Health Care Workers In India Research Articles

Intention to Vaccinate against SARS-CoV-2 amongst Healthcare Workers in India: A Multicenter Cross-sectional Study

Intention to Vaccinate against SARS-CoV-2 amongst Healthcare Workers in India: A Multicenter Cross-sectional Study

A survey of awareness, knowledge, attitude, and skills of telemedicine among healthcare professionals in India

BackgroundTelemedicine Practice Guidelines were promulgated in India in 2020. There is little information about the awareness, knowledge, attitude and skills (AKAS) of the healthcare professionals regarding telemedicine and its practice guidelines a year after. The aim of the study was to study the awareness, knowledge, attitudes and skills of the healthcare workers of the country about telemedicine especially in the context of telemedicine practice guidelines 2020. MethodsAn online survey was conducted over 12 weeks from active healthcare workers in India. A standard AKAS Questionnaire for telemedicine and other close and open ended questions were used. ResultsA total of 602 active healthcare workers participated in the study. It was seen that a majority of participants had high scores for awareness, knowledge, and attitude toward telemedicine but a mere 39.53% scored high for skills related to telemedicine. A majority of the respondents had no knowledge of the existence of telemedicine practice guidelines and very few had seen or read them. A majority of the respondents were keen to attend a course or training to enhance their understanding and practice of telemedicine. ConclusionThe results of the study show that the basic awareness and background knowledge regarding telemedicine exists in the healthcare professionals in the country. The requirement is to train and educate them about the skills and provisions of the telemedicine practice guidelines 2020 to ensure optimal use of telemedicine and to avoid medico-legal issues.

COVID 19-related burnout among healthcare workers in India and ECG based predictive machine learning model: Insights from the BRUCEE- Li study

ObjectivesCOVID-19 pandemic has led to unprecedented increase in rates of stress and burn out among healthcare workers (HCWs). Heart rate variability (HRV) has been shown to be reflective of stress and burnout. The present study evaluated the prevalence of burnout and attempted to develop a HRV based predictive machine learning (ML) model to detect burnout among HCWs during COVID-19 pandemic. MethodsMini-Z 1.0 survey was collected from 1615 HCWs, of whom 664, 512 and 439 were frontline, second-line and non-COVID HCWs respectively. Burnout was defined as score ≥3 on Mini-Z-burnout-item. A 12-lead digitized ECG recording was performed and ECG features of HRV were obtained using feature extraction. A ML model comprising demographic and HRV features was developed to detect burnout. ResultsBurnout rates were higher among second-line workers 20.5% than frontline 14.9% and non-COVID 13.2% workers. In multivariable analyses, features associated with higher likelihood of burnout were feeling stressed (OR = 6.02), feeling dissatisfied with current job (OR = 5.15), working in a chaotic, hectic environment (OR = 2.09) and feeling that COVID has significantly impacted the mental wellbeing (OR = 6.02). HCWs with burnout had a significantly lower HRV parameters like root mean square of successive RR intervals differences (RMSSD) [p < 0.0001] and standard deviation of the time interval between successive RR intervals (SDNN) [p < 0.001]) as compared to normal subjects. Extra tree classifier was the best performing ML model (sensitivity: 84%) ConclusionIn this study of HCWs from India, burnout prevalence was lower than reports from developed nations, and was higher among second-line versus frontline workers. Incorporation of HRV based ML model predicted burnout among HCWs with a good accuracy.

