Testing Of Healthcare Workers Research Articles

The effectiveness and efficiency of asymptomatic SARS-CoV-2 testing strategies for patient and healthcare workers within acute NHS hospitals during an omicron-like period

BackgroundAsymptomatic SARS-CoV-2 testing of hospitalised patients began in April-2020, with twice weekly healthcare worker (HCW) testing introduced in November-2020. Guidance recommending asymptomatic testing was withdrawn in August-2022. Assessing the impact of this decision from data alone is challenging due to concurrent changes in infection prevention and control practices, community transmission rates, and a reduction in ascertainment rate from reduced testing. Computational modelling is an effective tool for estimating the impact of this change.MethodsUsing a computational model of SARS-CoV-2 transmission in an English hospital we estimate the effectiveness of several asymptomatic testing strategies, namely; (1) Symptomatic testing of patients and HCWs, (2) testing of all patients on admission with/without repeat testing on days 3 and 5–7, and (3) symptomatic testing plus twice weekly asymptomatic HCW testing with 70% compliance. We estimate the number of patient and HCW infections, HCW absences, number of tests, and tests per case averted or absence avoided, with differing community prevalence rates over a 12-week period.ResultsTesting asymptomatic patients on admission reduces the rate of nosocomial SARS-CoV-2 infection by 8.1–21.5%. Additional testing at days 3 and 5–7 post admission does not significantly reduce infection rates. Twice weekly asymptomatic HCW testing can reduce the proportion of HCWs infected by 1.0-4.4% and monthly absences by 0.4–0.8%. Testing asymptomatic patients repeatedly requires up to 5.5 million patient tests over the period, and twice weekly asymptomatic HCW testing increases the total tests to almost 30 million. The most efficient patient testing strategy (in terms of tests required to prevent a single patient infection) was testing asymptomatic patients on admission across all prevalence levels. The least efficient was repeated testing of patients with twice weekly asymptomatic HCW testing in a low prevalence scenario, and in all other prevalence levels symptomatic patient testing with regular HCW testing was least efficient.ConclusionsTesting patients on admission can reduce the rate of nosocomial SARS-CoV-2 infection but there is little benefit of additional post-admission testing. Asymptomatic HCW testing has little incremental benefit for reducing patient cases at low prevalence but has a potential role at higher prevalence or with low community transmission. A full health-economic evaluation is required to determine the cost-effectiveness of these strategies.

COVID-19 Contact Tracing Experience at a Tertiary Healthcare Center in Saudi Arabia.

Introduction As of May 2023, the end of the pandemic, the cumulative number of COVID-19 cases reached more than 841,000 cases. Healthcare workers (HCWs) especially have been at the frontline during this pandemic and are at a higher chance of contracting COVID-19. Approximately half of all high-risk exposures were to healthcare personnel with COVID-19. While several tools for contact tracing were developed for the general public, contact tracing for infectious diseases in the healthcare setting is limited, and global testing of HCWs, or in-hospital digital tracing, is not performed in most facilities. The King Faisal Specialist Hospital and Research Center (KFSH&RC) collaborated with the Infection Control and Health Information Technology Affairs (HITA)to create an automated COVID-19 contact tracing tool specifically for HCWs who worked at the institute. This study aims to describe the contact tracing experience at KFSH&RC. Methods A retrospective study was conducted to describe the use of an automated tool that was developed to assist in the contact tracing process and that was to be used by KFSH&RC employees who had been in contact with a COVID-19-positiveindividual. This tool is utilized for the early identification of possible COVID-19 cases and risk stratification of the exposed individuals. The tool can be accessed through the KFSH&RC website; it also collects information about the COVID-19 exposure rate among the different departments such as administration, capital projects/facilities, and healthcare at a tertiary care hospital in Riyadh, Saudi Arabia Results The tool has been utilized 7,353 times by contact cases. Approximately 7% of those tested later developed a COVID-19 infection. When assessing the positivity rates per department, The Environmental Services Department had the highest positivity rate of 28.21%, followed by Health Information Technology and Analytics (HITA), and then the Central Transportation Department. Conclusion This study acts as the first of its kind to describe the successful use of the healthcare contact tracing system in one of Saudi Arabia's largest hospitals (KFSH&RC) and describe the infection trends in different departments of the hospital. Through the tracing system, the departments with the highest COVID-19 infection occurrences at the hospital were identified in a timely manner, and safety protocols were implemented.

