COVID-19 In Healthcare Workers Research Articles

COVID-19 infection and the broader impacts of the pandemic on healthcare workers.

The severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease or COVID-19 pandemic is associated with more than 230 million cases and has challenged healthcare systems globally. Many healthcare workers (HCWs) have acquired the infection, often through their workplace, with a significant number dying. The epidemiology of COVID-19 infection in HCWs continues to be explored, with manifold exposure risks identified, leading to COVID-19 being recognised as an occupational disease for HCWs. The physical illness due to COVID-19 in HCWs is similar to the general population, with some HCWs experiencing a long-term illness, which may impact their ability to return to work. HCWs have also been affected by the immense workplace and psychosocial disruption caused by the pandemic. The impacts on the psychological well-being of HCWs globally have been profound, with high prevalence estimates for mental health symptoms, including emotional exhaustion. Globally, governments, healthcare organisations and employers have key responsibilities, including: to be better prepared for crises with comprehensive disaster response management plans, and to protect and preserve the health workforce from the physical and psychological impacts of the pandemic. While prioritising HCWs in vaccine rollouts globally has been critical, managing exposures and outbreaks occurring in healthcare settings remains challenging and continues to lead to substantial disruption to the health workforce. Safeguarding healthcare workforces during crises is critical as we move forward on the new path of 'COVID normal'.

Protection Behaviors and Related Factors Against COVID-19 in the Healthcare Workers of the Hospitals in Iran: A Cross-Sectional Study.

Protective behaviors play a key role in reducing the incidence of COVID-19 in HealthCare Workers (HCWs), and these behaviors are related to other factors. These related factors have not been comprehensively evaluated and determined in the literature. This study aimed to determine protection behaviors against COVID-19 and their related factors using the Protection Motivation Theory (PMT) among HCWs of hospitals in Tehran, Iran, in 2021. For this cross-sectional study, 270 HCWs of different wards in 3 hospitals in Tehran, Iran, were selected through multistage sampling (April to July 2021). The participants completed a self-reporting questionnaire which consisted of a demographic characteristics form and questions about protective behaviors against COVID-19 and other constructs of the PMT (60 items). Data analysis was performed using descriptive and inferential methods. The mean score of the protective behaviors of the HCWs was 4.20 (SD = 0.56) and was significantly higher in the nurses, women, married individuals, and those with a BSc degree compared with others (p < 0.05). Furthermore, the results of multiple regression analysis showed that protection behavior among HCWs could be strongly predicted by the type of profession, protection motivation/intention, and self-efficacy constructs (F14, 255 = 16.34, p < 0.001). The protection behaviors of HCWs against COVID-19 were relatively desirable and these behaviors were related to and predicted by various factors. These results could apply to developing plans for protective behaviors against COVID-19 and possibly other infectious diseases among HCWs. Further research in this regard is recommended.

Psychological implications of Covid-19 in healthcare workers.

The Covid-19 outbreak has led to an unprecedented burden on the healthcare infrastructure. High morbidity and mortality rates have resulted in a state of stress and distress among the general population which has also impacted health professionals. This study was conducted to identify mental health disturbances among health professionals during the Covid-19 pandemic. It was a cross-sectional study, conducted in a Medical College in Himachal Pradesh, India. A self-administered anonymized questionnaire was administered to the healthcare workers. Mental health status was assessed using Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS). In addition, a 15-item questionnaire was prepared to identify the probable causes of stress in HCWs during the Covid-19 Pandemic. A statistical analysis used t-test was used to find the significance of the correlation between the PHQ-ADS score and the agreement score of different factors. The response rate for the questionnaire was 27%. Anxiety and depression were seen in 29% of participants, ranging from mild (18.3%), moderate (4.7%), and severe (5.9%). Among females 43.7% of the participants and among males, 13.1% had anxiety and depression. High PHQ-ADS scores were seen in nursing staff (70%) and postgraduate students (30%), who were in the third decade of life. Most (81.7%) of the HCWs were concerned about transmitting the disease to their near ones. Fear of coming to the hospital and dealing with patients. Even sub-threshold syndromes among HCWs need to be identified before they evolve into overt diseases. The psychological needs of healthcare workers should be prioritized as they are key players in the fight against Covid-19.

