Risk Of COVID-19 Exposure Research Articles

The party’s not over: Living situation, perceived party norms, and drinking games behavior among college students during the pandemic (COVID-19)

Objective: Playing drinking games (DGs) is a common, socially-interactive risky drinking activity. During the pandemic, many students either returned home to live with their parents or remained on campus. Because DGs often require social interaction, playing DGs in-person can increase students’ risk for COVID-19 exposure. Thus, we examined whether living situation and perceptions of one’s college/university as a party school increased risk for playing DGs in-person during a pandemic. Method: Students who reported recent alcohol use from 12 colleges/universities (n = 874; Mage = 19.38/SDage = 1.40; 75.6% White) completed self-report measures of alcohol use, DGs participation, demographics, and residential status in Fall 2020 to Spring 2021. Univariate and multivariate analyses were conducted. Results: Overall, 62.8% of students played DGs in-person during the pandemic. Those who lived with roommates were at increased risk compared to those who lived with parents. Conclusions: Given health risks of playing DGs in-person, targeted efforts may be warranted among at-risk students.

The impact of safety behavior, perceived risk, and workplace resources on COVID outcomes for U.S. Aircraft Rescue and Firefighting personnel.

Aircraft rescue and firefighting (ARFF) personnel are first responders located at airports in the United States who provide emergency response, mitigation, evacuation, and rescue of passengers and crew of aircraft at airports. The nature of their work puts ARFF personnel in close contact with travelers on a regular basis and at elevated risk for COVID-19 exposure. In this study, we focused on safety behavior, perceived risk, and workplace resources to understand COVID-19 outcomes in the early pandemic among the overlooked worker population of ARFF personnel. The goal of this study was to examine how a self-reported positive COVID test were associated with safety behavior, perceived risk, and workplace resources. Cross-sectional survey data were collected among ARFF personnel a year into the COVID-19 pandemic. Regression results showed that each additional unit increase in perceived susceptibility to COVID-19 was associated with a 133% increase in the odds of testing positive for COVID-19 (OR = 2.33, p < 0.05), and with each additional unit increase in perceived severity level, the odds of getting COVID-19 decreased by 47% (OR = 0.53, p < 0.05). Infection control among first responders may be improved by providing relevant information physical and emotional resources, and support that help shape perceptions of risk and adoption of prevention behaviors.

The impact of COVID-19 on routine child immunisation in South Africa

BackgroundThe COVID-19 pandemic disrupted immunisation programs worldwide, reversing gains that had brought vaccine-preventable diseases largely under control. This study explored the impact of COVID-19 on the uptake of routine child immunisation services in South Africa.MethodsWe conducted qualitative research using in-depth interviews with 51 purposively selected parents/caregivers of children below the age of five who missed or delayed one or more scheduled immunisation doses in 2020–2022 and with 12 healthcare providers who provided public immunisation services during the pandemic.ResultsDuring the pandemic lockdowns, most caregivers perceived the risk of their child being infected with COVID-19 during a clinic visit as more salient than the risk of missing immunisation doses. Caregivers reported minimal exposure to routine immunisation communication, as well as shortages of routine vaccines for children at public health facilities, healthcare workers experienced anxiety and burnout. There was a post-pandemic shift to more active decision-making about immunisation, which had previously been an almost automatic behaviour, leading some caregivers to delay vaccinating their children. There was also evidence of a “bad vaccine” mental model among some caregivers regarding COVID vaccinations, which could lead to doubts about the safety of routine childhood vaccinations.DiscussionThe shift from default to active decision-making highlights a risk that routine immunisation will backslide in future pandemics. Governments should build resilient health systems at all levels and communicate clearly about the benefits and availability of RIs and the safety of vaccinations in general, alongside supply-side interventions.ConclusionRoutine immunisation is widely accepted in South Africa, driven by generational norms and provider recommendations. During the COVID-19 pandemic, many caregivers faced the dilemma of balancing COVID-19 exposure risk with the risk of their child developing a deadly VPD, leading to missed RI visits. This shift to active decision-making highlights a future pandemic risk. Governments should build resilient health systems and focus on understanding and engaging procrastinating and doubtful caregivers. Clear communication about RI benefits and vaccine safety is crucial, as misinformation can lead to distrust in new vaccines.

