Examination of factors affecting SARS-CoV-2 transmission among healthcare workers following a large healthcare-associated outbreak of COVID-19 in North West Tasmania.
In March 2020, Australia experienced its first large COVID-19 outbreak in a healthcare setting when two persons who had returned from cruise ship travel were admitted to a hospital in North West Tasmania, leading to sustained severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission among healthcare workers (HCWs) in this hospital and another hospital co-located in the same health precinct. We examined factors influencing SARS-CoV-2 transmission in these hospitals to inform policies and practices that could reduce the risk of future outbreaks. Using the results of a survey and SARS-CoV-2 testing of HCWs who attended work at one or both hospitals during the exposure period (20 March to 13 April 2020), we assessed the association of demographic variables, work-related variables, and the average score for each of three infection prevention and control (IPC) measures (hand hygiene, personal protective equipment [PPE] donning and doffing, and personal distancing) with being a COVID-19 case using logistic regression. Of the 1779 HCWs invited to participate in the survey, 410 responded, of which 125 met the inclusion criteria for our analysis. On multivariable regression analysis, HCWs who were aged 31-50 years (odds ratio [OR] = 0.12 [95% confidence interval (CI): 0.03, 0.48]) or 51+ years (OR = 0.17 [95% CI: 0.04, 0.68]) had significantly lower odds of being a COVID-19 case when compared with HCWs who were aged 30 years or less, whereas those who worked part time (OR = 0.29 [95% CI: 0.08, 0.91]) had significantly lower odds of being a COVID-19 case when compared with HCWs who worked full time. HCWs having direct care of a COVID-19-positive patient (OR=5.42 [95% CI: 1.65, 20.8]) had significantly higher odds of being a COVID-19 case when compared with HCWs without direct care of a COVID-19-positive patient. The IPC measures showed no significant association with COVID-19 case status. Our study identified important associations between COVID-19 acquisition and age, work frequency, and direct contact with COVID-19 patients. However, the small sample size of IPC measures meant our study was inadequately powered to determine the significance of these associations with COVID-19 acquisition.
- Discussion
4
- 10.1016/j.cmi.2020.10.015
- Oct 23, 2020
- Clinical Microbiology and Infection
Risk assessment for rationalizing the use of personal protective equipment for SARS-CoV2 in healthcare settings with special focus on low- and middle-income settings
- Discussion
1
- 10.1016/j.jhin.2023.02.001
- Feb 10, 2023
- The Journal of Hospital Infection
Screening medical students for SARS-CoV-2 to facilitate face-to-face clinical teaching and prevent onward spread to patients
- Research Article
24
- 10.1016/j.jhin.2020.06.026
- Jun 23, 2020
- Journal of Hospital Infection
Do established infection prevention and control measures prevent spread of SARS-CoV-2 to the hospital environment beyond the patient room?
- Research Article
49
- 10.1016/j.jhin.2021.04.027
- May 1, 2021
- The Journal of Hospital Infection
SARS-CoV-2 routes of transmission and recommendations for preventing acquisition: joint British Infection Association (BIA), Healthcare Infection Society (HIS), Infection Prevention Society (IPS) and Royal College of Pathologists (RCPath) guidance
- Research Article
1
- 10.4102/sajid.v37i1.335
- Mar 10, 2022
- Southern African Journal of Infectious Diseases
BackgroundEvidence-based Infection Prevention and Control (IPC) measures are critical in protecting medical doctors from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Concerns surrounding access to personal protective equipment (PPE), compliance with IPC measures and the quality of available PPE have been raised as possible causes for high rates of SARS-CoV-2 infection in medical doctors in high transmission settings. This study aimed to determine the prevalence of SARS-CoV-2 infection and the risk factors for occupational infection in doctors in the hospitals in Nelson Mandela Bay (NMB).MethodsWe conducted a cross-sectional study wherein we electronically surveyed medical doctors in public-sector NMB hospitals from 01 March 2020 to 31 December 2020. We collected demographic, health, occupational and SARS-CoV-2 infection and exposure data. Categorical data were described as proportions and a multiple variable logistic regression model was used to identify risk factors for SARS-CoV-2 infection.ResultsThe survey was distributed amongst 498 doctors, 141 (28%) of whom replied. Forty-three (31%) participants reported that they had tested positive for SARS-CoV-2 during the study period. Eighty-nine participants (64%) reported inadequate access to PPE whilst only 68 (49%) participants adhered to PPE recommendations when interacting with patients with confirmed or suspected SARS-CoV-2 infection. We were unable to identify any significant predictors of SARS-CoV-2 infection.ConclusionThis study demonstrates a high prevalence of SARS-CoV-2 infection in public hospital doctors in NMB. Most participants reported inadequate access to PPE and poor compliance with IPC protocols. These findings suggest an urgent need for the improved implementation of IPC measures to protect doctors from SARS-CoV-2 infection.
- Discussion
5
- 10.1016/j.ajic.2020.07.040
- Aug 6, 2020
- American Journal of Infection Control
A care escalation framework to address lapses in donning and doffing of personal protective equipment during the COVID-19 pandemic
- Peer Review Report
- 10.7554/elife.76854.sa1
- Apr 4, 2022
Decision letter: Reconstruction of transmission chains of SARS-CoV-2 amidst multiple outbreaks in a geriatric acute-care hospital: a combined retrospective epidemiological and genomic study
- Research Article
20
- 10.1111/jdv.16646
- Jul 31, 2020
- Journal of the European Academy of Dermatology and Venereology
Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e346–e380.
