Abstract
Professional anxiety existed early in the coronavirus disease 2019 (COVID-19) pandemic with challenging infection prevention and control support. The aims of this study were to compare epidemiological features of healthcare workers (HCWs) within primary and secondary care with their serological evidence of infection. A prospective observational cohort of 1,916 HCWs completed a questionnaire, and their sera were assayed for detectable antibody to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleoprotein in the first wave of the pandemic. Datasets were compared between the two sub-cohorts in primary and secondary care and between the combined seropositive and seronegative cohorts. Curiosity of antibody status was high. Detectable antibody was 7% in the primary care and 5% in the secondary care workers at a time of 1.7% in the general community. Inappropriate personal protective equipment (PPE) was more common in primary care, and detectable antibody was twice as prevalent in HCWs who felt they did not have appropriate PPE. Contact tracing was perceived to be inadequate although it was more commonly performed in the seropositive cohort suggesting appropriate prioritisation. Both temperature and symptom checking alerts and work exclusion were significantly more prevalent in the seropositive cohort. The seroprevalence data support increased risk for HCWs, the importance of appropriate PPE and the usefulness of the daily temperature and symptom checks, particularly in primary care.
Highlights
The novel coronavirus that emerged in Wuhan, China, in 2019 was declared as a pandemic by the World Health Organization (WHO) in 2020 and named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the clinical infection named coronavirus disease (COVID-19) in February 2020 (1)
Limited personal protective equipment (PPE) early in the pandemic increased the fear of COVID-19 both in the public and healthcare workplaces due to the significantly high polymerase chain reaction (PCR) positivity rates amongst healthcare workers (HCWs), with peak percentages of up to 40% in May 2020 in Ireland, later falling to 15% in February 2021 (3)
Comparing the antibody detected and antibody not detected cohorts of all HCWs, of the total 1,916 HCWs entered in the study, 99.74% wished to know the result of their antibody test and 56.29% hoped to have antibodies; 75.68% of those who had detectable antibodies had expressed the hope that they would have antibodies compared to 54.92% with no detectable antibody who had hoped to have antibodies (P < 0.001)
Summary
The novel coronavirus that emerged in Wuhan, China, in 2019 was declared as a pandemic by the World Health Organization (WHO) in 2020 and named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the clinical infection named coronavirus disease (COVID-19) in February 2020 (1). Limited personal protective equipment (PPE) early in the pandemic increased the fear of COVID-19 both in the public and healthcare workplaces due to the significantly high polymerase chain reaction (PCR) positivity rates amongst HCWs, with peak percentages of up to 40% in May 2020 in Ireland, later falling to 15% in February 2021 (3). Little is known about the HCW COVID-19 seroprevalence experience in primary care community settings compared to secondary care in hospital practice, and to our knowledge, this is the first HCW seroprevalence study to compare HCWs in primary care with those in secondary care
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