State and Federal Legislators' Responses on Social Media to the Mental Health and Burnout of Health Care Workers Throughout the COVID-19 Pandemic: Natural Language Processing and Sentiment Analysis.

Burnout and the mental health burden of the COVID-19 pandemic have disproportionately impacted health care workers. The links between state policies, federal regulations, COVID-19 case counts, strains on health care systems, and the mental health of health care workers continue to evolve. The language used by state and federal legislators in public-facing venues such as social media is important, as it impacts public opinion and behavior, and it also reflects current policy-leader opinions and planned legislation. The objective of this study was to examine legislators' social media content on Twitter and Facebook throughout the COVID-19 pandemic to thematically characterize policy makers' attitudes and perspectives related to mental health and burnout in the health care workforce. Legislators' social media posts about mental health and burnout in the health care workforce were collected from January 2020 to November 2021 using Quorum, a digital database of policy-related documents. The total number of relevant social media posts per state legislator per calendar month was calculated and compared with COVID-19 case volume. Differences between themes expressed in Democratic and Republican posts were estimated using the Pearson chi-square test. Words within social media posts most associated with each political party were determined. Machine-learning was used to evaluate naturally occurring themes in the burnout- and mental health-related social media posts. A total of 4165 social media posts (1400 tweets and 2765 Facebook posts) were generated by 2047 unique state and federal legislators and 38 government entities. The majority of posts (n=2319, 55.68%) were generated by Democrats, followed by Republicans (n=1600, 40.34%). Among both parties, the volume of burnout-related posts was greatest during the initial COVID-19 surge. However, there was significant variation in the themes expressed by the 2 major political parties. Themes most correlated with Democratic posts were (1) frontline care and burnout, (2) vaccines, (3) COVID-19 outbreaks, and (4) mental health services. Themes most correlated with Republican social media posts were (1) legislation, (2) call for local action, (3) government support, and (4) health care worker testing and mental health. State and federal legislators use social media to share opinions and thoughts on key topics, including burnout and mental health strain among health care workers. Variations in the volume of posts indicated that a focus on burnout and the mental health of the health care workforce existed early in the pandemic but has waned. Significant differences emerged in the content posted by the 2 major US political parties, underscoring how each prioritized different aspects of the crisis.

Mass testing of healthcare workers for COVID-19-A single institution experience in Sabah, East Malaysia.

Approximately 1.29 million COVID-19 cases involving healthcare workers (HCWs) have been reported globally, leading to several hospitals conducting mass testing for early detection of infected HCWs. This study was conducted to report our experience and findings from the mass testing of HCWs from a public hospital in Sabah, Malaysia. The mass testing was conducted from 1st March 2020 to 30th June 2020, and involved self-reported data and laboratory results of 2089 HCWs. All HCWs who took at least two nasopharyngeal swabs for COVID-19 testing at two different time intervals during the study period were included. Throughout the mass testing period, various strategies such as practices of the new norm, daily temperature and symptom checking, wearing of appropriate personal protective equipment (PPE), identification of high-risk areas and travel declaration of staffs were within the hospital for prevention of COVID-19 transmission. We observed a small percentage of COVID-19 infected HCWs (n = 19, 0.91%) from the mass testing. Both symptomatic and asymptomatic COVID-19 HCWs were almost equal in number. A majority of those infected were nurses (n = 16, 0.77%) who had contact exposure to COVID-19 positive person or person under investigation (PUI) (n = 15, 0.72%). Four of the COVID-19 infected HCWs (n = 4/19, 21.05%) had no contact exposure. These HCWs were not identified through contact tracing. Fortunately, they were detected during the mass testing and were isolated promptly. In conclusion, mass testing of HCWs helped in early identification of COVID-19 infected HCWs not identified through contact tracing. Strategies such as stratified mass testing, strict compliance to new norm, appropriate PPE usage and identification of high-risk area were effective in the prevention of COVID-19 infection among HCWs.