Antibody response after first and second-dose of ChAdOx1-nCOV (CovishieldTM®) and BBV-152 (CovaxinTM®) among health care workers in India: The final results of cross-sectional coronavirus vaccine-induced antibody titre (COVAT) study

BackgroundWe assessed the humoral immune response of both ChAdOx1-nCOV (CovishieldTM) and BBV-152 (CovaxinTM) vaccines in Indian health care workers (HCW). MethodsA Pan-India, Cross-sectional, Coronavirus Vaccine-induced Antibody Titre (COVAT) study was conducted that measured SARS-CoV-2 anti-spike binding antibody quantitatively, 21 days or more after the first and second dose of two vaccines in both severe acute respiratory syndrome (SARS-CoV-2) naïve and recovered HCW. Primary aim was to analyze antibody response (seropositivity rate, Geometric Mean Titre [GMT] and 95% Confidence Interval [CI]) following each dose of both vaccines and its correlation to age, sex, blood group, body mass index (BMI) and comorbidities. Here we report the results of anti-spike antibody response after first and two completed doses. ResultsAmong the 515 HCW (305 Male, 210 Female) who took two doses of both vaccines, 95.0% showed seropositivity to anti-spike antibody. However, both seropositivity rate and GMT (95% CI) of anti-spike antibody was significantly higher in Covishield vs. Covaxin recipients (98.1 vs. 80.0%; 129.3 vs. 48.3 AU/mL; both p < 0.001). This difference persisted in 457 SARS-CoV-2 naïve and propensity-matched (age, sex and BMI) analysis of 116 participants. Age > 60-years, males, people with any comorbidities, and history of hypertension (HTN) had a significantly less anti-spike antibody GMT compared to age ≤ 60 years, females, no comorbidities and no HTN respectively, after the completion of two doses of either vaccine. Gender, presence of comorbidities, and vaccine type were independent predictors of antibody seropositivity rate and anti-spike antibody titre levels in multiple logistic and log transformed linear regression analysis. Both vaccine recipients had similar solicited mild to moderate adverse events and none had severe or unsolicited side effects. ConclusionsBoth vaccines elicited good immune response after two doses, although seropositivity rates and GMT of anti-spike antibody titre was significantly higher in Covishield compared to Covaxin recipients.

High COVID-19 Vaccine Hesitancy Among Healthcare Workers: Should Such a Trend Require Closer Attention by Policymakers?

BackgroundThe newly developed coronavirus disease 2019 (COVID-19) vaccines are considered to be a powerful tool to contain the devastating pandemic. Healthcare workers (HCWs) are at the highest risk of exposure to COVID-19 and, therefore, they are the priority group for vaccination.ObjectivesThe study aimed to examine the perceptions, attitudes, and acceptability of the COVID-19 vaccination among HCWs in India.Study designA cross-sectional pilot survey was conducted using an online questionnaire between 13 and 25 January 2021.ResultsAmong 264 respondents, 40.2% of HCWs would receive the vaccine against COVID-19 if available and 32.2% were willing to take the vaccine after observing adverse effects in others. Infected members in the immediate social network (OR:2.15; 95%CI:0.426-10.844), COVID-19 knowledge (OR:5.113; 95%CI:0.974-26.853), the safety of vaccines (OR:7.608; 95%CI:2.618-22.11), and those who did not receive a flu vaccine last year (OR:2.612; 95%CI:1.120-6.091) were found to have a statistically significant association with vaccine acceptance. The main reasons to delay/refuse vaccination included: ‘quick vaccine development and compromised quality’ (43.7%) and ‘lack of trusted information regarding COVID-19’ (41.3%).ConclusionsThe finding showed a high rate of vaccine hesitancy among HCWs. Policymakers should take steps to increase public awareness and secure timely and affordable vaccines for the HCWs and general population with effective vaccine promotion campaigns.

Impact of Second Wave of COVID-19 on Health Care Workers in India

The unprecedented second wave of SARS-CoV-2/COVID-19 pandemic has caught an already weak public health system unaware in India. The rising number of COVID-19 afflicted patients, shortage of testing strategy, disorganized vaccination drive, lack of oxygen-supported beds, and overwhelmed medical facilities in cities across India has led to a quintessential crisis never experienced before. Physicians, doctors, and other healthcare workers (HCWs) still recovering from the socioeconomic and adverse impact of the first wave, now face a further whirlpool of unfavorable mitigating factors including shortage of personnel, stretched resources, inadequate medical equipment, facilities, and the ever-existent occupational risk of contracting of SARS-CoV-2 viral infection and mortality. Exhibiting exemplary dedication, public health effort, and resilience in the health care management of COVID-19 patients in the first wave, they face an uphill task against the second deadlier wave. We explore the mounting challenges confronting these HCW and strategic solutions that can be undertaken to support them.

