Implementation of a COVID-19 surveillance programme for healthcare workers in a teaching hospital in an upper-middle-income country

Abstract

Introduction The reporting of Coronavirus Disease 19 (COVID-19) mortality among healthcare workers highlights their vulnerability in managing the COVID-19 pandemic. Some low- and middle-income countries have highlighted the challenges with COVID-19 testing, such as inadequate capacity, untrained laboratory personnel, and inadequate funding. This article describes the components and implementation of a healthcare worker surveillance programme in a designated COVID-19 teaching hospital in Malaysia. In addition, the distribution and characteristics of healthcare workers placed under surveillance are described. Material and methods A COVID-19 healthcare worker surveillance programme was implemented in University Malaya Medical Centre. The programme involved four teams: contact tracing, risk assessment, surveillance and outbreak investigation. Daily symptom surveillance was conducted over fourteen days for healthcare workers who were assessed to have low-, moderate- and high-risk of contracting COVID-19. A cross-sectional analysis was conducted for data collected over 24 weeks, from the 6th of March 2020 to the 20th of August 2020. Results A total of 1,174 healthcare workers were placed under surveillance. The majority were females (71.6%), aged between 25 and 34 years old (64.7%), were nursing staff (46.9%) and had no comorbidities (88.8%). A total of 70.9% were categorised as low-risk, 25.7% were moderate-risk, and 3.4% were at high risk of contracting COVID-19. One-third (35.2%) were symptomatic, with the sore throat (23.6%), cough (19.8%) and fever (5.0%) being the most commonly reported symptoms. A total of 17 healthcare workers tested positive for COVID-19, with a prevalence of 0.3% among all the healthcare workers. Risk category and presence of symptoms were associated with a positive COVID-19 test (p<0.001). Fever (p<0.001), cough (p = 0.003), shortness of breath (p = 0.015) and sore throat (p = 0.002) were associated with case positivity. Conclusion COVID-19 symptom surveillance and risk-based assessment have merits to be included in a healthcare worker surveillance programme to safeguard the health of the workforce.

Prevalence and factors associated with COVID-19 among healthcare workers at a university hospital in Thailand

“…The proportion of COVID-19 in HCWs in our study was 4.2%, while and the rate of HCWs infected in China was 0.2% and in France was 21.0% (Table 3), [15,20,[25][26][27][28][29][30][31][32][33] varying according to the time period measured and the COVID-19 outbreak situation in each country. A much higher incidence of infection among HCWs was observed in regions with high population incidence and prevalence, with significantly strained healthcare systems.…”

Hospital Financial Strategy in Response to COVID-19: A Systematic Review

“…Further, Ahuja also mentioned other forms of relief from the government, such as reduced tariffs for electrical power used by hospitals to provide care for COVID-19 cases and subsidies for healthcare workers' salaries, especially those directly involved in the treatment of COVID-19 patients (Ahuja et al, 2021). As healthcare workers also need frequent testing and infected healthcare workers need treatments as part of the surveillance program, instead of relying on hospitals cash flow to cover for these expenses, as an alternative source, hospitals could also utilize government-funded testing for their healthcare workers, at least partially, in order to ensure that their business is sustained (Wan et al, 2021).…”

Propagation of a hospital-associated cluster of COVID-19 in Malaysia

“…Additionally, a broad definition of close contact was applied, and it enabled HCWs and patients with possible exposure to a COVID-19 case to be identified. They were tested, underwent symptom surveillance, and promptly removed from the workplace if their risk levels were identified as medium- or high-risk [ 14 ]. These approaches were valuable in preventing the further propagation of COVID-19 in the hospital setting.…”

“…HCWs who developed new or worsening symptoms were reassessed and, if warranted, tested for SARS-CoV-2. The management of HCWs following the exposure to a positive case based on risk level is described elsewhere [ 14 ].…”