a mixed-effects linear model to examine the association between FTE days lost due to COVID-19 and LFD test coverage and applied a logistic regression to assess the association between nosocomial infections and LFD test coverage.We found that LFD testing in the healthcare setting was an impactful public health intervention.LFD testing reduced HCW absenteeism and nosocomial infections in NHS acute trusts; it was also cost effective in preventing nosocomial infections.What do these findings mean?Our analysis of the available data indicated that testing HCWs had varying impacts (on both nosocomial infections and HCW FTE days lost due to COVID-19) throughout the pandemic, possibly influenced by external factors such as community prevalence and vaccination.In any future pandemic, HCW testing interventions should incorporate collection of and/or timely access to relevant data, including HCW absenteeism, routine test results, community prevalence, and hospitalisation and mortality data.The lessons learnt from this study could be used by relevant authorities to support the real-time assessment of any testing service and adjustment of the testing regimen; they could also be used to help develop more targeted and agile testing systems, which operationally would require the ability to turn mass testing off and on as an epidemic progressed.

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On the impact of surveillance test strategies: a cost–benefit modelling analysis based upon real-world data from SARS-CoV-2

Spath,

Kundi,

Strassl

et al. 2024

Public Health

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Impact of COVID-19 RT-PCR testing of asymptomatic health care workers on absenteeism and hospital transmission during the pandemic

Cited by 5 publications

References 21 publications

Absenteeism of Healthcare Personnel in the COVID-19 Era: A Systematic Review of the Literature and Implications for the Post-Pandemic Seasons

Absenteeism of Healthcare Personnel in the COVID-19 Era: A Systematic Review of the Literature and Implications for the Post-Pandemic Seasons

Assessing the impact of testing for COVID-19 using lateral flow devices in NHS acute trusts in England

On the impact of surveillance test strategies: a cost–benefit modelling analysis based upon real-world data from SARS-CoV-2

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