- Research Article
14
- 10.1016/j.jhin.2020.08.015
- Aug 20, 2020
- The Journal of Hospital Infection
Transmission of infection from non-isolated patients with COVID-19 to healthcare workers
- Research Article
8
- 10.1097/jom.0000000000002238
- Apr 23, 2021
- Journal of Occupational & Environmental Medicine
SARS-CoV-2 Transmission Risk to Household and Family Contacts by Vaccinated Healthcare Workers.
- Discussion
3
- 10.1016/j.ejim.2022.02.005
- Feb 14, 2022
- European Journal of Internal Medicine
Double-gloving in an Intensive Care Unit during the COVID-19 pandemic
- Research Article
- 10.7759/cureus.52475
- Jan 18, 2024
- Cureus
Background and objectiveHealthcare workers (HCWs) are at a higher risk of contracting coronavirus disease 2019 (COVID-19) since they regularly come into direct contact with infected patients and their surroundings. In light of this, it is critical to study the potential risk factors for SARS-CoV-2 infection among HCWs to help determine its transmission patterns and prevent infections among HCWs, as well as healthcare-associated COVID-19.MethodsWe conducted a case-control study at a tertiary healthcare center from December 2020 to August 2021. HCWs who tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, by RT-PCR were included as cases and those who tested negative for RT-PCR and SARS-CoV-2 antibodies were recruited as controls. We interviewed 316 HCWs (187 cases and 129 controls) by using the WHO questionnaire titled “Protocol for assessment of potential risk factors for coronavirus disease 2019 among health workers in a health care setting” to assess infection prevention and control (IPC) knowledge and practices, including the use of personal protective equipment (PPE). The odds ratio (OR) for factors associated with infection was determined by multivariable logistic regression.ResultsThe majority (87.2%) of the cases were symptomatic. Adherence to IPC measures was higher among controls as compared to cases. A significantly higher number of controls used PPE compared to cases. The proportions of HCWs involved in cleaning, patient transport, reception, and catering were higher among cases (37.9%) compared to controls (19.1%). In multivariable analysis, undergoing training on care for COVID-19 patients was associated with a lower risk of infection (OR: 0.40, 95% CI: 0.24-0.69).ConclusionsAdherence to IPC and use of PPE were significantly higher among controls as compared to cases. Receiving training in COVID-19 patient care and compliance with IPC measures were associated with a lower risk of COVID-19 infection among HCWs in this study.
- Discussion
46
- 10.1016/j.jhin.2020.05.016
- May 15, 2020
- Journal of Hospital Infection
Is it possible to achieve 100 percent hand hygiene compliance during the coronavirus disease 2019 (COVID-19) pandemic?
- Discussion
24
- 10.1016/j.jinf.2021.01.010
- Jan 29, 2021
- Journal of Infection
Seroprevalence of antibodies against SARS-CoV-2 in a large national hospital and affiliated facility in Tokyo, Japan
- Research Article
2
- 10.3396/ijic.v19.22791
- Jan 1, 2023
- International Journal of Infection Control
Introduction: Considering the absence of effective treatment, the World Health Organization had recommended stringent infection prevention and control (IPC) measures against coronavirus disease 2019 (COVID-19) to reduce its transmission. The non-adherence of healthcare workers (HCWs) to these measures had been reported as a major cause of infection. Aim: To assess the level of self-reported adherence of HCWs to IPC measures during their social life and work time. Methods: This cross-sectional study included 559 HCWs (411 females and 148 males) working at 39 hospitals across different Egyptian governorates. A predesigned structured questionnaire about COVID-19 IPC measures was completed by trained interviewers. Results: Washing hands before eating (98.2%), using soap for hand wash (97.9%), washing hands after returning home (96.6%), and wearing a face mask when going outside in public places (83.7%) were the commonest daily-life practices among the 559 studied HCWs, while the least common was social distancing (46.0%). Less than half of the studied HCWs were adherent to the proper duration of handwashing (P < 0.01). Only 5.9% of the studied HCWs usually wore full personal protective equipment (PPE) at work (P = 0.051). The highest percentages of HCWs working at outpatient clinics and laboratories (98.1% each) ‘sometimes’ used PPE (P = 0.017). There was a significant difference in self-reported adherence to wearing face masks at hospitals according to specialties (P < 0.01). HCWs working at intensive care units (ICUs) recorded the highest attendance rates at IPC training (53.8%, P = 0.012). A relatively higher percentage of HCWs at COVID-19 isolation hospitals wore PPE (15.7%) versus 2.2–4.7% in other hospitals (P = 0.015). Conclusion: The majority of HCWs sometimes complied with wearing PPE (93.6%). HCWs were more adherent to wearing masks at hospitals (94.6%) compared to community settings (42.9%). Older age and female gender were significantly associated with self-reported adherence to some IPC measures. Hand hygiene training session emphasizing the proper duration of hand wash is mandatory.
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