Assessment of oral health needs among health care workers in Udaipur, India

Background: Health care workers are a part of community that provides health care services. They facilitate people from primary preventions to complex treatment procedures. In the course they often neglect their own health prospects especially oral health. The attitude regarding oral health in health care workers in India is a cause of concern. The aim of the study is to assess the oral health needs of the health care workers in Udaipur, India and to utilize data to be used as a guideline for improvements in their oral health care and improving their quality of life. Methodology: A written oral health case history format was prepared and was carefully examined on all willing participants for the study along with dental indices recording related to dental caries and tooth wear. The data was analyzed using IBM SPSS 21 software. Results: 87.5% of the health care workers were suffering from dental caries. Also, 16.3% had root stumps in their oral cavity of the teeth which were lost due to caries. Also, 17.5% participants had grossly decayed teeth due to caries. Noticeably, attrition of teeth was also noticed in 65% of the participants. These findings can be attributed to the amount of sugar present in food, lack of oral hygiene and poor oral health habits. Conclusion: Their knowledge regarding oral health care habits needs improvement. They are the people who can themselves apply and guide others to maintain good oral habits. Efforts should be established by caretakers to instill oral health education in health care workers.

How Safe is Covishield (ChAdOx1nCoV-19) Vaccine? Experience from a Tertiary Care Hospital in South India

Background: Coronavirus disease vaccine has been recently rolled out for health care workers in India. We aimed to determine the incidence of adverse events following immunization (AEFI) among healthcare workers (HCWs) after their first dose of the ChAdOx1nCoV-19 vaccine. Methodology: We recruited 218 HCWs for this cross-sectional study. We circulated a google form on the hospital and asked them to self-report their vaccination experience. Results: Two-thirds (69.7%, 95% confidence interval [CI]: 63.1–75.7) had minor AEFI, and none had severe AEFI. Body ache (46.8%, 95% CI: 40–53.6) was the most common symptom followed by headache (30.3%, 95% CI: 24.2–36.8). Most of them (39.4%, 95% CI: 32.9–46.2) experienced symptoms within 4–24 h after taking the vaccine. Majority (78.9%) were anxious before the vaccination. The younger age group and female gender were significantly associated with AEFI. Conclusion: HCWs experienced minor, self-limiting AEFI with the first dose of ChAdOx1nCoV-19. The hospital reported no serious AEFI following the vaccination.

Responsive and agile vaccination strategies against COVID-19 in India

Responsive and agile vaccination strategies against COVID-19 in India

Immunization among Healthcare Workers in India: A Need or a Want

Immunization is a highly effective way for prevention of some major infectious diseases. Healthcare workers (HCWs) are at greater risk of exposure as well as spread of vaccine preventable diseases, as they are in constant contact with patients and infectious materials. Many of these diseases still carry a potential for resurgence and can lead to outbreaks. Hence, vaccination programs among HCWs form an integral part of infection prevention &amp; control practices, thereby protecting the healthcare personnel from infection and protecting the patients from getting infected. [1] Even in countries with specific vaccination programs for HCWs, the coverage remains very low and the majority are susceptible for vaccine preventable diseases. So, it becomes imperative for a developing country like India and other countries in low-resource settings to have a national vaccination plan for HCWs. [Table 1]. shows the list of vaccines recommended for HCWs by World Health Organization and Center for Disease Control and Prevention. [2,3]

Acute Coronavirus Disease (COVID-19) in Vaccinated Frontline Healthcare Workers in India: An Observational Cohort Study