Occupational health surveillance of healthcare workers during COVID 19 pandemic: a narrative review.

Background and aims:Current literature has increasingly highlighted the risk of spreading the SARS-COV-2 infection in healthcare settings and showed the need for occupational health surveillance of HCWs during the current epidemiological emergency from COVID-19, as a preventive measure to minimize the spread of the infection. The purpose of this narrative review was to evaluate the literature and discover what the latest developments are about the management of the occupational health surveillance of healthcare workers (HCWs) during COVID-19 pandemic.Methods:We searched for publications in MEDLINE, Pubmed and Google Scholar using selected keywords. Each article was reviewed and categorized into one or more of the following three categories based on its subject matter: early diagnosis of COVID-19 in HCWs, detection of worker susceptibility to severe COVID-19, medical examination of HCWs returning to work after COVID-19.Results:Selected articles showed the RT-PCR test for Sars-CoV-2 as the gold standard to enable rapid identification of infected HCWs; an effective schedule of occupational health surveillance allows the identification of the susceptibility of the workers to severe Covid-19 and protect HCWs returning to work from the disease.Conclusions:The findings of the present narrative review show the need to strenghten the occupational health surveillance of HCWs during the current COVID-19 pandemic, with the aim not only to contain the spread of the infection in healthcare settings, but also to protect HCWs coming back to work after the disease. (www.actabiomedica.it)

Sources of Infection and Risk of COVID-19 for Healthcare Workers at a Tertiary Hospital

Sources of Infection and Risk of COVID-19 for Healthcare Workers at a Tertiary Hospital

Evaluation of knowledge and attitude of dental students regarding COVID-19: A multicentric study.

Despite the life-threatening risk that corona virus disease (COVID-19) poses to dentists, their role in suppressing its transmission and the need to deliver dental care to the patients is inevitable. In this regard, it is essential to determine the awareness and knowledge among Indian dental students regarding COVID-19 and to assess their preparedness to handle the current situation. This cross-sectional study enrolled 408 dental undergraduate (UG) and postgraduate (PG) students from private and government dental teaching hospitals. A closed-ended online questionnaire containing crucial elements of COVID management during dental procedures was given to the participants assessing their knowledge and perception pertaining to COVID-19 regarding dental practice. Chi-square, Mann-Whitney U, and Kruskal-Wallis tests were employed for statistical analysis. P ≤ 0.05 was considered statistically significant. The study consisted of 64.71% UG and 35.29% PG dental students, with a mean age of 25.75 ± 3.69 years and M: F ratio of 0.5:1. COVID-19 knowledge increased significantly with age (P = 0.0055) and educational level (P < 0.01). Awareness was also significantly greater in students from government institutions in comparison with private colleges (P < 0.001), with 91.67% of participants being aware of the transmission routes. However, familiarity with survival of virus in aerosols, considerations regarding the use of masks, and strategies for confirmed/suspected COVID-19 health-care workers to return to work after recovery were seen in only 35%, 53.9%, and 38.9% of the students, respectively. COVID-19 awareness among Indian dental students is significantly related to their education level. The lacunae in this knowledge need to be filled by adequate training by incorporating it as a part of their education.

Factors associated with peritraumatic stress symptoms among the frontline healthcare workers during the outbreak of COVID-19 in China

ObjectivesThis study aimed to examine the prevalence of peritraumatic stress symptoms (PTSSs), perceived threat, social support and factors contributing to clinically significant PTSS among frontline COVID-19 healthcare workers (HCWs) in...

