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Lee HR, Kim SR, Cho MH, Kim DE, Jang SY, Lee JE, Jeong HR, Kang HJ, Song JY, Chun BC. Incidence and risk factors of COVID-19 in a tertiary hospital and the effectiveness of booster vaccination among health care workers: A retrospective cohort study, January 2020 to June 2022. Am J Infect Control 2024; 52:688-695. [PMID: 38246494 DOI: 10.1016/j.ajic.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND Health care workers (HCWs) face a higher risk of infection and may transmit pathogens to patients during a pandemic. This study aims to evaluate infection-control measures by analyzing the incidence and risk factors of COVID-19 and estimating vaccine effectiveness (VE) at a tertiary hospital in Seoul, Republic of Korea. METHODS This study included 2,516 HCWs from January 1, 2020, to June 30, 2022. Data were analyzed to determine the incidence density and cumulative incidence; the results were compared by the age- and gender-specific standardized incidence ratios (SIR). VE was estimated with multivariate Cox proportional-hazard models as 1-adjusted hazard ratio × 100%. RESULTS SIR indicated a lower COVID-19 risk in the hospital population than in the general Korean population (SIR, 0.81; 95% confidence interval [CI]: 0.76-0.87). Multivariate Cox analysis indicated that, compared to doctors, nonmedical service supporters and other HCWs (excluding doctors and nurses) were high-risk groups (adjusted hazard ratio [95% CI], 1.72 [1.04-2.83] and 1.76 [1.20-2.58], respectively). Compared to the outpatient unit, the emergency department was a high-risk department (1.70 [1.16-2.50]). The VE of the booster dose was 55.47%, compared to no or incomplete vaccination (95% CI: 22.63-74.37). CONCLUSIONS Besides encouraging HCWs vaccination, effective infection-control measures should target high-risk groups and departments.
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Affiliation(s)
- Hae Ry Lee
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea; Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea
| | - Sung Ran Kim
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Min Hee Cho
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Da Eun Kim
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Su Yeon Jang
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Jae Eun Lee
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Hye Rin Jeong
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Hyeon Jeong Kang
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea
| | - Joon Young Song
- Infection Control Team, Korea University Guro Hospital, Seoul, South Korea; Division of Infectious Disease, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Byung Chul Chun
- Department of Epidemiology and Health Informatics, Graduate School of Public Health, Korea University, Seoul, South Korea; Department of Preventive Medicine, College of Medicine, Korea University, Seoul, South Korea.
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Niekrens V, Kunz B, Werner M, Valenza G, Seggewies C, Bogdan C, Esse J. Analysis of the effectiveness of hygiene measures and COVID-19 vaccination at a tertiary-care university hospital during the first two years of the SARS-CoV-2 pandemic. Heliyon 2024; 10:e30311. [PMID: 38726181 PMCID: PMC11079082 DOI: 10.1016/j.heliyon.2024.e30311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 04/23/2024] [Accepted: 04/23/2024] [Indexed: 05/12/2024] Open
Abstract
Objective Assessment of the effectiveness of protective measures at a tertiary-care hospital during the SARS-CoV-2 infection waves to provide advice for future pandemics. Design Retrospective cohort study among hospital staff using in-house surveillance data. Setting University Hospital Erlangen (UKER), a tertiary-care provider in Bavaria, Germany. Methods We outline the preventive measures introduced at UKER and retrospectively assess their effectiveness using anonymized monitoring data that were collected during the SARS-CoV-2 pandemic from February 2020 to the end of January 2022. Analysed data includes the incidence of SARS-CoV-2 infections among employees, the frequency of high-risk contacts with infected patients or staff members and breakthrough infections considering the context of exposure. Results The cumulative incidence of SARS-CoV-2 infections among UKER employees was higher before, but lower after the vaccination campaign when compared to the general population. Healthcare workers (HCW), notably physicians and nurses, were especially at risk of infection compared to other UKER employees with less direct patient contact (OR 1.36 [95% CI 1.18-1.57 p < 0.001]). Breakthrough infections mostly occurred after exposure during private life, i.e. in situations without protective equipment. The frequency of high-risk contacts during direct patient care remained stable after SARS-CoV-2 vaccination. Prior to vaccination, 5.2% of HCW with direct patient care tested positive for SARS-CoV-2 within 14 days. After vaccination until the onset of the Omicron wave, conversion rate dropped to 0%. Conclusions This study provides real-world data on the effectiveness of vaccination, contact tracing, personal protective equipment and general hygiene measures during the SARS-CoV-2 pandemic. Based on our findings, we recommend a protective approach combining all these preventive measures.