The role and relevance of asymptomatic healthcare worker testing in COVID-19 hospital outbreaks

Background: Many healthcare facilities have faced the decision of conducting point prevalence testing (PPT) of healthcare workers (HCW) during COVID-19 outbreaks. As a containment strategy, PPT can identify asymptomatic or presymptomatic cases for isolation. It is less clear how useful testing asymptomatic HCW is in understanding the spread and possible routes of transmission in an outbreak. This study investigated HCW cases identified through PPT during acute-care outbreaks in Fraser Health (FH), British Columbia, incorporating both epidemiological and whole-genome sequencing (WGS) data to determine their epidemiological source. Methods: This study was a retrospective review of cases associated with COVID-19 acute-care outbreaks in FH occurring between December 2020 and June 2021, when most of these infections were of the alpha and gamma lineages. All patients and HCWs with a positive COVID-19 test and epidemiologically linked to the outbreaks were included in the study. WGS results supported determination of epidemiological source for cases. The proportion of patient and HCW cases related to the outbreak was compared. All analyses were conducted using SAS version 4.3 software with the PROC GLM package. Results: Between December 2020 and June 2021, 49 acute-care COVID-19 outbreaks were declared. Point-prevalence testing of HCWs, in addition to routine patient PPT, was conducted in 28 outbreaks (57%), with 2,167 eligible HCWs (63%) tested. Testing identified 14 previously unknown HCW cases, representing 12.96% of all HCW cases epidemiologically linked to the outbreaks. None of these HCWs were determined to be the index case for their associated outbreak. There was no statistically significant difference between HCWs and patients regarding WGS failure rate, and all failed samples were removed from further analysis. Patients were 3.8 times as likely as HCWs to present as symptomatic when testing positive. HCWs were 2.2 times as likely as patients to have WGS results unrelated to the outbreak. Discussion: Although point-prevalence testing of HCW identified previously unknown cases, these cases were more likely than patients to be unrelated to the outbreak and therefore less useful in understanding the epidemiology of the outbreak. It is difficult to determine whether HCW PPT was effective at preventing transmission, especially with robust infection prevention measures already in place. Patients were more likely than HCWs to present as asymptomatic, however this may be due to the attribution of symptoms to other conditions. Conclusions: Point prevalence testing of HCWs during COVID-19 outbreaks may assist with preventing transmission but is less likely to contribute meaningful information to the investigation.Funding: NoneDisclosures: None

Patients' expectations of preventive measures of medical institutions during the SARS-CoV-2 pandemic in Germany in women with an increased risk of breast and ovarian cancer: a cross-sectional, web-based survey.

ObjectivesTo identify patient-approved contingency measures for protection of patients and healthcare workers (HCWs) from COVID-19 infection and to use these findings to improve staff’s preparedness to cope with the course of this pandemic or similar situations.Methods (design, setting, participants, interventions)We conducted a cross-sectional, web-based survey of women with an increased risk of breast or ovarian cancer, regardless of whether they had experienced an active malignant disease during the pandemic. A self-reported questionnaire, developed for this study, was used to assess expectations and opinions about preventive measures within medical institutions.ResultsSixty-four (71.9%) of the 89 potential participants responded to at least one question regarding contingency measures within medical institutions. Approximately 37% of the respondents preferred having information about their facility’s hygiene protocols before appointment; 57.8% of the respondents endorsed regular SARS-CoV-2 testing of patients prior to medical appointments and 95.3% endorsed regular testing of HCWs. Additionally, 84.4% of the respondents supported HCWs’ use of surgical masks and 68.8% supported HCWs’ use of masks with greater protection. Notably, 75.0% of the respondents advocated for the presence of a significant other during medical consultations; 71.9% approved the use of telemedicine and 93.8% endorsed changes in appointment practices to enable social distancing. No significant associations were found between respondents’ sociodemographic, disease-specific or pandemic-specific factors and their opinions on hygiene precautions.ConclusionsPatients at high risk of infection or severe course of COVID-19 approve strict contingency measures designed to lower the transmission of COVID-19 in medical facilities. Moreover, vulnerable groups may profit from contingency plans in healthcare facilities in order to follow preventive measures, avoid diagnostic delay or avoid worsening of pre-existing conditions. However, they also value the presence of a significant other during medical consultations and procedures.