Adherence to non-pharmacological preventive measures among healthcare workers in a middle-income country during the first year of the COVID-19 pandemic: Hospital and community setting

This study assessed, using a self-reported questionnaire, the adherence to PPE (mask, gowns, and gloves) at the workplace, as well as to non-pharmacological preventive measures (NPPM) (physical distance defined as hardly ever and/or never approaches other people within 1.5 meters, social isolation as leaving home less than once a week, hand hygiene was defined as performing hand hygiene ≥ 6 times per period, and adherence to the use of a mask outside of the workplace was defined as on all outings and hardly ever and/or never removes the mask) outside of the workplace among 1,296 health care workers (HCWs), including if NPPM adherence was associated with COVID-19 in HCWs. High adherence to PPE was independently associated with younger age, professional category, work in an area of direct patient assistance; use of public transportation, or adherence to NPPM outside of the workplace.

Narrative trajectories of disaster response: ethical preparedness from Katrina to COVID-19

While COVID-19 brings unprecedented challenges to the US healthcare system, understanding narratives of historical disasters illuminates ethical complexities shared with COVID-19. In 2005, Hurricane Katrina revealed a lack of disaster...

The Effects of COVID-19 on Healthcare Workers and Non-Healthcare Workers in Mexico: 14 Months into the Pandemic.

Background and Objectives: Healthcare workers (HCWs) play important roles in mitigating the COVID-19 pandemic and are more likely to become infected with COVID-19. Mexico, among other countries, had a high incidence and prevalence of cases and deaths from this disease. Material and Methods: This retrospective study evaluated the clinical characteristics as well as the geographical distribution of cases, deaths, and active cases of COVID-19 in HCWs and non-HCWs using official information from the Ministry of Health of Mexico. Results: A total of 235,343 cases of COVID-19 were reported in healthcare workers, and 2,094,191 cases were reported in non-healthcare workers. A total of 76.0% of cases in healthcare workers occurred in those who were between 25 and 50 years of age, and 71.4% of deaths occurred in those who were 50 to 69 years of age. Among healthcare workers, the most frequent comorbidities were obesity (15.2%), hypertension (10.9%), and diabetes (6.8%). Nurses were the group with the most cases (39.7%), followed by other healthcare workers (30.6%), physicians (26%), and dentists (1.6%). Physicians were the group with the most deaths (46%), followed by other professionals (30%), nurses (19%), and dentists (3%). Conclusion: These findings are likely the result of healthcare workers in Mexico being at a greater risk of exposure to SARS-CoV-2.

804. Infection Control and Clinical Support in Long-Term Care Homes During the COVID-19 Pandemic in North Toronto: A Quasi-Experimental Study

BackgroundWave one of the COVID-19 pandemic in Ontario, Canada, resulted in significant institutional outbreaks associated with high case fatality among older adults. Our hospital formally partnered with congregate care homes in north Toronto to support infection control and clinical management before wave two of the COVID-19 pandemic. Our aim was to evaluate the impact of this program on resident and healthcare worker (HCW) outcomes. MethodsA multicentre quasi-experimental study was conducted comparing outcomes between wave one (March-June, 2020) and wave two (October-December, 2020) among 17 congregate care homes (4 long term care homes and 13 residential homes). During wave two, weekly meetings and 42 on-site visits were conducted along with on-site daily hospital presence for all COVID-19 outbreaks to support infection control and resident management. The primary outcomes included COVID-19-case fatality rate as well as overall resident fatality including COVID-19 and non-COVID-19 related causes. Secondary outcomes included healthcare worker COVID-19 infections, and infection control practices among homes with paired audits (n=6), including hand hygiene, use of personal protective equipment, environmental cleaning and physical distancing practices. ResultsAmong 2203 residents during wave one and 2287 residents during wave two, there was reduction in COVID-19 case fatality rate (38.1% vs. 13.4%; p< 0.01), overall COVID-19-related fatality (2.3% vs. 1.0%; p< 0.01) and non COVID-19 related fatality (8.3% vs. 3.5%; p< 0.01). Weekly staff testing and increased syndromic surveillance was implemented during wave two. Among 2590 staff, there were 2.6% vs.4.2% staff who tested positive for COVID-19 during wave one and two, respectively. Changes in infection control practice were observed in regard to directly observed hand hygiene (83.3% vs. 100%), use of personal protective equipment (16.7% vs. 83.3%), environmental cleaning (66.7% vs. 100%) and physical distancing (66.7% vs. 83.3%). ConclusionIntegration of hospital with community congregate care homes was associated with improvements in resident outcomes during wave two of the pandemic. Further longitudinal support and evaluation is needed to ensure sustainability. Disclosures All Authors: No reported disclosures

