Healthcare Worker Transmission Research Articles

Chapare virus infection and current perspectives on dentistry.

This narrative review addresses relevant points about Chapare virus (CHAV) entry in oral cells, CHAV transmission, and preventive strategies in dental clinical settings. It is critical in dentistry due to the frequent presence of gingival hemorrhage occurred in CHAV-infected patients. Studies related to CHAV were searched in MEDLINE/PubMed, Scopus, EMBASE, and Web-of-Science databases without language restriction or year of publication. Recently, the PAHO/WHO and CDC indicate a presence of human-to-human transmission of CHAV associated with direct contact with saliva, blood, or urine, and also through droplets or aerosols created in healthcare procedures. CHAV was detected in human oropharyngeal saliva and gingival bleeding was confirmed in all cases of CHAV hemorrhagic fever, including evidence of nosocomial CHAV transmission in healthcare workers. We revisited the human transferrin receptor 1 (TfR1) expression in oral, nasal, and salivary glands tissues, as well as, we firstly identified the critical residues in the pre-glycoprotein (GP) complex of CHAV that interacts with human TfR1 using cutting-edge in silico bioinformatics platforms associated with molecular dynamic analysis. In this multidisciplinary view, we also point out critical elements to provide perspectives on the preventive strategies for dentists and frontline healthcare workers against CHAV, and in the implementation of salivary diagnostic platforms for virus detection, which can be critical to an urgent plan to prevent human-to-human transmission based on current evidence. The preventive strategies in dental clinical settings are pivotal due to the aerosol-generating procedures in dentistry with infected patients or suspected cases of CHAV infection.

Nasopharyngeal angiotensin converting enzyme 2 (ACE2) expression as a risk-factor for SARS-CoV-2 transmission in concurrent hospital associated outbreaks

BackgroundWidespread human-to-human transmission of the severe acute respiratory syndrome coronavirus two (SARS-CoV-2) stems from a strong affinity for the cellular receptor angiotensin converting enzyme two (ACE2). We investigate the relationship between a patient’s nasopharyngeal ACE2 transcription and secondary transmission within a series of concurrent hospital associated SARS-CoV-2 outbreaks in British Columbia, Canada.MethodsEpidemiological case data from the outbreak investigations was merged with public health laboratory records and viral lineage calls, from whole genome sequencing, to reconstruct the concurrent outbreaks using infection tracing transmission network analysis. ACE2 transcription and RNA viral load were measured by quantitative real-time polymerase chain reaction. The transmission network was resolved to calculate the number of potential secondary cases. Bivariate and multivariable analyses using Poisson and Negative Binomial regression models was performed to estimate the association between ACE2 transcription the number of SARS-CoV-2 secondary cases.ResultsThe infection tracing transmission network provided n = 76 potential transmission events across n = 103 cases. Bivariate comparisons found that on average ACE2 transcription did not differ between patients and healthcare workers (P = 0.86). High ACE2 transcription was observed in 98.6% of transmission events, either the primary or secondary case had above average ACE2. Multivariable analysis found that the association between ACE2 transcription (log2 fold-change) and the number of secondary transmission events differs between patients and healthcare workers. In health care workers Negative Binomial regression estimated that a one-unit change in ACE2 transcription decreases the number of secondary cases (β = -0.132 (95%CI: -0.255 to -0.0181) adjusting for RNA viral load. Conversely, in patients a one-unit change in ACE2 transcription increases the number of secondary cases (β = 0.187 (95% CI: 0.0101 to 0.370) adjusting for RNA viral load. Sensitivity analysis found no significant relationship between ACE2 and secondary transmission in health care workers and confirmed the positive association among patients.ConclusionOur study suggests that ACE2 transcription has a positive association with SARS-CoV-2 secondary transmission in admitted inpatients, but not health care workers in concurrent hospital associated outbreaks, and it should be further investigated as a risk-factor for viral transmission.