SARS-CoV-2 antibody screening in healthcare workers: lessons learned from the first months of COVID-19 outbreak in Europe. Significance of serology testing for effective pandemic management and reduction of the occupational risk

Abstract Introduction. Detected in 2019 in Wuhan, China, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing a coronavirus disease 2019 (COVID-19), has changed almost all aspects of human lives. It has had an enormous impact on societies, economies and politics across the world. Nevertheless, first and foremost, it has led to a global health crisis on an unprecedented scale. Since the pandemic’s beginning, one of the greatest global challenges has been to stop the spread of infection among healthcare workers (HCWs). As a front-line fighters, they are at higher risk of contracting SARS-CoV-2 than other professions. Aim. The study aimed to determine the role of serological testing among HCWs by analyzing screening results for the presence of SARS-CoV-2 antibodies in this group in 12 European countries during the first wave of the pandemic. Material and methods. Pubmed, MEDLINE, Web of Science, Google Scholar, and WHO COVID-19 databases were searched for studies on screening among HCWs using immunoassays or chemiluminescence assays for preventive purposes and determining the percentage of HCWs with acquired immunity to SARS-CoV-2. The number of 30 papers were selected. Immunoglobulin G (IgG) percentage was analyzed, and determination of immunoglobulin A (IgA) and immunoglobulin M (IgM) antibodies and their diagnostic usefulness. Results. The screening results of HCWs were juxtaposed with epidemic situation of that time and public health measures in given country. Conclusion. Introduction of routine serological testing of HCWs could be a valuable strategy to monitor the occupational risk in this group and effectiveness of local epidemic management strategies.

Seroprevalence and risk factors of COVID-19 in healthcare workers from 11 African countries: a scoping review and appraisal of existing evidence.

A better understanding of serological data and risk factors for coronavirus disease 2019 (COVID-19) infection in healthcare workers (HCWs) is especially important in African countries where human resources and health services are more constrained. We reviewed and appraised the evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence and its risk factors in HCWs in Africa to inform response and preparedness strategies during the SARS-CoV-2 pandemic. We followed the Preferred Reporting Items for systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines in this scoping review. Databases including PubMed, Embase and preprint servers were searched accordingly from the start of the COVID-19 pandemic to 19 April 2021. Our search yielded 12 peer-reviewed and four pre-print articles comprising data on 9223 HCWs from 11 countries in Africa. Seroprevalence varied widely and ranged from 0% to 45.1%. Seropositivity was associated with older age, lower education, working as a nurse/non-clinical HCW or in gynaecology, emergency, outpatient or surgery departments. Asymptomatic rates were high and half of the studies recommended routine testing of HCWs. This scoping review found a varying but often high SARS-CoV-2 seroprevalence in HCWs in 11 African countries and identified certain risk factors. COVID-19 public health strategies for policy and planning should consider these risk factors and the potential for high seroprevalence among HCWs when prioritizing infection prevention and control measures and vaccine deployment.

Mobile PCR-based surveillance for SARS-CoV-2 to reduce visiting restrictions in nursing homes during the COVID-19 pandemic: a pilot study

PurposeResidents in nursing homes for the elderly (NH) are at high risk for death from COVID-19. We investigated whether repeated non-mandatory RT-PCR SARS-CoV-2 surveillance of NH staff and visitors reduces COVID-19 incidence rates in NH residents and allows to reduce visiting restrictions.MethodsThis pilot study at the beginning of the COVID-19 pandemic compared a surveillance approach of regular, twice-weekly voluntary PCR testing of health-care workers (HCW) and visitors in interventional NH (INH) with a setting without regular testing in control NH (CNH). Residents were not tested routinely within this study. Testing was performed in a mobile testing site with same-day result reporting. SARS-CoV-2 incidence among residents in both INH and CNH was the primary endpoint; secondary endpoints being SARS-CoV-2 infection among visitors and HCW in INH.ResultsTwo INH and two CNH participated between October and December, 2020. At INH1, 787 tests of HCW and 350 tests of visitors were performed, accounting for 18.1% (n = 1930) of visits. At INH2, 78 tests of HCW and 372 tests of visitors were done, i.e., 30.5% (n = 1220) of visits. At the two INH 23 HCW and three visitors tested positive for SARS-CoV-2. COVID-19 outbreaks occurred among residents in INH1 (identified through study testing) and in CNH1. Utilization of voluntary testing was low.ConclusionIn a real-world setting without available rapid testing, voluntary RT-PCR SARS-CoV-2 testing of HCW and visitors does not prevent COVID-19 outbreaks in NH. Complete, non-selective testing for these groups should be instituted before visiting restrictions can be reduced.Trial registrationThe study has been registered at ClinicalTrials.gov with the identifier: NCT04933981.