Filipino Rehabilitation Practitioners’ COVID-19 knowledge, practice and attitude: A cross-sectional study

Background: The rehabilitation team, consisting of physiatrists, physical and occupational therapists, and speech pathologists, faces heightened risk of COVID-19 exposure because of treatment practices in rehabilitation settings.Aim: The study aimed to assess the knowledge, practices and attitudes of rehabilitation professionals in treating COVID-19 patients and to determine potential associations with respondents’ demographic factors (e.g., age, gender, type of profession).Setting: The study was conducted in the Philippines.Methods: This cross-sectional study was conducted from June 2021 to July 2021. Researchers employed snowballing and purposive homogenous convenient sampling methods. Participants completed a 31-item online questionnaire via Google Forms.Results: A total of 410 rehabilitation professionals participated in the study. The total mean scores for knowledge, practices and attitudes are 41.14 ± 3.16, 104.54 ± 33.65 and 37.13 ± 3.55, respectively which were considered adequate. However, only 9.8% (n = 40) professional was actively treating COVID-19 patients with analysis of variance indicated that age, type of profession and gender did not significantly impact COVID-19 knowledge. However, age (p = 0.005) and type of profession (p = 0.004) were found to influence COVID-19 practices, with physiatrists exhibiting higher adherence. There was a strong positive correlation between age and positive COVID-19 attitudes (p 0.000).Conclusion: Filipino rehabilitation professionals have positive attitude, adequate knowledge and skills about COVID-19.Contribution: The study provides information to modify training courses and curricula to further improve the knowledge and practices related to COVID-19.

Informed consent and coercion in recruitment advertisements for oocyte donors

BackgroundAs the use of donor eggs for in vitro treatment has increased, both medically affiliated and private donor egg agencies have turned to online advertisements to recruit donors. The American Society for Reproductive Medicine provides recommendations encouraging ethical recruitment of donors, however there is no formal regulation for the informed consent process for egg donor recruitment and compensation. Underrepresentation of risks and targeted financial incentives may pose a risk to the informed consent process.MethodsData from online advertisements for egg donors active between January 1 - August 31, 2020, were collected to analyze content related to risks, Covid-19 precautions, donor payment, and desired donor characteristics. Advertisements for egg donors on Google, Craigslist, and social media were analyzed. Primary outcomes included the mention of the risks of egg donation, including the risk of Covid-19 exposure, in donor egg advertisements. Secondary outcomes included language targeting specific donor characteristics and financial compensation.Results103 advertisements were included. 35.9% (37/103) of advertisements mentioned some risk of the egg donation process, and 18.5% (19/103) mentioned risks or precautions related to Covid-19 exposure. Of advertisements for private donor egg agencies, 40.7% (24/59) mentioned any risk, compared to 29.6% (13/44) of medically affiliated egg donation programs; the difference was not statistically significant (p-value = 0.24). Agencies targeting students and donors of a specific race were more likely to offer payments over $10,000 for an egg donation cycle. Among advertisements offering over $20,000 for donor compensation, 72.7% (8/11) recruited women under the age of 21.ConclusionEgg donor recruitment advertisements, for both medically affiliated programs and private agencies, were unlikely to mention risks including the risk of exposure to Covid-19. Non-medically affiliated private donor egg agencies were more likely to violate multiple American Society for Reproductive Medicine ethics guidelines, including offering higher than average compensation, and recruiting donors from young and vulnerable populations.

Dentists' stress level during the COVID-19 pandemic and their opinion on the oral health status of their patients.

"Severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2) is the name of the etiological agent of the pandemic Corona Virus Disease (COVID-19) which was declared on March 11, 2020 by the WHO and which affected all countries of the world, including Romania. Our study aimed to evaluate the psycho-affective implications and economic consequences for dentists in Romania during the COVID-19 (Corona Virus Disease) pandemic state of emergency and their opinion on the patients' oral health impact. A cross-sectional observational and analytical study based on a questionnaire was conducted. Dentists who work in Romania affiliated in 2020 to the Romanian College of Dental Practitioners was the target population. Three hundred and seventy-three dentists participated in this survey. The age of the respondents ranged from 24 to 70. Men and women have the same expectation regarding the lockdown effect of worsening the oral health of the general population (worst, 79.5% of women and 81.3% of men, P=0.8842). The anxiety regarding the bank rates, supplementary investments, risk of COVID-19 infection and exposure to COVID-19 related mass-media information proved to be significantly higher among young dentists.

