Not sick enough to worry? "Influenza-like" symptoms and work-related behavior among healthcare workers and other professionals: Results of a global survey

Tartari, Ermira; Saris, Katja; Kenters, Nikki; Marimuthu, Kalisvar; Widmer, Andreas F.; Collignon, Peter; Cheng, Vincent Chi-Chung; Wong, Shuk-Ching; Gottlieb, Thomas; Tambyah, Paul A.; Perencevich, Eli N.; Allegranzi, Benedetta; Dramowski, Angela; Edmond, Michael B.; Voß, Andreas

doi:10.1371/journal.pone.0232168

Cited by 35 publications

(70 citation statements)

References 29 publications

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“…sore throat, nasal discharge, etc.) who would still go to work is higher (89–99%) [ 29 ]. This also seems true for COVID-19; a report of HCWs screened during an outbreak in a LTCF in the US showed that 64.6% of HCWs with confirmed SARS-CoV-2 infection worked while they were symptomatic, and for a median duration of 2 days (range 1–10) [ 30 ].…”

Section: Methodsmentioning

confidence: 99%

Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers

Abbas

Nunes

Martischang

et al. 2021

Antimicrob Resist Infect Control

236

213

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Objectives To compile current published reports on nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evaluate the role of healthcare workers (HCWs) in transmission, and evaluate outbreak management practices. Methods Narrative literature review. Short conclusion The coronavirus disease 2019 (COVID-19) pandemic has placed a large burden on hospitals and healthcare providers worldwide, which increases the risk of nosocomial transmission and outbreaks to “non-COVID” patients or residents, who represent the highest-risk population in terms of mortality, as well as HCWs. To date, there are several reports on nosocomial outbreaks of SARS-CoV-2, and although the attack rate is variable, it can be as high as 60%, with high mortality. There is currently little evidence on transmission dynamics, particularly using genomic sequencing, and the role of HCWs in initiating or amplifying nosocomial outbreaks is not elucidated. There has been a paradigm shift in management practices of viral respiratory outbreaks, that includes widespread testing of patients (or residents) and HCWs, including asymptomatic individuals. These expanded testing criteria appear to be crucial in identifying and controlling outbreaks.

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Section: Methodsmentioning

confidence: 99%

Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers

Abbas

Nunes

Martischang

et al. 2021

Antimicrob Resist Infect Control

236

213

View full text Add to dashboard Cite

show abstract

“…This will require significant cultural change. A global survey on sickness presenteeism comparing the self-reported behavior of health care workers and non-healthcare workers with influenza like illness found that the majority of both groups would continue to work, despite health care workers knowing the risks of transmitting influenza-like illness to vulnerable patients (62). Possible reasons for sickness presenteeism included understaffing, a sense of obligation to colleagues, and economic reasons such as lack of sick leave -all of which exist in veterinary settings.…”

Section: What Can Veterinary Teams Do To Prepare For Ethical Challenges?mentioning

confidence: 99%

Frequency, Stressfulness and Type of Ethically Challenging Situations Encountered by Veterinary Team Members During the COVID-19 Pandemic