Background: Despite vaccination against SARS-CoV-2 (Covid-19), individuals may still develop acute COVID-19 illness. We examined the clinical profile and outcomes of healthcare workers (HCW) in India who developed Covid-19 infection despite being vaccinated. Methods: HCWs in India who developed acute Covid-19 infection despite receiving at least 1 dose of the vaccination were invited to complete an online questionnaire. Out of contacted 2160 HCWs, 316 (14.6%) developed acute Covid-19 infection post- vaccination. We compared their clinical profile based on whether they had received the first or second dose of vaccine, presence or absence of pneumonia and fever at presentation. Results: Of the 316 participants, 50 (15.8%) had developed Covid-19 after receiving only the first dose of the vaccine. Participants who completed both doses of vaccine (n=266) were more likely to be asymptomatic (13.9% vs 2.0%, p=0.016), but clinical outcomes such as hospitalization, need for mechanical ventilation and supplemental oxygen were similar. Participants with pneumonia (n=105, 33.2%) had elevated C-reactive protein (CRP, 25.4±21.2 vs 6.8±8.8 mg/L, p<0.001) compared with those without, and were more likely to require hospitalization (30.5% vs 6.2%, p<0.001) and supplemental oxygen (9.5% vs 0.0%, p<0.001). On multivariable analyses, the completion of both doses of vaccination was protective for the development of fever in Covid-19 illness (adjusted OR 0.33, 95%CI 0.15-0.72), after adjusting for age, prior medical conditions and CRP. Post-vaccination antibody titres to the spike protein were not significantly associated with symptoms or outcomes. Conclusion: Among HCWs vaccinated against Covid-19, a significant proportion (14.6%) developed acute infection. Although similar in terms of clinical outcomes and biochemical markers, participants who completed both doses of vaccination developed milder symptoms. Funding Statement: None. Declaration of Interests: VKS is the current recipient of Senior Clinician Scientist Award from National Medical Research Council, Ministry of Health, Singapore. Other authors have no financial disclosures. ACYC has received grant funding from the National Medical Research Council (NMRC), Singapore and support from the Ministry of Health (MOH), Singapore. Ethics Approval Statement: Ethics approval was obtained from the institutional review board (Zydus Hospitals Ethics Committee (Ref: 2021/05/04) prior to the conduct of this study. Informed consent was obtained from each participant prior to the conduct of the online questionnaire.

SARS-CoV-2 seroprevalence among the general population and healthcare workers in India, December 2020–January 2021

BackgroundEarlier serosurveys in India revealed seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) of 0.73% in May–June 2020 and 7.1% in August–September 2020. A third serosurvey was conducted between December 2020 and January 2021 to estimate the seroprevalence of SARS-CoV-2 infection among the general population and healthcare workers (HCWs) in India. MethodsThe third serosurvey was conducted in the same 70 districts as the first and second serosurveys. For each district, at least 400 individuals aged ≥10 years from the general population and 100 HCWs from subdistrict-level health facilities were enrolled. Serum samples from the general population were tested for the presence of immunoglobulin G (IgG) antibodies against the nucleocapsid (N) and spike (S1-RBD) proteins of SARS-CoV-2, whereas serum samples from HCWs were tested for anti-S1-RBD. Weighted seroprevalence adjusted for assay characteristics was estimated. ResultsOf the 28,598 serum samples from the general population, 4585 (16%) had IgG antibodies against the N protein, 6647 (23.2%) had IgG antibodies against the S1-RBD protein, and 7436 (26%) had IgG antibodies against either the N protein or the S1-RBD protein. Weighted and assay-characteristic-adjusted seroprevalence against either of the antibodies was 24.1% [95% confidence interval (CI) 23.0–25.3%]. Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI 23.5–27.8%). ConclusionsNearly one in four individuals aged ≥10 years from the general population as well as HCWs in India had been exposed to SARS-CoV-2 by December 2020.

Mental health issues and coping among health care workers during COVID19 pandemic: Indian perspective.