Immune Status for Hepatitis B and Risk for Occupational Exposure Virus Among Italian Nurses

Background: Healthcare workers (HCWs) are considered at higher risk for hepatitis B virus infection compared to the general population, due to their potential contact with blood or body fluids and possible needle stick injuries. In turn, infected HCWs may be a risk for patients. Hepatitis B vaccination programs represent a strategic approach to control the infection. Objectives: In this study, we aimed to evaluate the serological status of HCWs employed at the teaching hospital of Rome Tor Vergata and their risk of occupational injuries after the adoption of directive 2010/32/EU. Methods: Medical records of 539 HCWs were evaluated during their occupational medical examination at the Tor Vergata teaching hospital (PTV). All subjects were screened for specific viral markers: Hepatitis B surface antibodies (anti-HBs IgG), antibodies to hepatitis core antigen (anti-HBc IgG), and hepatitis B surface antigen (HBsAg). Data regarding needlestick injuries were collected by the prevention service team during the same year. Results: In this sample population, we found five subjects (0.9%) positive to the HBsAg, and most of them (four) were born in foreign countries. Moreover, seven subjects (1.3% of our population) were HBsAg-positive and anti-HBc-positive. A protective anti-HBs titer was found in 462 out of 527 (85.7%) subjects. The risk of being serologically unprotected was higher in males and subjects aged 40 years or older. The nurses were more protected than other healthcare professionals considering the anti-hepatitis B surface antibody titer. In 2018, 16 needlestick injuries were reported among our population of HCWs, with a global risk of 2.9% per year. Conclusions: Although hepatitis B virus (HBV) infection rate among HCWs was similar to that of the general population, the risk of HBV transmission in HCWs was likely to be high due to suboptimal vaccination coverage.

Immune Status for Hepatitis B and Risk for Occupational Exposure Virus Among Italian Nurses

Background: Healthcare workers (HCWs) are considered at higher risk for hepatitis B virus infection compared to the general population, due to their potential contact with blood or body fluids and possible needle stick injuries. In turn, infected HCWs may be a risk for patients. Hepatitis B vaccination programs represent a strategic approach to control the infection. Objectives: In this study, we aimed to evaluate the serological status of HCWs employed at the teaching hospital of Rome Tor Vergata and their risk of occupational injuries after the adoption of directive 2010/32/EU. Methods: Medical records of 539 HCWs were evaluated during their occupational medical examination at the Tor Vergata teaching hospital (PTV). All subjects were screened for specific viral markers: Hepatitis B surface antibodies (anti-HBs IgG), antibodies to hepatitis core antigen (anti-HBc IgG), and hepatitis B surface antigen (HBsAg). Data regarding needlestick injuries were collected by the prevention service team during the same year. Results: In this sample population, we found five subjects (0.9%) positive to the HBsAg, and most of them (four) were born in foreign countries. Moreover, seven subjects (1.3% of our population) were HBsAg-positive and anti-HBc-positive. A protective anti-HBs titer was found in 462 out of 527 (85.7%) subjects. The risk of being serologically unprotected was higher in males and subjects aged 40 years or older. The nurses were more protected than other healthcare professionals considering the anti-hepatitis B surface antibody titer. In 2018, 16 needlestick injuries were reported among our population of HCWs, with a global risk of 2.9% per year. Conclusions: Although hepatitis B virus (HBV) infection rate among HCWs was similar to that of the general population, the risk of HBV transmission in HCWs was likely to be high due to suboptimal vaccination coverage.

The Risk Factors for SARS-CoV-2 Transmission in Healthcare Workers of Secondary Level Intensive Care Units

The Risk Factors for SARS-CoV-2 Transmission in Healthcare Workers of Secondary Level Intensive Care Units

Childcare Stress, Burnout, and Intent to Reduce Hours or Leave the Job During the COVID-19 Pandemic Among US Health Care Workers