1937 The future of research: Participant perspectives on remote trial delivery

Abstract Introduction The PROMOTe trial was conducted entirely remotely, which aimed to enable a wider recruitment of participants, minimised risk of Covid-19 exposure and adhere to former travel restrictions. Participant experiences with remote clinical trials are not well understood. This work aimed to characterise participant perspectives on the remote delivery of the PROMOTe trial. Methods The trial involved remote measurement of short physical performance battery and grip strength, and remote collection of stool, urine, saliva, and capillary blood. Equipment including a dynamometer was posted to participants. Participants returned biological samples by post. A mixed methods approach was used, whereby participants were invited to complete an online questionnaire consisting of Likert, multiple-choice and open-ended questions upon trial completion. Results Of 72 trial participants, mean age 73.1, 80.6% (n = 58) completed the questionnaire. 53.5% (n = 31) had no preference between remote or in-person participation. Of those who preferred to take part remotely, 57.1% (n = 4) stated this was because there was no need to travel. 57.1% (n = 12) of those who preferred to take part in-person stated this was because they preferred to talk to the staff and ask questions face-to-face. Participants found that taking 5 out of the 8 physical measures were of similar difficulty over video teleconferencing compared to in-person. 100.0% (n = 58) of participants found it “easy” or “average” to collect stool, urine, and saliva, while 63.2% (n = 36) of participants thought it was “easy” or “average” to collect capillary blood. All participants found packaging and returning all four sample types of “easy” or “average” difficulty. Conclusion These findings suggest that the majority of participants found remote trial delivery, including handling equipment and collecting biological samples, both acceptable and manageable. Remote trial delivery has potential for increasing access of older people to trial participation.

Home Health Care During Physical Distancing Affects Physical and Psychosocial Aspects, Self-Efficacy, Family Function, and Quality of Life of Families in Indonesia

Background: Physical distancing during the COVID-19 pandemic has impacted the activities of daily living (ADLs) of families, such as physical and psychosocial aspects, self-efficacy, family social function, and overall quality of life. However, research investigating the effects of home health care in enhancing these aspects during the physical distancing period remains limited.Purpose: This study aimed to evaluate the effects of implementing home health care on physical and psychosocial aspects, self-efficacy, family social function, and quality of life of families in East Java Province, Indonesia.Methods: A quasi-experimental study was conducted among 768 healthy families that were purposively recruited from April to May 2020. The home health care program was implemented for one month to provide nursing care to the families. Data were collected using self-administered questionnaires, and SPSS software was employed for data analysis. Chi-square tests were applied for categorical variables, while paired t-tests were used for continuous variables.Results: Significant differences were observed in blood pressure, pulse, and temperature before and after the implementation of home health care during the physical distancing period (p&lt;0.05). There was an increase in body mass index (23.29(5.59) vs. 23.78(7.53); p=0.001). Notably, significant differences were also found in COVID-19 exposure risk factors, personal risk factors, sleep patterns, and physical activity before and after home health care (p&lt;0.05). Furthermore, improvements were noted in self-efficacy, family social function, and the quality of life of the families after one month of home health care (p&lt;0.05).Conclusion: Home health care during physical distancing positively affected the physical and psychosocial aspects, self-efficacy, family social function, and quality of life of the families. Thus, the guidance and support offered through home health care should be further developed to help families navigate the “new normal” era of COVID-19.