Diagnosing occupational COVID-19 in Croatian healthcare workers.

Coronavirus disease 2019 (COVID-19) can be diagnosed as occupational disease by an occupational health physician (OHP), if supported by relevant work-related and medical documentation. The aim of this study was to analyse such documentation submitted by Croatian healthcare workers (HCWs) and discuss its relevance in view of European and Croatian guidelines. The study included 100 Croatian HCWs who were SARS-CoV-2-positive and requested that their infection be diagnosed as occupational disease by their OHPs from 1 May 2020 to 10 March 2021. As participants they were asked to fill out our online Occupational COVID-19 in Healthcare Workers Questionnaire. For the purpose of this study we analysed answers about the type of close contact at the workplace, COVID-19 symptoms, and enclosed work-related (job description, employer statement about exposure to SARS-CoV-2) and medical documentation (positive SARS-CoV-2 polymerase chain reaction test and patient history confirming the diagnosis of COVID-19). Most participants were working in hospitals (N=95), mostly nurses (N=75), who became infected by a patient (N=68) or colleague (N=31), and had at least one COVID-19 symptom (N=87). Eighty participants did not enclose obligatory documents, 41 of whom failed to submit job description and 31 both job description and employer statement. These findings confirm that the major risk of occupational COVID-19 in HCWs is close contact with patients and colleagues, and points out the need for better cooperation between OHPs, occupational safety experts, employers, and diseased workers.

A hospital-wide response to multiple outbreaks of COVID-19 in health care workers: Lessons learned from the field

Introduction: The Royal Melbourne Hospital (RMH) experienced a significant number of staff COVID-19 infections during July and August 2020 concurrent with a state-wide surge in cases. We describe the epidemiology of the infections and the interventions associated with outbreak control.

The lost productivity cost of absenteeism due to COVID-19 in health care workers in Iran: a case study in the hospitals of Mashhad University of Medical Sciences

BackgroundHuman resources management plays an important role in social development and economic growth. Absence from work due to health problems can make obstacles to the growth of economy. This study conducted aimed to estimate the absenteeism costs of COVID-19 among the personnel of hospitals affiliated to Mashhad University of Medical Sciences in Mashhad, Iran.MethodsThis cross-sectional study was conducted between February 19, 2020, and September 21, 2020. The absenteeism costs were calculated using the human capital approach. Finally, we applied the linear regression to assess the impact of variables on the lost productivity of absenteeism due to COVID-19 among the personnel of hospitals affiliated to Mashhad University of Medical Sciences.ResultsThe results of this study showed that 1958 personnel had COVID-19. The total of absenteeism days in our study were 32,209 days, with an average of 16.44 absenteeism days. Total costs due to absenteeism were estimated to be nearly $1.3 million, with an average of $671.4 per patient. The results of regression model showed that gender (male), age (> 50 years), employment Type (non-permanent) and monthly income had a positive relationship with the absenteeism cost. Also, there are a negative significant relationship between absenteeism cost with job (physicians) and work experience.ConclusionsAbsenteeism costs of COVID-19 in the hospitals of Mashhad University of Medical Sciences represent a significant economic burden. The findings of our study emphasize the emergency strategies to prevent and control COVID-19 among the healthcare workers. It can decrease the economic impacts of COVID-19 and improve human resources management during the COVID-19 pandemic.