The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals.

Nosocomial transmission of SARS-CoV-2 is a key concern, and evaluating the effect of testing and infection prevention and control strategies is essential for guiding policy in this area. Using a within-hospital SEIR transition model of SARS-CoV-2 in a typical English hospital, we estimate that between 9 March 2020 and 17 July 2020 approximately 20% of infections in inpatients, and 73% of infections in healthcare workers (HCWs) were due to nosocomial transmission. Model results suggest that placing suspected COVID-19 patients in single rooms or bays has the potential to reduce hospital-acquired infections in patients by up to 35%. Periodic testing of HCWs has a smaller effect on the number of hospital-acquired COVID-19 cases in patients, but reduces infection in HCWs by as much as 37% and results in only a small proportion of staff absences (approx. 0.3% per day). This is considerably less than the 20–25% of staff that have been reported to be absent from work owing to suspected COVID-19 and self-isolation. Model-based evaluations of interventions, informed by data collected so far, can help to inform policy as the pandemic progresses and help prevent transmission in the vulnerable hospital population.This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.

Primary care nurses' preparedness for COVID-19 in the Western Cape province, South Africa.

IntroductionThe novel coronavirus 2019 or COVID-19 pandemic has brought about a global public health crisis. Primary care (PC) nurses render first line care, or refer for more specialised services.AimTo investigate the preparedness of PC nurses for COVID-19 in the Western Cape.SettingThe Western Cape province of South Africa.MethodsWe administered an online survey, with closed and open-ended questions, to 83 Stellenbosch University postgraduate PC nursing students and alumni working in the Western Cape, between 03 July and 01 September 2020.ResultsThe results indicated that 43.3% of participants were confident about the infection, prevention, and control (IPC) training they received and 56.7% felt prepared to provide direct care to suspected cases of COVID-19. Primary care nurses were more comfortable to triage (78.3%) than to manage persons with COVID-19 (42.2%), indicating that they may not be functioning to the full capacity of their education and training. Adequate infrastructure was reported by less than a third of the participants (30.1%) and 59.1% reported that personal protective equipment (PPE) was always available. Primary care nurses needed support in coping with stress (57.8%) although few (14.5%) reported access to mental health services.Conclusion Primary care nurses were not prepared optimally for the COVID-19 pandemic. Challenges included adequate training, infrastructure, the availability of personal protective equipment, COVID-19 testing of health care workers and management support. Primary care nurses need comprehensive support to manage stress and anxiety.

Broad-based SARS-CoV-2 testing program for healthcare workers in a primary care hospital in France

A broad-based SARS-CoV-2 testing program for all symptomatic healthcare workers (HCWs) was implemented in Tenon hospital, Paris, France. From February 26 to April 22, 2020, 701 symptomatic HCWs were screened, of whom 247 (35.2%) tested positive for SARS-Cov-2. Myalgia, fever, anosmia and ageusia were associated with RT-PCR positivity. Testing of HCWs is an essential step toward control of the epidemic. Further studies could establish clinical algorithms for SARS-CoV-2 diagnosis to compensate for RT-PCR test and chest CT limits or unavailability.