Childcare stress (CCS) is high during the COVID-19 pandemic because of remote learning and fear of illness transmission in health care workers (HCWs). Associations between CCS and burnout, intent to reduce (ITR) hours, and intent to leave (ITL) are not known. To determine associations between CCS, anxiety and depression, burnout, ITR in 1 year, and ITL in 2 years. This survey study, Coping with COVID, a brief work-life and wellness survey of US HCWs, was conducted between April and December 2020, assessing CCS, burnout, anxiety, depression, workload, and work intentions. The survey was distributed to clinicians and staff in participating health care organizations with more than 100 physicians. Data were analyzed from October 2021 to May 2022. The survey asked, "due to…COVID-19, I am experiencing concerns about childcare," and the presence of CCS was considered as a score of 3 or 4 on a scale from 1, not at all, to 4, a great extent. The survey also asked about fear of exposure or transmission, anxiety, depression, workload, and single-item measures of burnout, ITR, and ITL. In 208 organizations, 58 408 HCWs (15 766 physicians [26.9%], 11 409 nurses [19.5%], 39 218 women [67.1%], and 33 817 White participants [57.9%]) responded with a median organizational response rate of 32%. CCS was present in 21% (12 197 respondents) of HCWs. CCS was more frequent among racial and ethnic minority individuals and those not identifying race or ethnicity vs White respondents (5028 respondents [25.2%] vs 6356 respondents [18.8%]; P < .001; proportional difference, -7.1; 95% CI, -7.8 to -6.3) and among women vs men (8281 respondents [21.1%] vs 2573 respondents [17.9%]; odds ratio [OR], 1.22; 95% CI, 1.17 to 1.29). Those with CCS had 115% greater odds of anxiety or depression (OR, 2.15; 95% CI, 2.04-2.26; P < .001), and 80% greater odds of burnout (OR, 1.80; 95% CI, 1.70-1.90; P < .001) vs indidivuals without CCS. High CCS was associated with 91% greater odds of ITR (OR, 1.91; 95% CI, 1.76 to 2.08; P < .001) and 28% greater odds of ITL (OR, 1.28; 95% CI, 1.17 to 1.40; P < .001). In this survey study, CCS was disproportionately described across different subgroups of HCWs and was associated with anxiety, depression, burnout, ITR, and ITL. Addressing CCS may improve HCWs' quality of life and HCW retention and work participation.

Risks of catching COVID-19 according to vaccination status of healthcare workers during the SARS-CoV-2 Delta variant dominant period and their clinical characteristics.

The exposure of healthcare workers (HCWs) to severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) has been a major concern since the beginning of the coronavirus disease 2019 (COVID‐19) pandemic. The study aimed to investigate the relationship between vaccination status and the status of catching COVID‐19 in HCWs working in a Training and Research Hospital in Turkey, and the clinical course of the disease in those who were caught. The vaccination status of 1279 HCWs working at Siirt Training and Research Hospital during the period when the SARS‐CoV‐2 Delta variant was dominant, their cases of catching COVID‐19 during this period, and the clinical course of the disease in patients with COVID‐19 were investigated retrospectively. We found that the rate of COVID‐19 transmission was lowest in fully vaccinated HCWs (p < 0.05). The rate of COVID‐19 transmission in HCWs who received two doses of BioNTech vaccine (4.4%) and two doses of CoronaVac+ one dose of BioNTech vaccines (2.7%) was considerably lower than those without vaccination (26.2%) (p < 0.05). The transmission rate was lowest among those vaccinated with two doses of CoronaVac+ one dose of BioNTech. Hospitalization was not required in fully vaccinated HCWs. The lymphocyte count was found to be significantly higher in fully vaccinated patients than incompletely vaccinated and unvaccinated patients. Although C‐reactive protein (CRP), d‐dimer, and ferritin values were higher in unvaccinated and partially vaccinated patients than in fully vaccinated patients, the differences were not statistically significant. As a result, the transmission rate of COVID‐19 was lowest in fully vaccinated HCWs and in those vaccinated with two doses of CoronaVac+ one dose of BioNTech. In fully vaccinated HCWs, hospitalization was not needed.

Risk Factors for Transmission of the SARS-Cov 2 Virus in Health Workers

Background: Healthcare workers (HCWs) serve as front liners in the battle against COVID-19. They are often expected to be in constant contact with infected patients, posing higher risk of transmission. To date, literature on risk factors of COVID-19 transmission in HCWs are still limited. Purpose: We conducted this systematic review to identify the risk factors for SARS-CoV-2 virus transmission among HCWs. Methods: We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol. Four internet databases were searched using predefined search terms. The keywords used were {“COVID-19” OR “SARS-CoV-2”}, {“transmission” OR “transmission risk”}, and (“healthcare professionals” OR “healthcare workers” OR “healthcare staff”). All English articles which were published from January 2020 to June 2021 involving HCWs in hospitals treating COVID-19 were included into the study. Results: Out of initial 636 studies found using the predefined search terms, 18 studies fulfilled the inclusion criteria and were subsequently analyzed. We found that risk factors for COVID-19 could be divided into 5 categories: use of personal protective equipment (PPE), infection control procedures, unsafe workplace practices, provision of institutional support, and presence of individual risk factors in healthcare workers. Good hospital governance is necessary to establish policies regarding control of COVID-19 infection which will protect the patients and HCWs. Conclusion: Proper use of PPE, compliance to proper infection control procedures, establishment of safe workplace practices, provision of institutional support for prevention measures, and lack of individual risk factors may reduce the transmission risk of SARS-CoV-2 virus among healthcare workers. Further studies are warranted to identify methods for reducing incidence and mortality rate due to COVID-19 at HCWs.

