SARS-CoV-2 Infection in Healthcare Personnel With High-risk Occupational Exposure: Evaluation of 7-Day Exclusion From Work Policy

Abstract

Background Starting in late February 2020, Greece is experiencing a coronavirus disease 2019 (COVID-19) epidemic. Healthcare personnel (HCP) were disproportionately affected, accounting for approximately 10% of notified cases. Exclusion from work for 7 days was recommended for HCP with high-risk occupational exposure. Our aim was to evaluate the 7-day exclusion from work policy for HCP with high-risk exposure. Methods HCP with a history of occupational exposure to COVID-19 were notified to the Hellenic National Public Health Organization, regardless of their exposure risk category. Exposed HCP were followed for 14 days after last exposure. Results We prospectively studied 3398 occupationally exposed HCP; nursing personnel accounted for most exposures (n=1705; 50.2%). Of the 3398 exposed HCP, 1599 (47.1%) were classified as low-risk, 765 (22.5%) as moderate-risk, and 1031 (30.4%) as high-risk exposures. Sixty-six (1.9%) HCP developed COVID-19 at a mean of 3.65 days (range: 0-17 days) post-exposure. Of the 66 HCP with COVID-19, 46, 7, and 13 had a history of high-, moderate- or low-risk exposure (4.5%, 0.9%, and 0.8% of all high-, moderate-, and low-risk exposures, respectively). Hospitalization and absenteeism were more prevalent among HCP with high-risk exposure. A logistic regression analysis showed that the following variables were significantly associated with an increased risk for the onset of COVID-19: male, administrative personnel, underlying disease and high-risk exposure. Conclusion HCP with high-risk occupational exposure to COVID-19 had increased probability of serious morbidity, healthcare seeking, hospitalization and absenteeism. Our findings justify the 7-day exclusion from work policy for HCP with high-risk exposure.

Validation of Centers for Disease Control and Prevention level 3 risk classification for healthcare workers exposed to severe acute respiratory coronavirus virus 2 (SARS-CoV-2)

“…The 9.2% infection rate we observed among HCWs with high-risk exposures is consistent with previously published data. 6,7 However, our finding differs in demonstrating a full gradient of risk, with infection rates associated with medium-risk exposures intermediate between low-and high-risk groups. The observed "dose response" between exposure severity and infection rates suggests a causal relationship during the study timeframe.…”

Hospital factors associated with SARS-CoV-2 infection among healthcare personnel in Greece

“…Starting in late 2019, the world is faced with a pandemic of a respiratory disease named coronavirus disease 2019 (COVID-19) which is caused by a novel beta-coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [ 1 ]. Healthcare personnel (HCP) have been recognized as a high-risk group for SARS-CoV-2 infection [ [2] , [3] , [4] ], as also shown during the epidemics of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome [ 5 , 6 ]. During the first SARS-CoV-2 epidemic wave in Greece HCP accounted for approximately 10% of notified cases [ 2 ].…”

“…Healthcare personnel (HCP) have been recognized as a high-risk group for SARS-CoV-2 infection [ [2] , [3] , [4] ], as also shown during the epidemics of severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome [ 5 , 6 ]. During the first SARS-CoV-2 epidemic wave in Greece HCP accounted for approximately 10% of notified cases [ 2 ]. Herein, we estimate the risk of infection among HCP by hospital characteristics.…”

SARS-CoV-2 infection: advocacy for training and social distancing in healthcare settings

“…In addition, Maltezou et al. observed that administrative personnel were more likely to get infected in hospital than front-line workers, suggesting that administrative staff were less trained in the use of PPE [ 6 ]. Lockdown commenced in France on 17 th March 2020.…”