Quadmester-wise comparison of disease transmission dynamics of COVID-19 among health care workers in Kannur district, Kerala

Background: Health-care workers (HCWs) may get infected by direct or indirect contact with infected patients or other HCWs or from the community as well, depending on the phase through which pandemic progresses. Knowledge about the disease transmission dynamics as the pandemic advances is a need so that appropriate monitoring, prevention and control measures for HCWs can be implemented at local level. The main objective of this study was quadmester-wise comparison of disease transmission dynamics of COVID-19 among HCWs in Kannur district.Methods: A cross-sectional study was carried out among HCWs reported positive for SARS-CoV-2 in Kannur district, Kerala. COVID-19 positive HCWs reported in the district were consolidated and contacted over phone and details were collected using a semi-structured questionnaire. Data were entered into microsoft excel and analysed using statistical package for social sciences (SPSS) trial version. Chi-square test was used to compare differences observed in the two groups and binary logistic regression was done to pick out the significant predictors of variability in disease transmission among the two groups.Results: Total respondents in the first and second quadmester were 243 and 1665, respectively. Factors like gender, clinical features, source of infection, family as source and type of duty taken were found to be statistically significant for the disease transmission dynamics among HCWs.Conclusions: As the pandemic advances, irrespective of the type of work place, self-reporting and regular testing of HCWs will help to check HCWs from getting infected and spreading the disease.

Determinants of burnout and other aspects of psychological well-being in healthcare workers during the Covid-19 pandemic: A multinational cross-sectional study.

The Covid-19 pandemic has placed unprecedented pressure on healthcare systems and workers around the world. Such pressures may impact on working conditions, psychological wellbeing and perception of safety. In spite of this, no study has assessed the relationship between safety attitudes and psychological outcomes. Moreover, only limited studies have examined the relationship between personal characteristics and psychological outcomes during Covid-19. From 22nd March 2020 to 18th June 2020, healthcare workers from the United Kingdom, Poland, and Singapore were invited to participate using a self-administered questionnaire comprising the Safety Attitudes Questionnaire (SAQ), Oldenburg Burnout Inventory (OLBI) and Hospital Anxiety and Depression Scale (HADS) to evaluate safety culture, burnout and anxiety/depression. Multivariate logistic regression was used to determine predictors of burnout, anxiety and depression. Of 3,537 healthcare workers who participated in the study, 2,364 (67%) screened positive for burnout, 701 (20%) for anxiety, and 389 (11%) for depression. Significant predictors of burnout included patient-facing roles: doctor (OR 2.10; 95% CI 1.49–2.95), nurse (OR 1.38; 95% CI 1.04–1.84), and ‘other clinical’ (OR 2.02; 95% CI 1.45–2.82); being redeployed (OR 1.27; 95% CI 1.02–1.58), bottom quartile SAQ score (OR 2.43; 95% CI 1.98–2.99), anxiety (OR 4.87; 95% CI 3.92–6.06) and depression (OR 4.06; 95% CI 3.04–5.42). Significant factors inversely correlated with burnout included being tested for SARS-CoV-2 (OR 0.64; 95% CI 0.51–0.82) and top quartile SAQ score (OR 0.30; 95% CI 0.22–0.40). Significant factors associated with anxiety and depression, included burnout, gender, safety attitudes and job role. Our findings demonstrate a significant burden of burnout, anxiety, and depression amongst healthcare workers. A strong association was seen between SARS-CoV-2 testing, safety attitudes, gender, job role, redeployment and psychological state. These findings highlight the importance of targeted support services for at risk groups and proactive SARS-CoV-2 testing of healthcare workers.

Seroprevalence of SARS-CoV-2 IgG antibodies among health care workers prior to vaccine administration in Europe, the USA and East Asia: A systematic review and meta-analysis.