Investigation of the relation between risk assessment of exposure and nosocomial SARS-CoV-2 transmission in healthcare workers: a prospective single-centre study

ObjectivesHealthcare workers (HCWs) are among the risk groups for COVID-19. Determining transmission routes and risk levels during healthcare is of great importance in preventing nosocomial outbreaks. This study aimed to...

Work-Related Human T-lymphotropic Virus 1 and 2 (HTLV-1/2) Infection: A Systematic Review.

Human T-lymphotropic virus 1 and 2 (HTLV-1/2) belong to the delta group of retroviruses which may cause a life-long infection in humans, HTLV-1 leading to adult T-cell leukemia/lymphoma and other diseases. Different transmission modes have been described, such as breastfeeding, and, as for other blood-borne pathogens, unsafe sexual activity, intravenous drug usage, and blood transfusion and transplantation. The present systematic review was conducted to identify all peer-reviewed studies concerning the work-related infection by HTLV-1/2. A literature search was conducted from January to May 2021, according to the PRISMA methodology, selecting 29 studies: seven related to health care workers (HCWs), five to non-HCWs, and 17 to sex workers (SWs). The findings showed no clear evidence as to the possibility of HTLV-1/2 occupational transmission in HCWs, according to the limited number and quality of the papers. Moreover, non-HCWs showed a higher prevalence in jobs consistent with a lower socioeconomic status or that could represent a familial cluster, and an increased risk of zoonotic transmission from STLV-1-infected non-human primates has been observed in African hunters. Finally, a general increase of HTLV-1 infection was observed in SWs, whereas only one paper described an increased prevalence for HTLV-2, supporting the urgent need for prevention and control measures, including screening, diagnosis, and treatment of HTLV-1/2, to be offered routinely as part of a comprehensive approach to decrease the impact of sexually transmitted diseases in SWs.

SARS-CoV-2 seroprevalence in healthcare workers of a Swiss tertiary care centre at the end of the first wave: a cross-sectional study

ObjectiveTo assess the SARS-CoV-2 transmission in healthcare workers (HCWs) using seroprevalence as a surrogate marker of infection in our tertiary care centre according to exposure.DesignSeroprevalence cross-sectional study.SettingSingle centre at the...

Utilizing Worker's Compensation Claims to Assess sars-cov-2 Transmission in Healthcare Workers at a Large Health System

BackgroundHealthcare workers may be at an increased risk for SARS-CoV-2 (the virus that causes COVID-19) transmission due to prolonged, close contact with infectious patients. Therefore, it is imperative that healthcare organizations develop effective control measures to prevent transmission of SARS-CoV-2, including the use of personal protective equipment. We aimed to assess the effectiveness of control measures implemented at our health system through evaluation of worker's compensation reported exposures and accepted claims.MethodsWorkplace exposure and transmission of SARS-CoV-2 was determined using a communicable disease reporting process through worker's compensation between March 1, 2020 and August 31, 2020 at a multicenter health system. The total number of employees positive for SARS-CoV-2 was extracted from Employee Health laboratory reports.ResultsA total of 693 COVID-19 related exposures were reported from 3/1/2020 to 8/31/2020. Of those, 85 tested positive for SARS-CoV-2. Through the worker's compensation event investigation and physician review, 51 employees (7.4% of reported exposures) were determined to have, on a medically more probable than not basis, acquired SARS-CoV-2 from a workplace exposure (26 patient exposures, 14 co-worker exposures, 6 patient and co-worker exposures, and 5 unknown exposures). The overall number of employee positives during the study time period was 441. Workplace acquisition accounted for 11.6% of the employee cases.ConclusionsOf the reported COVID-19 exposures, 7.4% resulted in workplace transmission, indicating that control measures implemented by the health system are effective at limiting virus transmission in the workplace. Additionally, workplace associated cases accounted for 11.5% of overall employee positives, suggesting that employees are acquiring the virus in settings other than the workplace. This data reinforces the effectiveness of the hierarchy of controls in preventing workplace hazards and emphasizes the need for healthcare workers to practice infection prevention measures both in and outside of the workplace to prevent the spread of SARS-CoV-2.

