SARS-CoV-2 incidence and effect on absences at a university hospital in Germany

Abstract

Abstract Background The COVID-19 pandemic highlighted the challenges and risks of in-hospital exposures among the health workforce. Health facilities were compelled to conduct their operation while both securing patient care and employees’ health in the context of changing regulatory requirements. Methods We performed Time Series Models and a T-Test for Polymerase Chain Reaction (PCR) SARS-CoV-2 in-hospital test results reported via the digital COVID-19 platform of the LMU University Hospital, Germany. The cohort consists of all persons employed at the hospital during the platform's utilisation (N = 14,419; 11.2021-12.2022). Results Overall, 179,135 in-hospital PCR tests were executed (monthly range: 5,528-24,560; R2=.993) of which 6,538 were positive (monthly range: 92-1,095; R2=.991). In a symptomless or evanescent course of infection, employees were able to get a control test and resume their duties prior to the designated end of isolation if their viral load were below the benchmark of, initially, 100,000 or, as adapted later, 1,000,000 copies/ml (as per Robert Koch Institute's recommendation): 8,100 PCR control results below the respective benchmark were reported (monthly range: 92-1,429; R2=.995). In total, 6,841 persons were able to resume duties prior to their isolation expiration date (monthly range: 10-1,478; R2=.996). No significant differences between the monthly number of PCR tests indicating a new infection and control tests were observed (t=−1.246, p=.235). Incidence trends were tracked closely via the hospital's platform. Conclusions The number of executed and positively reported tests fluctuated considerably. The benchmark for PCR tests in positive symptomless or evanescent cases allowed for a large number of staff to resume their duties prior to the expiration of their mandated isolation, yet without presenting a risk to other employees or patients. This measure prevented major staff shortages and ensured the uninterrupted provision of patient care at the hospital. Key messages • The establishment of a control test process facilitates the risk-reduced resumption of duty following a positive PCR test and reduces the isolation period with a decisive effect on staff capacity. • In-hospital test surveillance requires evidence-informed and agile adaptations, thus highlighting the need for centralised strategic management, including segmented visualisation and analysis.