BackgroundKnowing the seroprevalence of SARS-CoV-2 IgG antibodies across geographic regions before vaccine administration is one key piece of knowledge to achieve herd immunity. While people of all ages, occupations, and communities are at risk of getting infected with SARS-CoV-2, the health care workers (HCWs) are possibly at the highest risk. Most seroprevalence surveys with HCWs conducted worldwide have been limited to Europe, North America, and East Asia. We aimed to understand how the seroprevalence of SARS-CoV-2 IgG antibodies varied across these geographic regions among HCWs based on the available evidences.MethodsBy searching through PubMed, ScienceDirect, and Google Scholar databases, eligible studies published from January 1, 2020 to January 15, 2021 were included for the systematic review and meta-analysis. The random-effects model was used to estimate the pooled proportion of IgG seropositive HCWs. Publication bias was assessed by funnel plot and confirmed by Egger's test. Heterogeneity was quantified using I2 statistics. We performed sensitivity analyses based on sample size, diagnostic method and publication status. The study protocol was registered with PROSPERO (CRD42020219086).FindingsA total of 53 peer-reviewed articles were selected, including 173,353 HCWs (32.7% male) from the United States, ten European, and three East Asian countries. The overall seropositive prevalence rate of IgG antibodies was 8.6% in these regions (95% CI= 7.2–9.9%). Pooled seroprevalence of IgG antibodies was higher in studies conducted in the USA (12.4%, 95% CI= 7.8–17%) than in Europe (7.7%, 95% CI=6.3–9.2%) and East Asia (4.8%, 95% CI=2.9–6.7%). The subgroup study also estimated that male HCWs had 9.4% (95% CI= 7.2–11.6%) IgG seroconversion, and female HCWs had 7.8% (95% CI=5.9–9.7%). The study exhibits a high prevalence of IgG antibodies among HCWs under 40 years in the USA, conversely, it was high in older HCWs (≥40 years of age) in Europe and East Asia. In the months February-April 2020, the estimated pooled seroprevalence was 5.7% (4.0–7.4%) that increased to 8·2% (6.2–10%) in April-May and further to 9.9% (6.9–12.9%) in the May-September time-period.InterpretationIn the view of all evidence to date, a significant variation in the prevalence of SARS-CoV-2 antibodies in HCWs is observed in regions of Europe, the United States, and East Asia. The patterns of IgG antibodies by time, age, and gender suggest noticeable regional differences in transmission of the virus. Based on the insights driven from the analysis, priority is required for effective vaccination for older HCWs from Europe and East Asia. A considerable high seroprevalence of IgG among HCWs from the USA suggests a high rate of past infection that indicates the need to take adequate measures to prevent hospital spread. Moreover, the seroprevalence trend was not substantially changed after May 2020, suggesting a slow progression of long-term SARS-CoV-2 immunity. Routine testing of HCWs for SARS-CoV-2 should be considered even after the rollout of vaccination to identify the areas of increased transmission.FundingNone

Co-infection of malaria and early clearance of SARS-CoV-2 in healthcare workers.

Healthcare workers (HCWs) are at higher risk of contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Information regarding co-infection of SARS-CoV-2 with vector-borne diseases (malaria and dengue) is crucial especially for the countries wherein malaria and dengue are endemic. The objective was to study the prevalence, demographic, clinical presentations among HCWs with coronavirus disease 2019 (COVID-19) and to compare the viral clearance in HCWs with COVID-19 and co-infection of malaria and dengue. This retrospective study was conducted at a dedicated COVID-19 hospital, BYL Nair Charitable Hospital (NH), Mumbai, India April 6th-October 31st 2020. The SARS-CoV-2 infection in HCWs was confirmed by reverse transcription-plymerase chain reaction. Out of 491 HCWs infected with SARS-CoV-2, analysis of viral clearance was carried out in 467 HCWs over seven month periods, The prevalence of SARS-CoV-2 infection in HCWs was 13% (491 out of 3711). Out of the HCWs with COVID-19, prevalence of SARS-CoV-2 infection was higher among security guards (25%) with 1% mortality. The co-infection of malaria or dengue was reported in 31 HCWs (6.3%). The mean duration of virus clearance was longer (12 days) in symptomatic HCWs as compared to asymptomatic (8 days, p < .005). The recovery of SARS-CoV-2 infection in HCWs was faster (mean 8 days) with co-infection of malaria than without malaria (p < .005). We recommend universal testing of HCWs, to optimize staffing levels during the current pandemic as HCWs are the most precious resource. There is a need to effectively implement standard protocols for prevention of vector-borne diseases, especially in the hospital settings.