COVID-19 in health care workers, Australia 2020.

Health care workers are at increased risk of SARS-CoV-2 infection due to potential exposure to patients or staff in health care settings. Australian health care services and health care workers experienced intense pressure to prepare for and respond to SARS-CoV-2 infections. We summarise national data on health care worker infections and associated outbreaks during 2020. We collected aggregated data on infected health care workers and outbreaks in health care facilities from all jurisdictions. Health care workers working solely in residential aged care and outbreaks in residential aged care facilities were excluded. Jurisdictions provided data on the number of health care setting outbreaks, confirmed cases, hospitalisation, source of infection, and health care worker role. We analysed data for two periods that aligned with two distinct peaks in the epidemic relative to 1 June 2020, referred to here as the first wave (23 January - 31 May 2020) and the second wave (1 June - 18 September 2020). Jurisdictions reported a total of 2,163 health care worker infections with SARS-CoV-2 during the surveillance period. Source of acquisition was known for 81.0% of cases (1,667/2,059). The majority of cases in the first wave were acquired overseas, shifting to locally-acquired cases in the second wave. The odds of infection in the second wave compared to the first wave were higher for nurses/midwives (odds ratio, OR: 1.61; 95% confidence interval (95% CI): 1.32-2.00), lower for medical practitioners (OR: 0.36; 95% CI: 0.28-0.47) and did not differ for 'other' health care workers (OR: 1.07; 95% CI: 0. 87-1.32). The odds of infection in the second wave were higher in a health care setting (OR: 1.76; 95% CI: 1.28-2.41) than in the community. There were 120 outbreaks in health care settings with 1,428 cases, of which 56.7% (809/1,428) were health care workers. The majority (88/120; 73.8%) of outbreaks in health care settings occurred in the second wave of the epidemic, with 90.9% of these (80/88) occurring in Victoria. In the second wave of the epidemic, when there was heightened community transmission, health care workers were more likely to be infected in the workplace. Throughout the epidemic, nurses were more likely to be infected than staff in other roles.

COVID-19 in health care workers, Australia 2020

Background Health care workers are at increased risk of SARS-CoV-2 infection due to potential exposure to patients or staff in health care settings. Australian health care services and health care workers experienced intense pressure to prepare for and respond to SARS-CoV-2 infections. We summarise national data on health care worker infections and associated outbreaks during 2020. Methods We collected aggregated data on infected health care workers and outbreaks in health care facilities from all jurisdictions. Health care workers working solely in residential aged care and outbreaks in residential aged care facilities were excluded. Jurisdictions provided data on the number of health care setting outbreaks, confirmed cases, hospitalisation, source of infection, and health care worker role. We analysed data for two periods that aligned with two distinct peaks in the epidemic relative to 1 June 2020, referred to here as the first wave (23 January – 31 May 2020) and the second wave (1 June – 18 September 2020). Results Jurisdictions reported a total of 2,163 health care worker infections with SARS-CoV-2 during the surveillance period. Source of acquisition was known for 81.0% of cases (1,667/2,059). The majority of cases in the first wave were acquired overseas, shifting to locally-acquired cases in the second wave. The odds of infection in the second wave compared to the first wave were higher for nurses/midwives (odds ratio, OR: 1.61; 95% confidence interval (95% CI): 1.32–2.00), lower for medical practitioners (OR: 0.36; 95% CI: 0.28–0.47) and did not differ for ‘other’ health care workers (OR: 1.07; 95% CI: 0. 87–1.32). The odds of infection in the second wave were higher in a health care setting (OR: 1.76; 95% CI: 1.28–2.41) than in the community. There were 120 outbreaks in health care settings with 1,428 cases, of which 56.7% (809/1,428) were health care workers. The majority (88/120; 73.8%) of outbreaks in health care settings occurred in the second wave of the epidemic, with 90.9% of these (80/88) occurring in Victoria. Conclusions In the second wave of the epidemic, when there was heightened community transmission, health care workers were more likely to be infected in the workplace. Throughout the epidemic, nurses were more likely to be infected than staff in other roles.