The prevalence of COVID-19 among healthcare professionals at primary healthcare centers

Background: The SARS-CoV-2 infection typically triggers discernible immunological responses in most reported cases. Employing a serological test could identify prior asymptomatic infections and aid in evaluating an individual's immune status. Given that healthcare professionals face a higher risk of COVID-19 exposure, the utilization of personal protective equipment remains the foremost approach in averting disease transmission within healthcare facilities. Objectives: To ascertain the prevalence of COVID-19 among healthcare professionals working in primary healthcare centers located within the AL-Sader city district. Method: During the period between November 1st, 2020, and December 31st, 2020, a cross-sectional study was carried out in nine primary healthcare centers, chosen through a cluster random sampling method. Result: Out of the 470 participants included in the study, 101 (21.5%) had a documented history of COVID-19 infection, with 76 confirmed through polymerase chain reaction analysis. Notably, a notable correlation between a positive rapid immunological test result and a prior history of COVID-19 infection (p-value &lt; 0.001). The rapid test showed a sensitivity of 56.6% and a specificity of 79.2%. Specifically, 125 participants (26.6%) tested positive using the rapid test, with 104 (83.2%) exhibiting IgG antibodies, 5 (4%) displaying IgM, and 16 (12.8%) showing both IgG and IgM antibodies. Conclusion: The prevalence of COVID-19 infection among participants exceeded the anticipated levels. Significantly, there was a discernible correlation between positive rapid test results and COVID-19 infection, as well as factors such as smoking, comorbidities, PPE training, and household infections.

Risking one's life to save one's livelihood: Precarious work, presenteeism, and worry about disease exposure during the COVID-19 pandemic.

The present study advances research on the negative consequences of precarious work experiences (PWE), which include perceptions of threats to one's job and financial security as well as a sense of powerlessness and inability to exercise rights in the workplace. Using the COVID-19 pandemic as a backdrop, we examine how PWE relate to sickness presenteeism and worry about work-related COVID-19 exposure. In a 12-week, four-wave study of workers working fully in-person, perceptions of powerlessness and job insecurity were associated with presenteeism (e.g., general presenteeism as well as attending work with known or possible COVID-19 infection) and concerns about disease exposure at work. Whereas powerlessness primarily operated at the between-person level of analysis, job insecurity's effects emerged at both levels of analysis. A sense of powerlessness at work also predicted sending children to school/daycare sick. In sum, the findings suggest that precarity related to being able to keep one's job and a sense of powerlessness at work contribute to concerns about the risk of COVID-19 exposure at work and, simultaneously, behaviors that may contribute to the health risks faced by others. This research provides added support to the argument that precarious work should be addressed in order to improve both worker well-being and public health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Practice- and System-Based Interventions to Reduce COVID-19 Transmission in Primary Care Settings: A Qualitative Study.

Using qualitative interviews with 68 family physicians (FPs) in Canada, we describe practice- and system-based approaches that were used to mitigate COVID-19 exposure in primary care settings across Canada to ensure the continuation of primary care delivery. Participants described how they applied infection prevention and control procedures (risk assessment, hand hygiene, control of environment, administrative control, personal protective equipment) and relied on centralized services that directed patients with COVID-19 to settings outside of primary care, such as testing centres. The multi-layered approach mitigated the risk of COVID-19 exposure while also conserving resources, preserving capacity and supporting supply chains.

Use of a hybrid digital training approach for hormonal IUD providers in Nigeria: results from a mixed method study

BackgroundIn Nigeria, in-service trainings for new family planning (FP) methods have typically been conducted using a combination of classroom-based learning, skills labs, and supervised practicums. This mixed-methods study evaluated the feasibility, acceptability, provider competency, and costs associated with a hybrid digital and in-person training model for the hormonal intrauterine device (IUD).MethodsThe study was conducted in Enugu, Kano, and Oyo states, Nigeria, and enrolled FP providers previously trained on non-hormonal IUDs. Participants completed a digital didactic training, an in-person model-based practicum with an Objective Structured Clinical Examination (OSCE), followed by supervised provision of service to clients. Provider knowledge gains and clinical competency were assessed and described descriptively. Data on the feasibility, acceptability, and scalability of the approach were gathered from participating providers, clinical supervisors, and key stakeholders. Training costs were captured using an activity-based approach and used to calculate a cost per provider trained. All analyses were descriptive.ResultsSixty-two providers took the hybrid digital training, of whom 60 (91%) were included in the study (n = 36 from public sector, n = 15 from private sector, and n = 9 both public/private). The average knowledge score increased from 62 to 86% pre- and post-training. Clinical competency was overall very high (mean: 94%), and all providers achieved certification. Providers liked that the digital training could be done at the time/place of their choosing (84%), was self-paced (79%), and reduced risk of COVID-19 exposure (75%). Clinical supervisors and Ministry of Health stakeholders also had positive impressions of the training and its scalability. The hybrid training package cost $316 per provider trained.ConclusionsWe found that a hybrid digital training approach to hormonal IUD service provision in Nigeria was acceptable and feasible. Providers demonstrated increases in knowledge following the training and achieved high levels of clinical competency. Both providers and clinical supervisors felt that the digital training content was of high quality and an acceptable (sometimes preferable) alternative to classroom-based, in-person training. This study provided insights into a hybrid digital training model for a long-acting contraceptive, relevant to scale-up in Nigeria and similar settings.