Improving knowledge, attitudes and practice to prevent COVID-19 transmission in healthcare workers and the public in Thailand

BackgroundKey infection prevention and control measures to limit transmission of COVID-19 include social distancing, hand hygiene, use of facemasks and personal protective equipment. However, these have limited or no impact if not applied correctly through lack of knowledge, inappropriate attitude or incorrect practice. In order to maximise the impact of infection prevention and control measures on COVID-19 spread, we undertook a study to assess and improve knowledge, attitudes and practice among 119 healthcare workers and 100 general public in Thailand. The study setting was two inpatient hospitals providing COVID-19 testing and treatment. Detailed information on knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations.ResultsKnowledge of the main transmission routes, commonest symptoms and recommended prevention methods was mostly very high (> 80%) in both groups. There was lower awareness of aerosols, food and drink and pets as sources of transmission; of the correct duration for handwashing; recommended distance for social/physical distancing; and about recommended types of face coverings. Information sources most used and most trusted were the workplace, work colleagues, health workers and television. The results were used to produce a set of targeted educational videos which addressed many of these gaps with subsequent improvements on retesting in a number of areas. This included improvements in handwashing practice with an increase in the number of areas correctly washed in 65.5% of the public, and 57.9% of healthcare workers. The videos were then further optimized with feedback from participants followed by another round of retesting.ConclusionsDetailed information on gaps in knowledge, attitudes and practice among the general public and healthcare workers regarding COVID-19 transmission and its prevention were obtained from a combination of questionnaires and observations. This was used to produce targeted educational videos which addressed these gaps with subsequent improvements on retesting. The resulting videos were then disseminated as a resource to aid in efforts to fight COVID-19 in Thailand and worldwide.

Risk of SARS-CoV-2 Transmission in Health Care Personnel Working in a Pediatric COVID-19 Unit.

The paucity of symptoms and the difficulties in wearing personal protective equipment make children a potential source of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for health care workers (HCWs). Previous experience in pediatric settings reported high rate of intrahospital SARS-CoV-2 transmission in HCWs caring for children. We aimed at investigating the rate and determinants of SARS-CoV-2 infection among HCWs working in a regional reference center in the Southern Italy. A prospective observational study was conducted to monitor the occurrence of SARS-CoV-2 infections among HCWs and investigate the relation between the infection rate and hours of exposure or number and characteristics of procedures, including nasopharyngeal swab, high-flow oxygen delivery, suctioning of airway secretions, sputum induction, and nebulizer administration. After 5 months of monitoring, 425.6 hours of SARS-CoV-2 exposure (18.5 hours per person), and 920 hospital procedures, no case of nosocomial transmission was reported among the 23 HCWs enrolled in the study. The application of stringent preventive measures, also outside the area dedicated to patients' care, can effectively control infection spreading also in pediatric settings.

SARS-CoV-2 Seroprevalence Survey in People Involved in Different Essential Activities during the General Lock-Down Phase in the Province of Prato (Tuscany, Italy).

Serosurveys may help to assess the transmission dynamics in high-risk groups. The aim of the study was to assess the SARS-CoV-2 antibody seroprevalence in people who had performed essential activities during the lock-down period in the Province of Prato (Italy), and to evaluate the risk of exposure to SARS-CoV-2 according to the type of service. All the workers and volunteers of the Civil Protection, employees of the municipalities, and all the staff of the Health Authority of the Province of Prato were invited to be tested with a rapid serological test. A total of 4656 participants were tested. SARS-CoV-2 antibodies were found in 138 (2.96%) cases. The seroprevalence in health care workers, in participants involved in essential support services and in those who worked from home were 4.1%, 1.4% and 1.0%, respectively. Health care workers experienced higher odds of seropositivity (OR 4.38, 95%CI 2.19–10.41) than participants who were assigned to work-from-home; no significant seropositivity differences were observed between support services and work-from-home groups. A low circulation of SARS-CoV-2 was observed among participants performing different essential activities. Findings highlighted the risk of in-hospital transmission in healthcare workers and that community support services may increase the risk of seropositivity to a limited extent in low incidence areas.