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Affiliation(s)
- Valentin Niekrens
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
| | - Bernd Kunz
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
| | - Markus Werner
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
| | - Giuseppe Valenza
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
| | - Christof Seggewies
- Medical Informatics and Communication Center, Universitätsklinikum Erlangen, Glückstraße 11, D-91054, Erlangen, Germany
| | - Christian Bogdan
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
- FAU Profile Center Immunomedicine, Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Schlossplatz 1, D-91054, Erlangen, Germany
| | - Jan Esse
- Mikrobiologisches Institut - Klinische Mikrobiologie, Immunologie und Hygiene, Universitätsklinikum Erlangen and Friedrich-Alexander-Universität (FAU) Erlangen-Nürnberg, Wasserturmstraße 3/5, D-91054, Erlangen, Germany
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3
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Lui JNM, Andres EB, Johnston JM. How do organizational culture and leadership style affect nurse presenteeism and productivity?: A cross sectional study of Hong Kong acute public hospitals. Int J Nurs Stud 2024; 152:104675. [PMID: 38277926 DOI: 10.1016/j.ijnurstu.2023.104675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 11/03/2023] [Accepted: 12/11/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND Presenteeism is defined as a type of work behavior in which employees are physically present at work when ill, often with reduced performance. While organizational culture and leadership style are known to impact the organizational behavior of hospital staff, as indicated by increased burnout and decreased work engagement, their impact on nurse presenteeism and productivity has not been explored. Moreover, nursing studies often neglect the importance of using multi-level analysis, adopting aggregated unit-level scores to account for collective perceptions to evaluate culture and leadership. OBJECTIVE This study aims to evaluate the impact of unit-level organizational culture and leadership style on individual-level nurse presenteeism and productivity in acute care hospitals using multilevel analysis. DESIGN Cross-sectional study. SETTING(S) Three major acute care public hospitals in Hong Kong, where public hospitals provide over 90 % of inpatient services. PARTICIPANTS All full-time nurses (N = 4657) in the three study hospitals were invited to participate in this study. A total of 2339 nurses responded to the survey for a 65 % response rate. METHODS Organizational culture and leadership style are characterized using the competing values framework and a two-factor leadership style typology, respectively. Multilevel hierarchical linear modeling was applied with unit-level clustering in each hospital. RESULTS Hierarchical culture was the dominant culture (M = 3.64, SD = 0.74) in our nurse sample. None of the unit-level organizational culture and leadership styles were associated with nurse presenteeism, however, rational organizational culture at the unit-level was significantly associated with increased productivity (regression coefficient: 0.17, 95 % CI: 0.04-0.31). CONCLUSIONS This study provides hospital managers with improved understanding of the differential impact of unit-level organizational culture and leadership style on nurse presenteeism and productivity. Unit-level leadership style did not have a direct impact on nurse presenteeism and productivity in this study, while the externally focused rational organizational culture increased nurse productivity. Further research is needed to understand the impacts of modifiable work factors and nurse psychosocial emotions on presenteeism and productivity.
