Sources of exposure identified through structured interviews of healthcare workers who test positive for severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A prospective analysis at two teaching hospitals

Rhee, Chanu; Baker, Meghan A; Tucker, Robert; Griesbach, Diane; McDonald, Dinah; Williams, Sarah A.; Fiumara, Karen; Resnick, Andrew S.

doi:10.1017/ash.2021.243

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…One quasi-experimental study found no difference in healthcare personnel infection rates between two hospitals that had identical infection control policies except that one used negative pressure rooms for 96% of COVID-19 patient days whereas the other only used negative pressure rooms for 22% of COVID-19 patient days [77 ▪ ]. The study design was not optimal to detect small differences in hospital-acquired infections, however, because most healthcare personnel infections are acquired in the community [78]; this creates substantial noise when trying to elucidate risk factors for hospital-based transmission.…”

Section: Structural Approaches To Preventionmentioning

confidence: 99%

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Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

Rhee

Baker

2022

Current Opinion in Infectious Diseases

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Purpose of review COVID-19 has catalyzed a wealth of new data on the science of respiratory pathogen transmission and revealed opportunities to enhance infection prevention practices in healthcare settings. Recent findingsNew data refute the traditional division between droplet vs airborne transmission and clarify the central role of aerosols in spreading all respiratory viruses, including Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), even in the absence of so-called 'aerosol-generating procedures' (AGPs). Indeed, most AGPs generate fewer aerosols than talking, labored breathing, or coughing. Risk factors for transmission include high viral loads, symptoms, proximity, prolonged exposure, lack of masking, and poor ventilation. Testing all patients on admission and thereafter can identify early occult infections and prevent hospital-based clusters. Additional prevention strategies include universal masking, encouraging universal vaccination, preferential use of N95 respirators when community rates are high, improving native ventilation, utilizing portable high-efficiency particulate air filters when ventilation is limited, and minimizing room sharing when possible. SummaryMultifaceted infection prevention programs that include universal testing, masking, vaccination, and enhanced ventilation can minimize nosocomial SARS-CoV-2 infections in patients and workplace infections in healthcare personnel. Extending these insights to other respiratory viruses may further increase the safety of healthcare and ready hospitals for novel respiratory viruses that may emerge in the future.

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Section: Structural Approaches To Preventionmentioning

confidence: 99%

“…The study design was not optimal to detect small differences in hospital-acquired infections, however, because most healthcare personnel infections are acquired in the community [78]; this creates substantial noise when trying to elucidate risk factors for hospital-based transmission.…”

mentioning

confidence: 99%

Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

Rhee

Baker

2022

Current Opinion in Infectious Diseases

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SARS-CoV-2 infection among healthcare workers: the role of occupational and household exposures during the first three pandemic waves in Quebec, Canada

Carazo,

Denis,

Padet

et al. 2023

ASHE

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Objective: We described the evolution of SARS-CoV-2 source of infection in a cohort of healthcare workers (HCWs) of Quebec, Canada, during the first three pandemic waves. We also estimated their household secondary attack rate (SAR) and its risk factors. Design: Cross-sectional surveys. Participants: HCWs with a SARS-CoV-2 infection confirmed by polymerasa chain reaction and diagnosed between March 2020 and May 2021. Methods: We collected demographic, clinical, vaccination, and employment information, self-reported perceived source of infection, and transmission to household members during the first three pandemic waves. SAR was calculated for households with ≥2 members where the HCW was the index case. A Poisson regression model estimated the association between risk factors and SAR. Results: Among the 11,670 HCWs completing the survey, 91%, perceived their workplace as the source of infection during the first wave (March–July 2020), 71% during the second wave (July 2020–March 2021), and 40% during the third wave (March–May 2021). Conversely, HCWs reported an increasing proportion of household-acquired infections with each wave from 4% to 14% and 33%, respectively. The overall household SAR of 7,990 HCWs living with ≥1 person was 30% (95%CI: 29–30). SAR increased with the presence of symptoms, older age, and during Alpha-variant predominant period. Conclusions: HCWs and their household members were largely affected during the first pandemic waves of COVID-19, but the relative importance of occupational exposure changed overtime. Pandemic preparedness in healthcare settings is essential to protect HCWs from emerging biological hazard exposures.

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Coronavirus Disease 2019’s Challenges to Infection Control Dogma Regarding Respiratory Virus Transmission

Baker

Rhee

2022

Clinical Infectious Diseases

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Sources of exposure identified through structured interviews of healthcare workers who test positive for severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A prospective analysis at two teaching hospitals

Cited by 3 publications

References 13 publications

Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

SARS-CoV-2 infection among healthcare workers: the role of occupational and household exposures during the first three pandemic waves in Quebec, Canada

Coronavirus Disease 2019’s Challenges to Infection Control Dogma Regarding Respiratory Virus Transmission

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