et al. 2021

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Ethically challenging situations (ECS) are common in veterinary settings and can lead to moral stress. However, there is no published information about how a global pandemic affects the frequency and types of ECS encountered by veterinary team members. An online mixed methods survey was developed to determine the frequency, stressfulness and types of ECS experienced by veterinarians, animal health technicians and veterinary nurses since the advent of the global COVID-19 pandemic in March 2020. Responses from 540 veterinary team members from 22 countries were analyzed. With the advent of the COVID-19 pandemic, the median frequency of ECS encountered by respondents increased from several times per month to several times per week (Spearman Rank Correlation 0.619, P < 0.0001). The most common ECS (encountered at least several times per week) were: challenging decisions about how to proceed when clients have limited finances (64.4%), conflict between personal well-being and professional role (64.3%), conflict between the interests of clients and the interests of their animals (59.6%). These were followed by challenging decisions about what counts as an essential veterinary service (48.1%); conflict between well-being of family/household members and professional role (46.3%); and challenging decisions about whether to perform non-contact veterinary visits (46.3%). The most stressful ECS (reported to be very or maximally stressful) were: conflicts between the interests of clients and the interests of their animals (50.2%), other (42.9%), conflicts between the interests of my employer and my own interests (42.5%), challenging decisions about how to proceed when clients have limited finances (39.4%), conflict between personal well-being and professional role (38.0%), and conflict between well-being of family/household members and professional role (33.6%). Thematic analysis of free-text responses revealed biosecurity, client financial limitations, animal welfare, working conditions, and client relations as prominent themes. This is, to the best of our knowledge, the first study to describe the impacts of the pandemic on ECS experienced by veterinary teams globally. It identifies an increase in the frequency of ECS associated with the COVID-19 pandemic, and a number of stressors unique to the pandemic. We identified a number of resources and strategies that may help veterinary team members navigate ethical challenges that may emerge in their daily work, as well as in the context of global crises.

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“…Occupational testing first became available to symptomatic HCW at Liverpool University Hospitals NHS Foundation Trust on 2 nd April 2020. However, presenteeism in HCW may be a contributory factor, even in the context of a global respiratory pandemic (Tartari et al, 2020). Clarification on and reinforcement of self-isolation and testing policies for HCW when symptomatic is advisable, especially given symptomatic infections are likely more transmissible (Buitrago-Garcia et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: an observational cohort study

Walker

Byrne

Howard

et al. 2021

Preprint

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Background The SARS-CoV-2 pandemic has caused an unprecedented strain on healthcare systems worldwide, including the UK National Health Service (NHS). During the first wave of SARS-CoV-2 transmission in UK, SARS-CoV-2 NHS diagnostic test availability was limited to self-isolating symptomatic staff. The burden of symptomatic and asymptomatic infection in healthcare workers (HCW) attending work was unknown. Methods We conducted an observational cohort study of SARS-CoV-2 infection in HCW working in an acute NHS Trust during the first wave of the COVID-19 pandemic, using serial self-collected saliva and nasopharyngeal (NP) samples. We also collected self-assessed symptom profiles and isolation behaviours. We retrospectively compared SARS-CoV-2 detection by RT-PCR from saliva (weekly) and NP swabs (twice weekly) from 85 individuals in this cohort and evaluated the association with symptoms. Findings Over a 12-week period from 30th March 2020, 40% (n=34/85, CI95% 31.3-51.8%) HCWs had evidence of SARS-CoV-2 infection by surveillance NP swab and/or saliva RT-qPCR. Agreement between paired saliva and NP swabs was poor (28.6%, CI95% 13.2-48.7%) with both methods detecting symptomatic and asymptomatic infections. Symptoms were reported by 47.1% (n=40) and self-isolation by 25.9% participants (n=22). Only 41.2% (n=14/34) participants with SARS-CoV-2 infection reported any symptoms within 14 days of the infection. Interpretation HCWs are a potential source of SARS-CoV-2 transmission in hospitals and symptom screening will identify the minority of infections in HCW. Saliva is an easily accessible fluid sample for screening for SARS-CoV-2 infection and in addition to NP swab, facilitated ascertainment of symptomatic and asymptomatic cases in this setting. Combined saliva and NP testing would improve detection of SARS-CoV-2 for surveillance. Better understanding of transmissibility from asymptomatic staff using transmission-based infection precautions, is required to inform policy.

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Not sick enough to worry? "Influenza-like" symptoms and work-related behavior among healthcare workers and other professionals: Results of a global survey

Cited by 35 publications

References 29 publications

Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers

Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers

Frequency, Stressfulness and Type of Ethically Challenging Situations Encountered by Veterinary Team Members During the COVID-19 Pandemic

Detection of SARS-CoV-2 infection by saliva and nasopharyngeal sampling in frontline healthcare workers: an observational cohort study

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