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Affiliation(s)
- Juliana Nga Man Lui
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
| | | | - Janice Mary Johnston
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, G/F, Patrick Manson Building (North Wing), 7 Sassoon Road, Pokfulam, Hong Kong, China
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Lam T, Saso A, Torres Ortiz A, Hatcher J, Woodman M, Chandran S, Thistlethwayte R, Best T, Johnson M, Wagstaffe H, Mai A, Buckland M, Gilmour K, Goldblatt D, Grandjean L. Socioeconomic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study. Clin Infect Dis 2024; 78:594-602. [PMID: 37647517 PMCID: PMC10954340 DOI: 10.1093/cid/ciad522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/26/2023] [Accepted: 08/29/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND To protect healthcare workers (HCWs) from the consequences of disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is necessary to understand the risk factors that drive exposure and infection within hospitals. Insufficient consideration of key socioeconomic variables is a limitation of existing studies that can lead to bias and residual confounding of proposed risk factors for infection. METHODS The Co-STARs study prospectively enrolled 3679 HCWs between April 2020 and September 2020. We used multivariate logistic regression to comprehensively characterize the demographic, occupational, socioeconomic, and environmental risk factors for SARS-CoV-2 seropositivity. RESULTS After adjusting for key confounders, relative household overcrowding (odds ratio [OR], 1.4 [95% confidence interval {CI}, 1.1-1.9]; P = .006), Black, Black British, Caribbean, or African ethnicity (OR, 1.7 [95% CI, 1.2-2.3]; P = .003), increasing age (ages 50-60 years: OR, 1.8 [95% CI, 1.3-2.4]; P < .001), lack of access to sick pay (OR, 1.8 [95% CI, 1.3-2.4]; P < .001). CONCLUSIONS Socioeconomic and demographic factors outside the hospital were the main drivers of infection and exposure to SARS-CoV-2 during the first wave of the pandemic in an urban pediatric referral hospital. Overcrowding and out-of-hospital SARS-CoV-2 contact are less amenable to intervention. However, lack of access to sick pay among externally contracted staff is more easily rectifiable. Our findings suggest that providing easier access to sick pay would lead to a decrease in SARS-CoV-2 transmission and potentially that of other infectious diseases in hospital settings. CLINICAL TRIALS REGISTRATION NCT04380896.
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Affiliation(s)
- Tanya Lam
- Department of Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
| | - Anja Saso
- Department of Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
- Department of Tropical and Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Medical Research Council Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Arturo Torres Ortiz
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - James Hatcher
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - Marc Woodman
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Shruthi Chandran
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | | | - Timothy Best
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - Marina Johnson
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Helen Wagstaffe
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Annabelle Mai
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - Matthew Buckland
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - Kimberly Gilmour
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - David Goldblatt
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Louis Grandjean
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
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Hsu CW, Yang WW, Hou CY, Feng IJ, Huang TY, Lee PL, Guo HR, Huang CY, Su SB. Patients with Hepatitis C Undergoing Direct-Acting Antiviral Treatment Have a Lower SARS-CoV-2 Infection Rate. Life (Basel) 2023; 13:2326. [PMID: 38137927 PMCID: PMC10745044 DOI: 10.3390/life13122326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023] Open
Abstract
This study retrospectively analyzed the medical records of 602 patients with first-time positive results for the HCV nucleic acid test between 1 May 2021 and 31 March 2023, exploring the association between DAA treatment and SARS-CoV-2 infection. The results showed that 9.8% of HCV patients were co-infected with SARS-CoV-2. Gender, age, vaccination status, and HCV genotype did not significantly affect SARS-CoV-2 infection. However, patients undergoing DAA treatment showed significantly lower rates of SARS-CoV-2 infection and mortality compared to those not undergoing DAA treatment. The analysis also compared patients undergoing different DAA treatments, with Epclusa and Maviret showing superior protection against SARS-CoV-2. Furthermore, this study explored the severity and mortality of SARS-CoV-2 infection in patients undergoing and having completed DAA treatment. It revealed that patients diagnosed with COVID-19 during DAA treatment experienced only mild symptoms, and none died, suggesting a potential protective effect of DAA treatment against severe outcomes of SARS-CoV-2 infection. The findings contribute to the understanding of the interplay between HCV, DAA treatment, and SARS-CoV-2 infection, highlighting the need for continued monitoring and healthcare measures for individuals with chronic conditions during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Chin-Wen Hsu
- Department of Family Medicine, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - Wan-Wen Yang