ObjectivesWe assessed mental health issues among Indian health care workers (HCWs) and their coping strategies during COVID 19 pandemic.MethodologyAn online survey was conducted in 348 HCWs using PHQ-SADS and Brief-COPE inventory.ResultsDepression, anxiety and somatic symptoms were present in 54 %, 44.3 % and 54.6 % of HCWs and were more in those working in COVID19 areas. The nurses and female HCWs had more moderate to severe somatic symptoms. HCWs with moderate to severe symptoms used simultaneously both maladaptive and adaptive coping strategies.ConclusionThe HCWs during COVID19 pandemic have significant mental health issues and use multiple coping strategies.

Methicillin Resistant Staphylococcus Aureus Carrier Status among Indian Healthcare Workers: A Systematic Review and Meta-Analysis

Infection with Methicillin Resistant Staphylococcus aureus (MRSA) is a threat to quality care in the hospital.Asymptomatic colonization of MRSA escalates the burden of infection. The rate of MRSA colonizationamong healthcare workers (HCW) is not homogenous across the globe. Even though there are individualstudy reports on MRSA colonization, no pooled data is available in India. Therefore, it is important toevaluate the problem of MRSA colonization to develop a policy on preventive measures. We performeda systematic review and meta-analysis of MRSA carrier status among Indian HCWs using five databases(Scopus, PubMed-Medline, IndMed, CINAHL and Google-Scholar) from the articles published from 2008to 2017 (10 years). STATA 13.0 with metaprop package in STATA was used to find the rate of colonization.Among 2,349 HCWs, the pooled prevalence of MRSA colonization in throat, nose, axilla, palm, fingertipsand web-spaces was nine percent (CI 6% - 13%; p=0.001, I291.68%). Further, the forest plot of MRSAcolonization in nasal cavity alone was performed, and the prevalence of nasal colonization of MRSA among1,251 Indian HCWs was found to be 11% (CI 5-17%, p=0.001, I2 93.3%). The colonization rate is not veryhigh nor negligible. Therefore, the hospital administrator along with the hospital infection control committeeneeds to formulate a policy on periodic screening and decolonization of HCWs in high-risk areas.

Mental health issues among health care workers during the COVID-19 pandemic - A study from India.

Mental health issues among health care workers (HCWs) in treatment settings during COVID-19 remains understudied in India. This study examines its prevalence and correlates among HCWs in Karnataka State, India. HCWs who attended a workshop to improve mental health well-being during COVID-19 completed an anonymous online questionnaire. In addition to socio-demographics, domains assessed include occupational characteristics, COVID-19 related concerns, anxiety/depression, substance use, suicidality, lifestyle and family functioning. Of the 3083 HCWs who completed the survey (response rate-51.4 %), anxiety disorder and depression was highest among those with frontline COVID-19 responsibilities (anxiety disorder-26.6 %, depression-23.8 %). Prevalence was significantly higher among those with clinical responsibilities compared to those with supportive responsibilities (anxiety disorder: 23.9 % vs 15.5 %), (depression: 20.0 % vs 14.2 %). In the backward step-wise logistic regression analysis, HCWs with anxiety disorder were more likely to be doctors/nurses/hospital assistants, older, female, unmarried, without a leisure activity, report increased alcohol use and suicidal thoughts after pandemic onset, and having a history of receiving mental health interventions. Participants with depression additionally had family distress and hardly ever exercised. To conclude, mental health issues are common among HCWs in India. Interventions need to ensure that HCWs are protected from mental health consequences of working in COVID-19 treatment settings.

