Internal Medicine Resident Work Absence During the COVID-19 Pandemic at a Large Academic Medical Center in New York City

Abstract

Background Montefiore Medical Center (MMC) is a large tertiary care center in the Bronx, New York City, with 245 internal medicine residents. Beginning on February 29, 2020, residents became ill with COVID-19-like illness (CLI), which required absence from work. There was initially a shortage of personal protective equipment and delays in SARS-CoV-2 testing, which gradually improved during March and April 2020. Objective We evaluated the relationship between CLI-related work absence rates of internal medicine residents and MMC's COVID-19 hospital census over time. Methods Data on resident work absence between February 29 and May 22 were reviewed along with MMC's COVID-19 hospital census data. To determine the effect of patient exposure on resident CLI incidence, we compared the mean incidence of CLI per patient exposure days (PED = daily hospital census × days pre- or post-peak) before and after peak COVID-19 hospital census. Results Forty-two percent (103 of 245) of internal medicine residents were absent from work, resulting in 875 missed workdays. At the peak of resident work absence, 16% (38 of 245) were out sick. Residents were absent for a median of 7 days (IQR 6–9.5 days). Mean resident CLI incidence per PED (CLI/PED) was 13.9-fold lower post-peak compared to pre-peak ( P = .003). Conclusions At the beginning of the COVID-19 pandemic in New York City, a large portion of internal medicine residents at this single center became ill. However, the incidence of CLI decreased over time, despite ongoing exposure to patients with COVID-19.

Prevalence of, and factors associated with, long-term COVID-19 sick leave in working-age patients followed in general practices in Germany

“…Taken together, these various complications of COVID-19 may negatively impact the ability of working-age patients to work. As a matter of fact, a large number of studies have reported high rates of sick leave in workers affected by COVID-19 (Alquézar-Arbé et al, 2020;Calvo-Bonacho et al, 2020;Carvalho-Schneider et al, 2021;COVIDSurg Collaborative, 2021;Groenewold et al, 2020;Khorasanee et al, 2021;Merkin et al, 2020;Prezant et al, 2020;Suárez-García et al, 2020). For example, one study using data collected in a UK medical center in March and April 2020 found that 39% of physicians were absent at least once due to sickness, and that absences due to sickness amounted to 1,240 days in the overall sample (Khorasanee et al, 2021).…”

“…Interestingly, COVID-19 is not only associated with a wide range of symptoms of a potentially chronic nature but is also a risk factor for poor physical health ( Tanji et al., 2021 ), impaired mental well-being ( Xiong et al., 2020 ), and increased disability ( Pizarro-Pennarolli et al., 2021 ). Taken together, these various complications of COVID-19 may negatively impact the ability of working-age patients to work; in fact, a large number of studies have reported high rates of sick leave in workers affected by COVID-19 ( Alquézar-Arbé et al., 2020 ; Calvo-Bonacho et al., 2020 ; Carvalho-Schneider et al., 2021 ; COVIDSurg Collaborative, 2021 ; Groenewold et al., 2020 ; Khorasanee et al., 2021 ; Merkin et al., 2020 ; Prezant et al., 2020 ; Suárez-García et al., 2020 ). For example, 1 study using data collected in a UK medical centre in March and April 2020 found that 39% of physicians were absent at least once due to sickness and that absences due to sickness amounted to 1240 days in the overall sample ( Khorasanee et al., 2021 ).…”

The Comparative Effectiveness of Virtual Reality Versus E-Module on the Training of Donning and Doffing Personal Protective Equipment: A Randomized, Simulation-Based Educational Study

“…Residents represent an important subgroup with regards to PPE competency, as many were deployed to the front lines during the initial COVID-19 response and may have experienced some of the highest risks for exposure [ 20 ]. At this very institution, a study found that 42% of internal medicine residents deployed during the initial COVID-19 response presented with COVID-19 or COVID-like illness [ 21 ]. This rate is likely comparable to emergency medicine and otolaryngology residents, who held similar roles at the time.…”

Teamwork and Leadership Under Fire at the Epicenter of the COVID-19 Epidemic in the Bronx

“…To implement and disseminate these frequent protocol changes we used our 3C approach by coordinating the implementation of these changes through the MCT and communicating these changes to all providers through our various communication methods (see above). As a result of these efforts, resident sick calls returned to pre-COVID levels within weeks despite an ongoing rise in the number of COVID-19 patients hospitalized at our institution ( 8 ).…”