Effectivity and Efficiency of repeat testing of Health care workers (HCW) for SARS-CoV-2

On the 9th of January 2021 roughly 240 new infection cases with SARS-CoV-2 per day were detected in China, about 24.000 in Germany and 240.000 in the United States. The Chinese government declared the province to be under martial law, Germany has a lockdown where people are asked not to travel- if they do so the should self-quarantine or maybe they risk a fine and in the United States there are various restrictions and recommendations. There is no doubt that draconic measures are most efficient in order to control the spreading of the virus, but martial law as an answer to pandemic infection is considered to be incompatible with western democratic rules and constitutions. We will have to find a way in order to reduce both the morbidity and mortality due to the pandemic and the political, socioeconomic and psychological consequences. It is known that asymptomatic SARS-CoV-2 carriers can spread the infection. Asymptomatic people may carry the virus and stay asymptomatic throughout the infection or they are presymptomatic, that means they develop clinical symptoms on the day of PCR-testing or later onwards. Within a hospital, there are 6 different ways for transmission of infection: - the symptomatic, SARS-CoV-2 positive patient to another patient (i) or to healthcare workers (HCW) (ii); - asymptomatic patients to another patient (iii) or to asymptomatic HCW (iv) and - finally asymptomatic HCW to other fellow HCW (v) or to asymptomatic patients (vi). Nowadays, with deep knowledge about COVID-19 among HCWs and a vast availability of personal protection equipment, the first two possibilities play an insignificant role. Every possible routine measure is taken in order to reduce the risk of bringing COVID-19 into the hospital (iii and iv), e.g. outpatient visits are restricted to those with negative medical history for any clinical symptoms, risk factors, travel history and no fever measured at point of care; elective patients undergo an operation only if delaying operative therapy for more than three months will lead to death or irreversible deterioration of the disease and if they present with a negative PCR not older tan 72 hours; visits from friends and relatives are banned. So spread of infection by asymptomatic HCWs, infection routes (v) and (vi), is of serious concern.

The impact of testing and infection prevention and control strategies on within-hospital transmission dynamics of COVID-19 in English hospitals. (Special Issue: Modelling that shaped the early COVID-19 pandemic response in the UK.)

Nosocomial transmission of SARS-CoV-2 is a key concern, and evaluating the effect of testing and infection prevention and control strategies is essential for guiding policy in this area. Using a within-hospital SEIR transition model of SARS-CoV-2 in a typical English hospital, we estimate that between 9 March 2020 and 17 July 2020 approximately 20% of infections in inpatients, and 73% of infections in healthcare workers (HCWs) were due to nosocomial transmission. Model results suggest that placing suspected COVID-19 patients in single rooms or bays has the potential to reduce hospital-acquired infections in patients by up to 35%. Periodic testing of HCWs has a smaller effect on the number of hospital-acquired COVID-19 cases in patients, but reduces infection in HCWs by as much as 37% and results in only a small proportion of staff absences (approx. 0.3% per day). This is considerably less than the 20-25% of staff that have been reported to be absent from work owing to suspected COVID-19 and self-isolation. Model-based evaluations of interventions, informed by data collected so far, can help to inform policy as the pandemic progresses and help prevent transmission in the vulnerable hospital population.

COVID-19 Pandemic: What is Known Till June 2020 and What is Yet to Know?

Since first cluster of unknown pneumonia from China reported in December 2019 to World Health Organization, more than 10.5 million new cases and more than 0.513 million deaths have been reported till June 30, 2020 in six months' time. World got to know lot of facts about COVID-19 within short period of six months and success stories too concerning its containment. The situation has constantly been unfolding every moment educating people regarding public health and clinical aspects of the infection and disease and its impact on countries and communities. But still lot of information and evidences are required with regard to pharmacological interventions including effective drugs and efficacious vaccine to mitigate the impact of COVID-19 pandemic at all levels. It seems that we have to live with COVID-19 months-years as the virus is going to stay for longer period of time. The option is to continue practice of effective non-pharmacological interventions as to minimize spread of COVID-19 and ensure adequate provision of PPE to healthcare workforce and testing of health-care workers (HCWs) as to alleviate the anxiety of HCW and lessen their depletion by unnecessary quarantine thereby protect their health and reduce in hospital transmission.

Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK

ObjectiveThe COVID-19 pandemic has set unprecedented demand on the healthcare workforce around the world. The UK has been one of the most affected countries in Europe. The aim of this...