SARS-CoV-2 Sero-Prevalence Among General Population and Healthcare Workers in India, December 2020 - January 2021

Background: Repeated cross-sectional serosurveys in the same geographic area establish the trend of the evolving pandemic. We present the findings of the third round of a national serosurvey to estimate the seroprevalence of SARS-CoV-2 infection among the general population and health care workers of India. Methods: We conducted the third population-based serosurvey between Dec 18, 2020 and Jan 6, 2021 in the same 700 villages or wards from 70 districts in 21 states across India, which were selected for the first and second serosurveys. We enrolled from each district, at least 400 individuals aged ≥ 10 years from general population and 100 HCWs from sub-district level public health facilities. Serum samples from general population were tested for the presence of IgG antibodies against nucleocapsid (N) and spike protein (S1-RBD) of SARS-CoV-2 using the Abbott and Siemens assays respectively, whereas sera from HCWs were tested for anti-S1-RBD. For general population, sera positive for either of the antibodies were considered positive, while sera positive for anti-S1-RBD were considered as positive for HCW. Weighted seroprevalence estimates were adjusted for sensitivity and specificity of respective assays. Findings: Of the 28,598 sera from general population, 4585 (16%) had IgG antibodies against N, 6647 (23.2%) against S1-RBD and 7436 (26%) against either. The weighted and assay characteristic adjusted seroprevalence against either of the antibodies was 24.1 (95%CI: 23.0% to 25.3%). Seroprevalence was lower in rural areas (21.4%, 95% CI: 20.3% to 22.6%) compared to urban non-slum (29.4%, 95% CI: 26.9% - 32.1%) and slum areas (34.6%, 95% CI: 31.0% to 38.3%). Among 7385 HCWs, the seroprevalence of anti-S1-RBD IgG antibodies was 25.6% (95% CI: 23.5% to 27.8%). Interpretation: Nearly one in four individuals aged 10 years or older from general population as well as HCWs were exposed to SARS-CoV-2 by December 2020 amounting to 271 million infections in India.Funding Statement: Indian Council of Medical ResearchDeclaration of Interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare no competing interestsEthics Approval Statement: The project was approved by Institutional Human Ethics Committee at ICMR-National Institute of Epidemiology.

Role of ivermectin in the prevention of SARS-CoV-2 infection among healthcare workers in India: A matched case-control study

Ivermectin is one among several potential drugs explored for its therapeutic and preventive role in SARS-CoV-2 infection. The study was aimed to explore the association between ivermectin prophylaxis and the development of SARS-CoV-2 infection among healthcare workers. A hospital-based matched case-control study was conducted among healthcare workers of AIIMS Bhubaneswar, India, from September to October 2020. Profession, gender, age and date of diagnosis were matched for 186 case-control pairs. Cases and controls were healthcare workers who tested positive and negative, respectively, for COVID-19 by RT-PCR. Exposure was defined as the intake of ivermectin and/or hydroxychloroquine and/or vitamin-C and/or other prophylaxis for COVID-19. Data collection and entry was done in Epicollect5, and analysis was performed using STATA version 13. Conditional logistic regression models were used to describe the associated factors for SARS-CoV-2 infection. Ivermectin prophylaxis was taken by 76 controls and 41 cases. Two-dose ivermectin prophylaxis (AOR 0.27, 95% CI, 0.15-0.51) was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. Those involved in physical activity (AOR 3.06 95% CI, 1.18-7.93) for more than an hour/day were more likely to contract SARS-CoV-2 infection. Type of household, COVID duty, single-dose ivermectin prophylaxis, vitamin-C prophylaxis and hydroxychloroquine prophylaxis were not associated with SARS-CoV-2 infection. Two-dose ivermectin prophylaxis at a dose of 300 μg/kg with a gap of 72 hours was associated with a 73% reduction of SARS-CoV-2 infection among healthcare workers for the following month. Chemoprophylaxis has relevance in the containment of pandemic.

Weathering the Storm: Psychological Impact of COVID-19 Pandemic on Clinical and Nonclinical Healthcare Workers in India.