- Department of Clinical Pathology, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - Chia-Yi Hou
- Department of Clinical Pathology, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - I-Jung Feng
- Institute of Precision Medicine, National Sun Yat-Sen University, Kaohsiung 804201, Taiwan
| | - Ting-Yi Huang
- Department of Hepato-Gastroenterology, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - Pei-Lun Lee
- Department of Hepato-Gastroenterology, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - How-Ran Guo
- Department of Environmental and Occupational Health, College of Medicine, National Cheng Kung University, Tainan 70428, Taiwan;
| | - Chien-Yuan Huang
- Division of Occupational Medicine, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
| | - Shih-Bin Su
- Division of Occupational Medicine, Chi-Mei Medical Center, Liouying, Tainan 736402, Taiwan
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Gal-Nădășan EG, Popescu IM, Bădițoiu LM, Gal-Nădășan N, Cioca F, Popovici ED, Dinu AR, Horhat FG, Margan MM, Vulcănescu DD, Anghel A, Marian C, Căpraru ID. Healthcare Workers' Vulnerability to SARS-CoV-2 in Western Romania: A Study on Incidence and Risk Factors for Non-Vaccination and Reinfection. Int J Gen Med 2023; 16:5621-5632. [PMID: 38045906 PMCID: PMC10693272 DOI: 10.2147/ijgm.s442098] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023] Open
Abstract
Purpose The COVID-19 pandemic has severely impacted healthcare workers, a professional category at risk of infection in both hospital and community settings. The aim of the study was to compare morbidity among hospital staff and that in general population, as well as the factors predicting non-vaccination and reinfection. Patients and Methods The present study is a retrospective, cross-sectional study. It was conducted by including all the confirmed COVID-19 infection cases in medical staff members during the period 01.01.2021-31.03.2022 that were reported to the Public Health Authority of Timis County, Timisoara, Western Romania. Results Direct, strong, statistically significant correlations were found between the incidence of COVID-19 recorded in all categories of medical personnel and the community pandemic trend, with maximum values for auxiliary and medium medical staff (rho = 0.852/0.821, p < 0.001). The high socio-economic level, as well as the advanced medical education level, were predictor factors for anti-SARS-COV-2 vaccination among the personnel. The non-vaccinated status as well as incomplete vaccination or even the 2-dose vaccination represented independent risk factors for reinfection in 2022. Conversely, receiving a higher number of vaccine doses emerged as the primary protective factor. Notably, reduced adherence to the administration of the following doses was observed particularly among medium and auxiliary staff, leading to additional risks of infection with the Omicron variant. Conclusion Despite over 70% vaccination coverage among all studied medical personnel categories, there was low adherence to repeat doses of vaccination, particularly among medium and auxiliary staff. The study highlighted a distinct necessity for enhanced training on preventive behaviours and targeted prevention/control strategies for all professional groups interacting with patients, including caretakers, ambulance workers, receptionists, physiotherapists, and psychologists.
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Affiliation(s)
| | - Irina-Maria Popescu
- Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Luminița Mirela Bădițoiu
- Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Multidisciplinary Research Center on Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Norbert Gal-Nădășan
- Department of Automation and Applied Informatics, Faculty of Automation and Computers, Politehnica University, Timişoara, Romania
| | - Flavius Cioca
- Department of Medical Informatics and Biostatistics, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Emilian Damian Popovici
- Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Anca-Raluca Dinu
- Department of Medical Recovery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Florin George Horhat
- Multidisciplinary Research Center on Antimicrobial Resistance, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Mădălin-Marius Margan
- Department of Functional Sciences, Discipline of Public Health, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Dan Dumitru Vulcănescu
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Andrei Anghel
- Department of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Cătălin Marian
- Department of Biochemistry, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
| | - Ionuț Dragoș Căpraru
- Department of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
- Public Health Authority of Timis County, Timisoara, Romania
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Cooper BS, Evans S, Jafari Y, Pham TM, Mo Y, Lim C, Pritchard MG, Pople D, Hall V, Stimson J, Eyre DW, Read JM, Donnelly CA, Horby P, Watson C, Funk S, Robotham JV, Knight GM. The burden and dynamics of hospital-acquired SARS-CoV-2 in England. Nature 2023; 623:132-138. [PMID: 37853126 PMCID: PMC10620085 DOI: 10.1038/s41586-023-06634-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 09/12/2023] [Indexed: 10/20/2023]
Abstract
