Pandemic peak SARS-CoV-2 infection and seroconversion rates in London frontline health-care workers

Houlihan, Catherine; Vora, Nina; Byrne, Thomas; Lewer, Dan; Kelly, Gavin; Heaney, Judith; Gandhi, Sonia; Spyer, Moira; Beale, Rupert; Cherepanov, Peter; Moore, D. J.; Gilson, Richard; Gamblin, S.J.; Kassiotis, George; McCoy, Laura E; Swanton, Charles; Hayward, Andrew; Nastouli, Eleni; Investigators, Safer

doi:10.1016/s0140-6736(20)31484-7

Cited by 218 publications

(252 citation statements)

References 3 publications

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“…Concurrently, as the COVID-19 death toll climbed, some hospitals reported 44% of their staff testing positive for COVID-19 (6). The prevalence of COVID-19 amongst GPs was not well documented.…”

Section: Introductionmentioning

confidence: 99%

Recovery, restoration, and risk: a cross-sectional survey of the impact of COVID-19 on GPs in the first UK city to lock down

Trivedi

Moorthy

et al. 2020

BJGP Open

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BackgroundThe COVID-19 pandemic has impacted GPs immensely. Work patterns have changed, risk stratification has been proposed, and the mental health of clinicians has been adversely affected. The COVID-19 prevalence among GPs is unknown. This study focuses on assessing the impact of COVID-19 on GPs in Leicestershire, the first UK city to lock down locally.AimThis survey assessed the prevalence of COVID-19 in GPs and explored GP work patterns in comparison with national guidance. It used a validated perceived stress tool to evaluate the impact of COVID-19 on GP stress perception.Design & settingThe cross-sectional retrospective survey was sent to all the GPs in Leicestershire.MethodA total of 111 GPs in Leicestershire took part voluntarily in an anonymised questionnaire-based study. A 29-item survey using SmartSurvey software was designed with multiple choice and Likert response scale questions.ResultsCOVID-19 prevalence in GPs in Leicestershire was 8.1%; 70.3% of GPs were of Black, Asian, and minority ethnic (BAME) origin; 91.9% of GPs had undergone risk stratification; and 79.3% of GPs felt supported by their practice, but only 59.5% felt supported with mental health. GPs described feeling more stressed during the COVID-19 pandemic than they had been previously.ConclusionThis is the first study evaluating COVID-19 prevalence among GPs in Leicestershire. Despite government interventions, GPs felt less supported with their mental health compared with pre-COVID-19 times. Thus, the NHS in England should focus on GP stress and wellbeing as they work towards the restoration and recovery of primary care while battling the second wave.

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Section: Introductionmentioning

confidence: 99%

Recovery, restoration, and risk: a cross-sectional survey of the impact of COVID-19 on GPs in the first UK city to lock down

Trivedi

Moorthy

et al. 2020

BJGP Open

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“…The sample size for the cohort study was estimated as 201 based on the expected proportion of HCWs (45% was reported in hospital setting in London by Houlihan et al [ 2 ]) who could have acquired SARS-CoV-2 during the peak period of the pandemic. This sample was calculated at a 95% confidence level and confidence interval of 7.5.…”

Section: Protocolmentioning

confidence: 99%

“…Despite infection prevention and control (IPC) measures including isolation of cases and the use of personal protective equipment (PPE), HCWs still acquire the infection at a higher rate than the general population. A prospective study of 200 frontline HCWs in London during the peak of viral transmission showed that 44% became infected, more than double that of the local population [ 2 ]. A smartphone application survey of almost 100,000 HCWs from the United Kingdom (UK) and United States of America (USA), and over two million members of the general public, with self-reporting of positive reverse transcription-polymerase chain reaction (RT-PCR) for the SARS-CoV-2 infections was performed [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol

Adeniyi

Stead

Singata‐Madliki

et al. 2021

IJERPH

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Healthcare workers (HCWs) are at increased risk of infection by the virulent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Though data exist on the positivity rate of the SARS-CoV-2 reverse transcription polymerase chain reaction (RT-PCR) test as well as COVID-19-related deaths amongst HCWs in South Africa, the overall infection rate remains underestimated by these indicators. It is also unclear whether the humoral immune response after SARS-CoV-2 infection offers durable protection against reinfection. This study will assess the SARS-CoV-2 seroprevalence amongst HCWs in the Eastern Cape (EC) and examine the longitudinal changes (rate of decay) in the antibody levels after infection in this cohort. Using a multi-stage cluster sampling of healthcare workers in selected health facilities in the EC, a cross-sectional study of 2250 participants will be recruited. In order to assess the community infection rate, 750 antenatal women in the same settings will be recruited. Relevant demographic and clinical characteristics will be obtained by a self-administered questionnaire. A chemiluminescent microparticle immunoassay (CMIA) will be used for the qualitative detection of IgG antibodies against SARS-CoV-2 nucleocapsid protein. A nested cohort study will be conducted by performing eight-weekly antibody assays (X2) from 201 participants who tested positive for both SARS-CoV-2 RT-PCR and serology. Logistic regression models will be fitted to identify the independent risk factors for SARS-CoV-2 infection. The cumulative SARS-CoV-2 infection rate and infection fatality rate among the frontline HCWs will be estimated. In addition, the study will highlight the overall effectiveness of infection prevention and control measures (IPC) per exposure sites/wards at the selected health facilities. Findings will inform the South African Department of Health’s policies on how to protect HCWs better as the country prepares for the second wave of the SARS-CoV pandemic.

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“…Several surveillance studies have explored rates of infection (antigen positive nose and throat swabs) and seropositivity (antibody positive blood test) in UK hospitals. In the SAFER study conducted in London at the peak of the first surge, 21% of frontline healthcare staff were infected and 45% were seropositive [35]. In another London study, just after the first surge peak, 7% of staff were infected and 21% were seropositive [36].…”

Section: Environmental Factors and Mitigationmentioning

confidence: 99%

Risk to health from COVID‐19 for anaesthetists and intensivists – a narrative review

Cook

2020

Anaesthesia

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Healthcare workers are at an increased risk of infection, harm and death from COVID-19. Close and prolonged exposure to individuals infectious with SARS-CoV-2 leads to infection. A person's individual characteristics (age, sex, ethnicity and comorbidities) then influence the subsequent risk of COVID-19 leading to hospitalisation, critical care admission or death. While relative risk is often reported as a measure of individual danger, absolute risk is more important and dynamic, particularly in the healthcare setting. Individual risk interacts with exposure and environmental risk-factors, and the extent of mitigation to determine overall risk. Hospitals are a unique environment in which there is a significantly increased risk of infection for all healthcare workers. Anaesthetists and intensivists particularly are at high risk of exposure to SARS-CoV-2 infected patients due to their working environments and exposure to certain patient groups. However, the available evidence suggests that the risk for this group of individuals is not currently increased. This review examines factors associated with increased risk of infection with SARS-CoV-2, increasing severity of COVID-19 and death. A risk tool is proposed that includes personal, environmental and mitigating factors, and enables an individualised dynamic 'point-of-time' risk assessment.

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Pandemic peak SARS-CoV-2 infection and seroconversion rates in London frontline health-care workers

Cited by 218 publications

References 3 publications

Recovery, restoration, and risk: a cross-sectional survey of the impact of COVID-19 on GPs in the first UK city to lock down

Recovery, restoration, and risk: a cross-sectional survey of the impact of COVID-19 on GPs in the first UK city to lock down

Eastern Cape Healthcare Workers Acquisition of SARS-CoV-2 (ECHAS): Cross-Sectional (Nested Cohort) Study Protocol

Risk to health from COVID‐19 for anaesthetists and intensivists – a narrative review

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