Healthcare workers novel coronavirus (nCOVID 19) life-threatening situation during the pandemic

Healthcare workers (HCWs) are the professional workers directly acquired infection during this coronavirus outbreak. Coronavirus potentially severe acute respiratory infection caused by nCOVID-19 has been declared by pandemic on 11th March 2020 by Word health organisation (WHO). The previous study has reported high susceptibility of respiratory infection in the HCWs. The HCWs are at increased risk for severe respiratory syndrome coronavirus infection. The spread of coronavirus became global public health event, threatening physical and Mental Health of HCWs. This study reviews the possible risk factors for being infected HCWs and avoid transmission of infection at the workplace. Spreading the coronavirus day by day is the life-threatening condition for Health care workers during a pandemic. The community should understand the HCW’s increased responsibility during this public health emergency and must provide the necessary social support as well. There should be enough protective and preventive measures for avoiding transmission in HCWs. Apart from heavy duties HCWs while using PPEs they also have physical and mental exhaustion along with the fear produced out of risk-specific exposures.

Clonal replacement of meticillin-resistant Staphylococcus aureus during repeated outbreaks in a long-term care facility

Meticillin-resistant Staphylococcus aureus (MRSA) is common among residents of long-term care facilities (LTCFs). Analysing the spa types of 22 isolates, mostly bloodstream infections (BSI), revealed five temporally distinct clonal outbreaks occurring in one ward of our local LTCF between 2012 and 2019. Each clone caused episodes of BSI for several months until replaced by another clone. A high MRSA carriage rate of 32% among healthcare workers in this ward was documented during the investigation of the 2019 outbreak. Clonal replacement of MRSA and the role of healthcare workers in transmission are discussed.

Particle removal from air by face masks made from Sterilization Wraps: Effectiveness and Reusability.

Wearing face masks is highly recommended to prevent SARS-CoV-2 transmission in health care workers and for the general public. The demand for high quality face masks has seen an upsurge in the recent times, leading to exploration of alternative economic and easily available options, without compromising on the quality. Particle removal from air in terms of capture efficiency of the filter media or the face mask is a crucial parameter for testing and quality assurance. Short-term reusability of the face masks is also an important aspect as the demand for masks will potentially outstrip the supply in future. Sterilization Wraps, which are used to wrap sterile surgical instruments, have shown a promising performance in terms of removal of particles from air. In this study, we evaluate the particle filtration characteristics of face masks made of 2 different metric weights [45 and 60 gram per square metre (GSM)] respectively, using locally available Sterilization Wraps. The aerosol filtration characteristics were also studied after sterilisation by different techniques such as heat with 50% humidity (thermal treatment), ethylene oxide (ETO), steam and radiation dose of 30kGy. We found that 60 GSM face mask had particle capture efficiency of 94% for total particles greater than 0.3 microns and this capture efficiency was maintained even after sterilisation with ETO and thermal treatment. The cost of producing these masks was 30 US cents/mask at our institute. Our study suggests that sterilization wrap material made of non-woven polypropylene spunbond-meltblown-spunbond (SMS) fibres could be an appropriate readily available inexpensive material for making face masks or N95 respirators.

Tracheotomy in Ventilated Patients With COVID-19.

Tracheotomy in Ventilated Patients With COVID-19.

Protecting healthcare workers from COVID-19: learning from variation in practice and policy identified through a global cross-sectional survey.

AimsThe COVID-19 pandemic presents an unprecedented burden on global healthcare systems, and existing infrastructures must adapt and evolve to meet the challenge. With health systems reliant on the health of their workforce, the importance of protection against disease transmission in healthcare workers (HCWs) is clear. This study collated responses from several countries, provided by clinicians familiar with practice in each location, to identify areas of best practice and policy so as to build consensus of those measures that might reduce the risk of transmission of COVID-19 to HCWs at work.MethodsA cross-sectional descriptive survey was designed with ten open and closed questions and sent to a representative sample. The sample was selected on a convenience basis of 27 senior surgeons, members of an international surgical society, who were all frontline workers in the COVID-19 pandemic. This study was reported according to the Standards for Reporting Qualitative Research (SRQR) checklist.ResultsResponses were received by all 27 surgeons from 22 countries across six continents. A number of the study respondents reported COVID-19-related infection and mortality in HCWs in their countries. Differing areas of practice and policy were identified and organized into themes including the specification of units receiving COVID-19 patients, availability and usage of personal protective equipment (PPE), other measures to reduce staff exposure, and communicating with and supporting HCWs. Areas more specific to surgery also identified some variation in practice and policy in relation to visitors to the hospital, the outpatient department, and in the operating room for both non-urgent and emergency care.ConclusionCOVID-19 presents a disproportionate risk to HCWs, potentially resulting in a diminished health system capacity, and consequently an impairment to population health. Implementation of these recommendations at an international level could provide a framework to reduce this burden.