Symptom Screening at Illness Onset of Health Care Personnel With SARS-CoV-2 Infection in King County, Washington

Chow, Eric J; Schwartz, Noah G.; Tobolowsky, Farrell; Zacks, Rachael; Huntington-Frazier, Melinda; Reddy, Sujan; Rao, Agam K.

doi:10.1001/jama.2020.6637

Cited by 177 publications

(194 citation statements)

References 6 publications

(8 reference statements)

Supporting

Mentioning

166

Contrasting

Unclassified

Order By: Relevance

“…27 In addition, subcontracted staff may have less access to paid sick leave -a critical element in allowing staff to self-isolate when ill. All of this is in line with evidence that staff are the main vectors of SARS-CoV-2 transmission in LTC facilities. [28][29][30] We are unaware of data that allow for comparisons of wages and rates of multisite employment between Ontario and British Columbia.…”

Section: Resultsmentioning

confidence: 99%

COVID-19 in long-term care homes in Ontario and British Columbia

Liu

Maxwell

Armstrong

et al. 2020

CMAJ

111

119

View full text Add to dashboard Cite

How was long-term care different in Ontario and British Columbia before COVID-19? Characteristics of residents Before the pandemic, the age and sex distribution of residents in LTC were similar in the 2 provinces (Table 2). 9,10 Although residents living in Ontario LTC homes appear to be more medically and functionally complex, it is unclear whether these are true differences or reflect differing documentation practices, which may arise as a consequence of different funding formulas. 15-17 Funding, staffing and direct care hours In 2018-2019, the average combined funding per resident per diem was higher in British Columbia ($222) than in Ontario ($203). 10,11 Most of this funding is used to pay staff in both provinces. 11,14 Some estimates suggest that, before the pandemic, residents in British Columbia received more daily hours of direct care (3.25) than residents in Ontario (2.71). 10,12 There are ANALYSIS HEALTH SERVICES

show abstract

Section: Resultsmentioning

confidence: 99%

COVID-19 in long-term care homes in Ontario and British Columbia

Liu

Maxwell

Armstrong

et al. 2020

CMAJ

111

119

View full text Add to dashboard Cite

show abstract

“…Identification of symptoms predictive of SARS-CoV-2 infection, single or in combination, is essential for the quest of screening guidance and in the recommendations of self-isolation to prevent further spread. In the large population-based study including 9282 HCW in the United States, 92% reported having at least one symptom among fever, cough and dyspnea 17 , and this symptom triad has been reported hallmark symptoms of COVID-19 infection [18][19][20] . Although fever was one of the most common Odds ratio of seropositivity to COVID-19 Odds ratio of seropositivity to COVID-19 symptoms among the seropositive HCW in this study, anosmia and ageusia were the symptoms most predictive of SARS-CoV-2 infection.…”

Section: Discussionmentioning

confidence: 99%

SARS-CoV-2 exposure, symptoms and seroprevalence in healthcare workers in Sweden

et al. 2020

View full text Add to dashboard Cite

SARS-CoV-2 may pose an occupational health risk to healthcare workers. Here, we report the seroprevalence of SARS-CoV-2 antibodies, self-reported symptoms and occupational exposure to SARS-CoV-2 among healthcare workers at a large acute care hospital in Sweden. The seroprevalence of IgG antibodies against SARS-CoV-2 was 19.1% among the 2149 healthcare workers recruited between April 14th and May 8th 2020, which was higher than the reported regional seroprevalence during the same time period. Symptoms associated with seroprevalence were anosmia (odds ratio (OR) 28.4, 95% CI 20.6–39.5) and ageusia (OR 19.2, 95% CI 14.3–26.1). Seroprevalence was also associated with patient contact (OR 2.9, 95% CI 1.9–4.5) and covid-19 patient contact (OR 3.3, 95% CI 2.2–5.3). These findings imply an occupational risk for SARS-CoV-2 infection among healthcare workers. Continued measures are warranted to assure healthcare workers safety and reduce transmission from healthcare workers to patients and to the community.

show abstract

“…Even with regular employee symptom screening, the use of face masks and other personal protective equipment, and other infection control measures, staff-to-resident transmission can occur while infected staff are asymptomatic or afebrile with mild symptoms that they fail to report. 5,6,10 Direct care staff also often work across multiple facilities, increasing the risk of cross-contamination. Many SNFs have implemented policies to limit staff working in more than one facility, but these policies could be further augmented by states offering financial support for hazard pay, paid sick leave, and other benefits to incentivize staff to limit movement outside their workplace.…”

Section: Discussionmentioning

confidence: 99%

Variation in SARS‐CoV‐2 Prevalence in U.S. Skilled Nursing Facilities

White

Kosar

Feifer

et al. 2020

J American Geriatrics Society

105

100

View full text Add to dashboard Cite

See related Special Article by Ouslander et al. in this issue. OBJECTIVE: To identify county and facility factors associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks in skilled nursing facilities (SNFs). DESIGN: Cross-sectional study linking county SARS-CoV-2 prevalence data, administrative data, state reports of SNF outbreaks, and data from Genesis HealthCare, a large multistate provider of post-acute and long-term care. State data are reported as of April 21, 2020; Genesis data are reported as of May 4, 2020. SETTING AND PARTICIPANTS: The Genesis sample consisted of 341 SNFs in 25 states, including a subset of 64 SNFs that underwent universal testing of all residents. The non-Genesis sample included all other SNFs (n = 3,016) in the 12 states where Genesis operates that released the names of SNFs with outbreaks. MEASUREMENTS: For Genesis and non-Genesis SNFs: any outbreak (one or more residents testing positive for SARS-CoV-2). For Genesis SNFs only: number of confirmed cases, SNF case fatality rate, and prevalence after universal testing. RESULTS: One hundred eighteen (34.6%) Genesis SNFs and 640 (21.2%) non-Genesis SNFs had outbreaks. A difference in county prevalence of 1,000 cases per 100,000 (1%) was associated with a 33.6 percentage point (95% confidence interval (CI) = 9.6-57.7 percentage point; P = .008) difference in the probability of an outbreak for Genesis and non-Genesis SNFs combined, and a difference of 12.5 cases per facility (95% CI = 4.4-20.8 cases; P = .003) for Genesis SNFs. A 10-bed difference in facility size was associated with a 0.9 percentage point (95% CI = 0.6-1.2 percentage point; P < .001) difference in the probability of outbreak. We found no consistent relationship between Nursing Home Compare Five-Star ratings or past infection control deficiency citations and probability or severity of outbreak. CONCLUSIONS: Larger SNFs and SNFs in areas of high SARS-CoV-2 prevalence are at high risk for outbreaks and must have access to universal testing to detect cases, implement mitigation strategies, and prevent further potentially avoidable cases and related complications.

show abstract

Symptom Screening at Illness Onset of Health Care Personnel With SARS-CoV-2 Infection in King County, Washington

Abstract: This study assessed the spectrum of initial symptoms at the onset of polymerase chain reaction–confirmed coronavirus disease 2019 (COVID-19) among health care personnel in King County, Washington.

Cited by 177 publications

References 6 publications

COVID-19 in long-term care homes in Ontario and British Columbia

COVID-19 in long-term care homes in Ontario and British Columbia

SARS-CoV-2 exposure, symptoms and seroprevalence in healthcare workers in Sweden

Variation in SARS‐CoV‐2 Prevalence in U.S. Skilled Nursing Facilities

Contact Info

Product

Resources

About