Evaluation of real and perceived risk to health care workers caring for patients with the Omicron variant of the SARS-CoV-2 virus in surgery and obstetrics

Abstract

We sought to assess risk to healthcare workers (HCWs) caring for patients with the Omicron variant of the SARS-CoV-2 virus in surgical/obstetrical settings, and the perception of risk amongst this group. From January to April, 2022, reverse transcription polymerase chain reaction was used to detect the presence of SARS-CoV-2 viral RNA in patient, environmental (floor, equipment, passive air) samples, and HCW’s masks (inside surface) during urgent surgery or obstetrical delivery for patients with SARS-CoV-2 infection (at a tertiary care centre). The primary outcome was the proportion of HCWs’ masks testing positive. Results were compared with a previous cross-sectional study involving obstetrical/surgical patients with earlier variants (2020/21) using the Mann-Whitney U and 2-sample z-test. HCWs completed a risk perception electronic questionnaire. 11 patients were included: 3 vaginal births and 8 surgeries. 5/108 samples (5%) tested positive for (SARS-CoV-2 Omicron) viral RNA: 2/5 endotracheal tubes, 1/22 floor samples, 1/4 patient masks and 1 nasal probe. No samples from the HCWs masks (0/35), surgical equipment (0/10) and air samples (0/11) tested positive. No significant differences were found between the Omicron and 2020/21 patient groups’ positivity rates (P = 0.838) or the level of viral load from the nasopharyngeal swabs (P = 0.405). Nurses had a higher risk perception than physicians (P = 0.038). No significant difference in contamination rates were found between SARS-CoV-2 Omicron BA.1 and previous variants in surgical/obstetrical settings. This is reassuring as no HCW mask was positive and no HCW tested positive for COVID-19 post-exposure.