COVID-19, Housing, and Environmental Injustice

In the United States, there has been a long history of environmental injustice that disproportionately affects racial and ethnic minorities and low-income communities due to racially targeted policies and widespread discrimination. Environmental racism can be revealed in housing discrimination that perpetuates inequities in exposure to environmental pollutants. Biased credit and mortgaging practices such as redlining have led to housing segregation of racial and ethnic minorities in the USA, permitting policymakers to diminish and disinvest in these communities. The COVID-19 pandemic has amplified housing instability for families of color, including Black and Hispanic/Latinx communities, putting them at increased risk for COVID-19 exposure. There is a need to investigate how environmental injustice intensifies the COVID-19 pandemic, illuminates racial and ethnic inequities in exposure to environmental contaminants, and fuels disparities in COVID-19 outcomes. The aims of this paper are to analyze and discuss environmental injustice and racial and ethnic disparities related to COVID-19 and housing. We also propose recommendations to address this pervasive issue.

Communicating COVID-19 exposure risk with an interactive website counteracts risk misestimation.

During the COVID-19 pandemic, individuals depended on risk information to make decisions about everyday behaviors and public policy. Here, we assessed whether an interactive website influenced individuals' risk tolerance to support public health goals. We collected data from 11,169 unique users who engaged with the online COVID-19 Event Risk Tool (https://covid19risk.biosci.gatech.edu/) between 9/22/21 and 1/22/22. The website featured interactive elements, including a dynamic risk map, survey questions, and a risk quiz with accuracy feedback. After learning about the risk of COVID-19 exposure, participants reported being less willing to participate in events that could spread COVID-19, especially for high-risk large events. We also uncovered a bias in risk estimation: Participants tended to overestimate the risk of small events but underestimate the risk of large events. Importantly, even participants who voluntarily sought information about COVID risks tended to misestimate exposure risk, demonstrating the need for intervention. Participants from liberal-leaning counties were more likely to use the website tools and more responsive to feedback about risk misestimation, indicating that political partisanship influences how individuals seek and engage with COVID-19 information. Lastly, we explored temporal dynamics and found that user engagement and risk estimation fluctuated over the course of the Omicron variant outbreak. Overall, we report an effective large-scale method for communicating viral exposure risk; our findings are relevant to broader research on risk communication, epidemiological modeling, and risky decision-making.

Prevalence and factors associated with burnout among healthcare providers in Malaysia: a web-based cross-sectional study.

This study aimed to assess the determinants of burnout among healthcare providers in the primary care setting. A web-based cross-sectional study was conducted among 1280 healthcare providers aged 18years and older from 30 primary care clinics in Selangor, Malaysia. In this study, the Copenhagen Burnout Inventory was used to assess burnout. The results were analyzed using multiple logistic regression. The prevalence of personal burnout was 41.7%, followed by work-related burnout (32.2%) and client-related burnout (14.5%). The determinants for personal burnout in this study were youngerage, being a doctor, higher COVID-19 exposure risk, do not know where to seek help, inability to handle stress, poorersleep quality score, highertotal COVID-19 fear score,higher total stress score, and lowertotal BRS score. The determinants of work-related burnout were youngerage, being a doctor, longeryears of working, higherCOVID-19 exposure risk, do not know where to seek help, lower altruistic score, poorersleep quality score, highertotal stress score, and lowertotal brief resilience score (BRS) score. The determinants of client-related burnout were doctor, single/divorced, more than one attachment site, and highersatisfaction toward the infection control, inability to handle stress, highertotal depression score, and lowertotal BRS score. Every fourth out of ten suffered from personal burnout, one-third from work-related burnout, and one-seventh from client-related burnout among healthcare providers during the COVID-19 pandemic. Healthcare systems must take care of healthcare workers' physical and emotional depletion, reducing the risk of burnout.