Hospital-based transmission had a dominant role in Middle East respiratory syndrome coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus (SARS-CoV) epidemics1,2, but large-scale studies of its role in the SARS-CoV-2 pandemic are lacking. Such transmission risks spreading the virus to the most vulnerable individuals and can have wider-scale impacts through hospital-community interactions. Using data from acute hospitals in England, we quantify within-hospital transmission, evaluate likely pathways of spread and factors associated with heightened transmission risk, and explore the wider dynamical consequences. We estimate that between June 2020 and March 2021 between 95,000 and 167,000 inpatients acquired SARS-CoV-2 in hospitals (1% to 2% of all hospital admissions in this period). Analysis of time series data provided evidence that patients who themselves acquired SARS-CoV-2 infection in hospital were the main sources of transmission to other patients. Increased transmission to inpatients was associated with hospitals having fewer single rooms and lower heated volume per bed. Moreover, we show that reducing hospital transmission could substantially enhance the efficiency of punctuated lockdown measures in suppressing community transmission. These findings reveal the previously unrecognized scale of hospital transmission, have direct implications for targeting of hospital control measures and highlight the need to design hospitals better equipped to limit the transmission of future high-consequence pathogens.
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Affiliation(s)
- Ben S Cooper
- NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
| | - Stephanie Evans
- HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK
| | - Yalda Jafari
- Centre for Mathematical Modelling of Infectious Diseases, IDE, EPH, London School of Hygiene & Tropical Medicine, London, UK
| | - Thi Mui Pham
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Yin Mo
- NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Division of Infectious Disease, Department of Medicine, National University Hospital, Singapore, Singapore
- Department of Medicine, National University of Singapore, Singapore, Singapore
| | - Cherry Lim
- NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Mahidol-Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Mark G Pritchard
- NDM Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Diane Pople
- HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK
| | - Victoria Hall
- HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK
| | - James Stimson
- HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK
| | - David W Eyre
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with UKHSA, Oxford, UK
| | - Jonathan M Read
- Lancaster Medical School, Lancaster University, Lancaster, UK
| | - Christl A Donnelly
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Statistics, University of Oxford, Oxford, UK
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, Imperial College London, London, UK
| | - Peter Horby
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Conall Watson
- Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sebastian Funk
- Centre for Mathematical Modelling of Infectious Diseases, IDE, EPH, London School of Hygiene & Tropical Medicine, London, UK
| | - Julie V Robotham
- HCAI, Fungal, AMR, AMU and Sepsis Division, UK Health Security Agency, London, UK
- NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at University of Oxford in partnership with UKHSA, Oxford, UK
| | - Gwenan M Knight
- Centre for Mathematical Modelling of Infectious Diseases, IDE, EPH, London School of Hygiene & Tropical Medicine, London, UK
- AMR Centre, IDE, EPH, London School of Hygiene & Tropical Medicine, London, UK
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Nair N, Varghese BT, Hasan H, Toba N, Alsharif G, Panicker P, Celiloglu H, Balila M, Fakhri A, Lua E, Khamis AH, Ho SB. Tracking Risk Factors Related to an Outbreak of COVID-19 Among Healthcare Workers in a General Medicine Ward. Cureus 2023; 15:e48429. [PMID: 37954630 PMCID: PMC10637762 DOI: 10.7759/cureus.48429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2023] [Indexed: 11/14/2023] Open
Abstract
Background An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection occurred in a medical ward involving patients and hospital staff from May to June 2020. Aim The aim of this study is to determine risk factors related to the outbreak of SARS-CoV-2 in six healthcare workers (HCWs) in a medical ward with initially unrecognized coronavirus disease 2019 (COVID-19) positive patients. Methods A retrospective cross-sectional study was conducted using a comprehensive questionnaire and personal interviews to determine the risk factors for COVID-19 infection in HCWs. Findings A total of 6/34 HCWs were diagnosed with COVID-19 in a medical ward. There were no differences between COVID-19 negative HCWs and COVID-19 positive HCWs in terms of mean duration of hours worked in the unit during the cluster event (180.2 vs 177.5 hours) (p>0.05), mean total time spent in contact with COVID-19 positive patients (12.8 vs 10.5 hours) (p>0.05), mean total time spent on aerosol-generating procedures (1.9 vs 0.9 hours) (p>0.05), and mean total time spent on non-aerosol generating procedures (10.9 vs 9.6 hours ) (p>0.05). There was no difference in exposure to COVID-19 positive family members among the HCWs (33% vs 3.7%, p=0.08). In contrast, exposure to COVID-19 positive contacts in the community was significantly greater in infected vs non-infected HCWs (16.7% vs 0%, p=0.03). Conclusion There was no significant difference in risk factors for contracting SARs-CoV2 among HCWs due to hospital exposures. COVID-19 positive HCWs were more likely to be exposed to positive individuals in their households and community, indicating that the source of SARS-CoV-2 infection came from outside the hospital.