BackgroundCoronavirus disease-2019 (COVID-19) pandemic has exposed healthcare workers (HCWs) to a unique set of challenges and stressors. Our frontline workers are under tremendous psychological pressure because of the ever-rising crisis. This study was done to assess the magnitude of the psychological impact of the COVID-19 pandemic on clinical and nonclinical HCWs in India.Materials and methodsIt was a cross-sectional, online survey that was done from June 1, 2020, to July 4, 2020. A total of 313 clinical and nonclinical HCWs, who were directly or indirectly involved in patient care, participated in the study. The psychological impact was assessed in terms of four variables: insomnia, anxiety, depression, and stress. Insomnia was assessed by the Insomnia Severity Index (ISI). Anxiety and depression were assessed via the Patient Health Questionnaire-4 (PHQ-4), which included a 2-item anxiety scale and a 2-item depression scale (PHQ-2). Stress was assessed via the Perceived Stress Scale (PSS). We also compared the psychological impact of this pandemic between clinical and nonclinical HCWs.Results7.3% of HCWs were having moderate insomnia, 3.8% had severe insomnia, and 20.8% were having subthreshold insomnia. Severe anxiety and depression were found in 6.7% of respondents. 8.0 and 32.3% of the respondents had moderate and mild anxiety–depression, respectively. 6.4% had high perceived stress. 47.6 and 46.0% of the respondents had moderate and low stress, respectively. There was a statistically significant difference in severe insomnia between clinical and nonclinical HCWs, whereas no significant difference in anxiety, depression, and stress between clinical and nonclinical HCWs.ConclusionThis study suggests that psychological morbidity is prevalent among both clinical and nonclinical HCWs and both males and females. Early intervention may be beneficial to prevent this issue.How to cite this articleSunil R, Bhatt MT, Bhumika TV, Thomas N, Puranik A, Chaudhuri S, et al. Weathering the Storm: Psychological Impact of COVID-19 Pandemic on Clinical and Nonclinical Healthcare Workers in India. Indian J Crit Care Med 2021;25(1):16–20.

Hydroxychloroquine in the prophylaxis of COVID 19: A survey of safety on the healthcare workers in India.

Hydroxychloroquine in the prophylaxis of COVID 19: A survey of safety on the healthcare workers in India.

Prevalence of Igg Antibodies Against SARS-CoV-2 Among the General Population and Healthcare Workers in India, June–July 2021

Background: India witnessed a severe second wave of COVID-19 during March and June 2021. We did the fourth nationwide serosurvey to estimate prevalence of SARS-CoV-2 antibodies in the general population aged >=6 years and health care workers (HCWs). Methods: We did a cross-sectional study between 14 June and 6 July 2021 in 700 clusters in the same 70 districts across 21 states/Union Territory. From each district, a minimum of 400 individuals aged >=6 years from general population and 100 HCWs from the district public health facilities were included. The serum samples were tested for the presence of IgG antibodies against S1-RBD and nucleocapsid protein of SARS-CoV-2 using chemiluminescence immunoassay. We estimated the weighted and test adjusted seroprevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein along with 95% CI. Findings: Of the 28,975 sera tested, the weighted and test adjusted prevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein among the general population aged >=6 years was 67.6% (95% CI: 66.4 – 68.7). The seroprevalence increased with age and was not different in rural and urban areas. Compared to unvaccinated adults (62.3%, 95% CI: 60.9 – 63.7), seroprevalence was significantly higher among individuals who received one (81.0%, 95% CI: 79.6 - 82.3) and two doses (89.8%, 95% CI: 88.4 - 91.1). The seroprevalence of IgG antibodies among 7,252 health care workers was 85.2% (95% CI: 83.5 - 86.7). Interpretation: Nearly one third of the population is still seronegative. It is necessary to accelerate the coverage of COVID-19 vaccination among adults and continue adherence to non-pharmaceutical interventions.Funding: Indian Council of Medical Research. Declaration of Interest: None to declare. Ethical Approval: The Institutional Human Ethics Committee of the ICMR National Institute ofEpidemiology, Chennai approved the study protocol.