Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient — Solano County, California, February 2020

Heinzerling, Amy; Stuckey, P Matthew J.; Scheuer, Tara; Xu, Kerui; Perkins, Kiran M.; Resseger, Heather; Magill, Shelley S.; Verani, Jennifer R.; Jain, Seema; Acosta, Meileen; Epson, Erin

doi:10.15585/mmwr.mm6915e5

Cited by 442 publications

(486 citation statements)

References 7 publications

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“…24,25 The overall proportion of COVID-19 positive tests in HCW was low and decreased during the study period corresponding with implementation of risk-mitigation measures in our health system such as the recommendations for universal masking and physical distancing but also followed the trend for non-HCW. Several of the previous studies of HCW risk for infection during the COVID-19 pandemic were limited by their sample sizes, [7][8][9] lack of generalizability for healthcare systems that have adequate access to PPE, 7-9 methodology relying on self-report, 12 limited ability to adjust for known risk factors of disease susceptibility and progression [7][8][9][10]12 and lacking data to investigate the relative effects of dual exposure of HCW to COVID-19 in the community versus the workplace. [7][8][9][10]12 The fact that HCW identi ed as patient-facing had a signi cantly higher odds for SARS-CoV-2 test positivity suggests an increased risk of COVID-19 infection with work exposure.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on healthcare workers risk of infection and outcomes in a large, integrated health system.

Misra‐Hebert

Jehi

et al. 2020

Preprint

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Background: Understanding the impact of the COVID-19 pandemic on healthcare workers (HCW) is crucial.Objective: Utilizing a health system COVID-19 research registry, we assessed HCW risk for COVID-19 infection, hospitalization and intensive care unit (ICU) admission.Design: Retrospective cohort study with overlap propensity score weighting.Participants: Individuals tested for SARS-CoV-2 infection in a large academic healthcare system (N=72,909) from March 8-June 9 2020 stratified by HCW and patient-facing status. Main Measures: SARS-CoV-2 test result, hospitalization, and ICU admission for COVID-19 infection. Key Results: Of 72,909 individuals tested, 9.0% (551) of 6,145 HCW tested positive for SARS-CoV-2 compared to 6.5% (4353) of 66,764 non-HCW. The HCW were younger than non-HCW (median age 39.7 vs. 57.5, p<0.001) with more females (proportion of males 21.5 vs. 44.9%, p<0.001), higher reporting of COVID-19 exposure (72 vs. 17 %, p<0.001) and fewer comorbidities. However, the overlap propensity score weighted proportions were 8.9 vs. 7.7 for HCW vs. non-HCW having a positive test with weighted odds ratio (OR) 1.17, 95% confidence interval (CI) 0.99-1.38. Among those testing positive, weighted proportions for hospitalization were 7.4 vs.15.9 for HCW vs. non-HCW with OR of 0.42 (CI 0.26-0.66) and for ICU admission: 2.2 vs.4.5 for HCW vs. non-HCW with OR of 0.48 (CI 0.20 -1.04). Those HCW identified as patient-facing compared to not had increased odds of a positive SARS-CoV-2 test (OR 1.60, CI 1.08-2.39, proportions 8.6 vs. 5.5), but no statistically significant increase in hospitalization (OR 0.88, CI 0.20-3.66, proportions 10.2 vs. 11.4) and ICU admission (OR 0.34, CI 0.01-3.97, proportions 1.8 vs. 5.2).Conclusions: In a large healthcare system, HCW had similar odds for testing SARS-CoV-2 positive, but lower odds of hospitalization compared to non-HCW. Patient-facing HCW had higher odds of a positive test. These results are key to understanding HCW risk mitigation during the COVID-19 pandemic.

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Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 pandemic on healthcare workers risk of infection and outcomes in a large, integrated health system.

Misra‐Hebert

Jehi

et al. 2020

Preprint

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“…Skilled nursing and long-term care facilities (6) and hospitals (7) are settings in which persons at higher risk for severe COVID-19 illness are in close contact with staff members, many of whom work at multiple facilities. Other workplaces also facilitated amplification of virus transmission, including critical infrastructure sectors, such as multiple meat packing facilities in rural areas.…”

Section: Workplaces and Settings Contributing To Accelerated Spreadmentioning

confidence: 99%

Public Health Response to the Initiation and Spread of Pandemic COVID-19 in the United States, February 24–April 21, 2020

Schuchat¹

2020

MMWR Morb. Mortal. Wkly. Rep.

304

241

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“…Moreover, the R 0 value we used in the model may be more representative of urban areas, which, because of population density, public transportation and other factors, tend to have a higher rates of contact than do regions with lower population density [10] . Nonetheless, empirical data on rates of infection and fatalities in groups of EWs in urban areas hard-hit by COVID-19 paint a clear picture of increased individual risk [11][12][13][14] , and the models developed here suggest that, at a minimum, this is likely to be a pervasive challenge in population centers. There is also evidence for elevated EW risk in factories and food-processing facilities in areas with lower population density [15] ; however we did not explore how the models behave in such conditions.…”

Section: Discussionmentioning

confidence: 99%

Impact of essential workers in the context of social distancing for epidemic control

Milligan

Fuller

Agarwal

et al. 2020

Preprint

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Many governments have responded to the ongoing COVID-19 pandemic by imposing social policies that restrict interactions outside of the home, resulting in a large fraction of the workforce either working from home or not working. However, to maintain essential services, a substantial number of workers are not subject to these limitations, and maintain many of their pre-intervention interactions. To explore how interactions among such "essential" workers, and between essential workers and the rest of the population, impact disease risk and the effectiveness of pandemic control, we evaluated several models of essential worker interactions within a standard epidemiology framework. The models were designed to correspond to key characteristics of, respectively, cashiers, factory employees, and healthcare workers. We find in all three models that essential workers are at substantially elevated risk of infection compared to the rest of the population, and that increasing the numbers of essential workers necessitates the imposition of more stringent interaction controls on the rest of the population in order to manage the pandemic. However, different archetypes of essential workers differ in both their individual probability of infection and impact on the broader pandemic, highlighting the need to understand and target for intervention the specific risks faced by different groups of essential workers.All rights reserved. No reuse allowed without permission.was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.

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Transmission of COVID-19 to Health Care Personnel During Exposures to a Hospitalized Patient — Solano County, California, February 2020

Cited by 442 publications

References 7 publications

Impact of the COVID-19 pandemic on healthcare workers risk of infection and outcomes in a large, integrated health system.

Impact of the COVID-19 pandemic on healthcare workers risk of infection and outcomes in a large, integrated health system.

Public Health Response to the Initiation and Spread of Pandemic COVID-19 in the United States, February 24–April 21, 2020

Impact of essential workers in the context of social distancing for epidemic control

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