Predicting COVID-19 exposure risk perception using machine learning

BackgroundSelf-perceived exposure risk determines the likelihood of COVID-19 preventive measure compliance to a large extent and is among the most important predictors of mental health problems. Therefore, there is a need to systematically identify important predictors of such risks. This study aims to provide insight into forecasting and understanding risk perceptions and help to adjust interventions that target various social groups in different pandemic phases.MethodsThis study was based on survey data collected from 5001 Norwegians in 2020 and 2021. Interpretable machine learning algorithms were used to predict perceived exposure risks. To detect the most important predictors, the models with best performance were chosen based on predictive errors and explained variances. Shapley additive values were used to examine individual heterogeneities, interpret feature impact and check interactions between the key predictors.ResultsGradient boosting machine exhibited the best model performance in this study (2020: RMSE=.93, MAE=.74, RSQ=.22; 2021: RMSE=.99, MAE=.77, RSQ=.12). The most influential predictors of perceived exposure risk were compliance with interventions, work-life conflict, age and gender. In 2020, work and occupation played a dominant role in predicting perceived risks whereas, in 2021, living and behavioural factors were among the most important predictors. Findings show large individual heterogeneities in feature importance based on people’s sociodemographic backgrounds, work and living situations.ConclusionThe findings provide insight into forecasting risk groups and contribute to the early detection of vulnerable people during the pandemic. This is useful for policymakers and stakeholders in developing timely interventions targeting different social groups. Future policies and interventions should be adapted to the needs of people with various life situations.

Racial and Ethnic Differences in Self-Reported COVID-19 Exposure Risks, Concerns, and Behaviors Among Diverse Participants in the Women's Health Initiative Study.

Racial and ethnic disparities in coronavirus disease 2019 (COVID-19) risk are well-documented; however, few studies in older adults have examined multiple factors related to COVID-19 exposure, concerns, and behaviors or conducted race- and ethnicity-stratified analyses. The Women's Health Initiative (WHI) provides a unique opportunity to address those gaps. We conducted a secondary analysis of WHI data from a supplemental survey of 48 492 older adults (mean age 84 years). In multivariable-adjusted modified Poisson regression analyses, we examined predisposing factors and COVID-19 exposure risk, concerns, and behaviors. We hypothesized that women from minoritized racial or ethnic groups, compared to non-Hispanic White women, would be more likely to report: exposure to COVID-19, a family or friend dying from COVID-19, difficulty getting routine medical care or deciding to forego care to avoid COVID-19 exposure, and having concerns about the COVID-19 pandemic. Asian women and non-Hispanic Black/African American women had a higher risk of being somewhat/very concerned about risk of getting COVID-19 compared to non-Hispanic White women and each was significantly more likely than non-Hispanic White women to report forgoing medical care to avoid COVID-19 exposure. However, Asian women were 35% less likely than non-Hispanic White women to report difficulty getting routine medical care since March 2020 (adjusted relative risk 0.65; 95% confidence interval 0.57, 0.75). We documented COVID-related racial and ethnic disparities in COVID-19 exposure risk, concerns, and care-related behaviors that disfavored minoritized racial and ethnic groups, particularly non-Hispanic Black/African American women.