Epidemiological model of COVID-19 in healthcare workers: occupational vs. environmental disease

Abstract This study aims to estimate the occupational etiology of COVID-19 in the healthcare sector and obtain a risk matrix for the burden of disease across occupations and specific activities. The study population included 4515 cases and 133077 controls. We have used an epidemiological model that included data collected over one year from employed persons with confirmed SARS-CoV-2 infection, age group 20-64, and residing in Sibiu County. We measured the incidence rate (IR), relative risk (RR), and risk of COVID-19 attributable to the occupational exposure (AR), respectively, statistical analysis based on frequency distribution and the portion of cases to compute the risk levels in social- and healthcare workers. According to this model, approximately 70.5% of COVID-19 risk could be attributable to occupational exposure. The workplace is a strong predictor of infection risk (RR 3.4), particularly in residential long-term care facilities, hospitals, and ambulance services. The highest-risk job functions are nurse, nursing assistant, ambulance worker, and dentist. In conclusion, we believe in having demonstrated that epidemiological modeling may be helpful for risk management and notification of COVID-19 as an occupational disease in frontline staff and essential healthcare personnel.

Long-term outcome after SARS-CoV-2 infection in healthcare workers: a single centre cohort study.

Long-term symptoms after acute COVID-19 are highly debated. Nevertheless, data on long-term symptoms of COVID-19 in healthcare workers are scarce. We assessed frequency and risk factors of persisting symptoms in a retrospective cohort of healthcare workers infected with SARS-CoV-2. Persistent symptoms at 3 and 12 months were reported by 26.5% and 13.5% of participants, respectively. Most commonly reported symptoms were fatigue, impaired sense of taste or smell and general weakness. A history of depression or state of exhaustion, pre-existing lung disease and older age were associated with persisting symptoms. Our study shows that a relevant proportion of healthcare workers with mild COVID-19 report persisting symptoms over 3 and 12 months. Although in the majority of cases symptoms are mild, this study highlights the need for further research into causes and therapy.

Individual Differences in the Affective Response to Pandemic-Related Stressors in COVID-19 Health Care Workers

BackgroundWe investigated the evolving prevalence of mood and anxiety symptoms among health care workers from May 2020 to January 2021, risk factors for adverse outcomes, and characteristic modes of affective responses to pandemic-related stressors. MethodsA total of 2307 health care workers (78.9% female, modal age 25–34 years) participated in an online survey assessing depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7 scale) symptoms, demographic variables, and self-reported impact of pandemic-related stressors. A total of 334 subjects were reassessed ∼6 months later. ResultsThe prevalence of clinically significant depression and anxiety was 45.3% and 43.3%, respectively, and a majority (59.9%–62.9%) of those individuals had persistent significant symptoms at 6-month follow-up. Younger age, female gender, and specific occupations (support staff > nurses > physicians) were associated with increased depressive and anxiety symptoms. The most important risk factors were social isolation and fear of contracting COVID-19. The prevalence of clinically significant mood and anxiety symptoms increased by 39.8% from May 2020 to January 2021. Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scores were highly correlated and associated with nearly identical risk factors, suggesting that they are not capturing independent constructs in this sample. Principal component analysis identified seven orthogonal symptom domains with unique risk factors. ConclusionsClinically significant mood and anxiety symptoms are highly prevalent and persistent among health care workers, and are associated with numerous risk factors, the strongest of which are related to pandemic stressors and potentially modifiable. Interventions aimed at reducing social isolation and mitigating the impact of fear of infection warrant further study.

Can united airway disease be the cause of variable severity experience of COVID-19 in health care workers?

Can united airway disease be the cause of variable severity experience of COVID-19 in health care workers?