Healthcare personnel at non–acute-care facilities are at risk of COVID-19 from workplace and community exposures

Background: Healthcare personnel (HCP) working in non–acute-care facilities are at high risk of COVID-19. We sought to determine SARS-CoV-2 seroprevalence, and analyzed behaviors and activities related to COVID-19 acquisition in this cohort. Methods: Between May and June 2021, HCP were enrolled at a skilled nursing facility and a memory care facility in St. Louis, Missouri. Data regarding demographics, prior SARS-CoV-2 testing, symptoms consistent with COVID-19 in the previous 6 months, COVID-19 vaccination, personal protective equipment (PPE) use, and COVID-19 exposures were collected via survey. Blood specimens were obtained to determine SARS-CoV-2 nucleocapsid IgG antibody seroprevalence (Abbott Laboratories). Study protocol was approved by the Washington University Institutional Review Board. Results: The survey was completed by 74 HCP. 82% of participants were female, and 31% reported &gt;10 years of healthcare experience. The overall SARS-CoV-2 seropositivity rate was 8.9% (5 HCP). Of the surveyed HCP, 50% reported symptoms concerning for COVID-19 in the prior 6 months. Headache (38%), fatigue (35%) and fever (27%) were the most common self-reported symptoms. Among symptomatic HCP, only 35% sought medical care for these symptoms. All HCP reported having taken at least 1 COVID-19 test prior to study enrollment. Of note, 18.9% (14 HCP) had a self-reported prior positive SARS-CoV-2 PCR test, of whom 9 HCP were seronegative. All seronegative HCP with a self-reported history of COVID-19 reported infection &gt;3 months before study participation. Completion of a primary COVID-19 vaccination series was reported by 86% of HCP. Known exposure to COVID-19 at work was reported by 28% of HCP. When asked about PPE at the time of workplace exposure, N95 mask use was reported by 81%, gloves by 57%, gowns by 33%, face shields by 29% and surgical masks by 14%. Known specific exposure to COVID-19 outside work was reported by 31% of HCP. Conclusions: One year after the initial COVID-19 pandemic impacted the St. Louis region, HCP at non–acute-care facilities had a SARS-CoV-2 seroprevalence of 8.9%. Similar frequency of exposures were reported from both the workplace and community, with high rates of PPE use at the workplace. HCP in such settings remain at high risk of COVID-19 exposure from workplace and community exposures. Ongoing efforts are needed to maintain PPE use to prevent SARS-CoV-2 transmission within non–acute-care facilities, and continue access to timely COVID-19 screening for HCP.Disclosure: None

Evaluation of Dentists' Knowledge and Attitude towards COVID-19 in Sari in 2021

Introduction: Dental health professionals and patients are at high risk of COVID-19 exposure due to blood and saliva droplets generated during dental procedures. People’s adherence for infection control is affected by their knowledge, attitudes, and practices towards COVID-19. Considering that dental practice is one of the most dangerous professions in terms of exposure to the disease, this study examines the knowledge and attitudes of dentists regarding COVID-19 in north of Iran. Material and Methods: This descriptive study was based on questionnaires that were distributed among dentists in north of Iran. Demographic characteristics, knowledge of participants about COVID-19 and infection control measures and their attitudes were evaluated. The effect of pandemic on dentists’ life and quality of dental services were also investigated. Results: Totally, 125 dentists completed the questionnaire (99 general dentists and 26 specialists). The majority of participants (n=84, 67.2%) did not perform unnecessary dental procedures during the pandemic, and 114 (91.2%) of them changed their working hours. The most of contributors (N=207, 86%) focus on preventive care, not perform unnecessary treatments and reduce the treatment sessions at the lowest possible. Conclusion: The present study concluded that majority of the participants had good knowledge and positive attitude regarding dental care and related preventive measures in the pandemic period. Although, it is suggested that dental health professionals continue to strengthen knowledge and improve attitude by health training programs.

Virtual Fracture Care in Long-Term Care Homes Avoiding Emergency Department Visits.

Long-term care residents with suspected fractures as a result of a fall typically transfer to the emergency department (ED) for diagnostic imaging and care. During the COVID-19 pandemic, transfer to the hospital increased the risk of COVID-19 exposure and resulted in extended isolation days for the resident. A fracture care pathway was developed and implemented to provide rapid diagnostic imaging results and stabilization in the care home, reducing transportation and exposure risk to COVID-19. Eligible residents with a stable fracture would receive a referral to a designated fracture clinic for consultation; fracture care is provided in the care home by long-term care staff. Evaluation of the pathway was completed and demonstrated that 100% of residents did not transfer to the ED and 47% of the residents did not transfer to a fracture clinic for additional care.