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Affiliation(s)
- Niranjana Nair
- Department of Medicine, Infection Control, and Quality Improvement, Mediclinic City Hospital, Dubai, ARE
| | - Ben Thomas Varghese
- Department of Internal Medicine, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
| | - Hemica Hasan
- Department of Internal Medicine, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
| | - Nagham Toba
- Department of Emergency Medicine, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
| | - Ghadah Alsharif
- Department of Pediatrics, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
| | - Poonam Panicker
- Department of Medicine, Infection Control, and Quality Improvement, Mediclinic City Hospital, Dubai, ARE
| | - Handan Celiloglu
- Department of Medicine, Infection Control, and Quality Improvement, Mediclinic City Hospital, Dubai, ARE
| | - Maida Balila
- Department of Medicine, Infection Control, and Quality Improvement, Mediclinic City Hospital, Dubai, ARE
| | - Ajaz Fakhri
- Department of Medicine, Infection Control, and Quality Improvement, Mediclinic City Hospital, Dubai, ARE
| | - Emily Lua
- Department of Medicine, Infection Control, and Quality Improvement, Mediclinic City Hospital, Dubai, ARE
| | - Amar H Khamis
- Department of Epidemiology and Public Health, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
| | - Samuel B Ho
- Department of Internal Medicine, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE
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9
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Yasin JCM, Barlem ELD, da Silveira RS, Ruivo ÉDG, Longaray AA, Brehmer LCF. Ethical issues experienced by nurses during COVID-19 in university hospitals. Rev Esc Enferm USP 2023; 57:e20230117. [PMID: 37882697 PMCID: PMC10601890 DOI: 10.1590/1980-220x-reeusp-2023-0117en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/01/2023] [Indexed: 10/27/2023] Open
Abstract
OBJECTIVE To identify the ethical issues experienced by nurses in the care for patients with COVID-19 and the factors that influence their occurrence. METHOD This is a cross-sectional, quantitative study, carried out between February and May 2022 with 101 nurses from two university hospitals, through the socio-occupational Ethical issues Experienced by Nurses in Emergency Questionnaire, adapted and validated for Brazilians. Descriptive statistical analysis, Pearson's correlation test and linear regression were performed, adopting p-value. RESULTS Ethical issues related to concern and stress in caring for infected patients were evidenced, being influenced by perception of social stigmatization (p = .003) and perception of hospital measures (p = .000). Agreement with infection control measures (4.46) and perception of hospital measures against COVID-19 (3.26) were factors with the highest mean between the constructs. CONCLUSION Nurses are faced with ethical issues in the face of concern and stress in caring for patients with COVID-19, who are affected by social issues and assistance. It is essential to support them, promoting their mental and social well-being to deal with new emergency situations.
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10
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Hare D, Dembicka KM, Brennan C, Campbell C, Sutton-Fitzpatrick U, Stapleton PJ, De Gascun CF, Dunne CP. Whole-genome sequencing to investigate transmission of SARS-CoV-2 in the acute healthcare setting: a systematic review. J Hosp Infect 2023; 140:139-155. [PMID: 37562592 DOI: 10.1016/j.jhin.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/03/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND Whole-genome sequencing (WGS) has been used widely to elucidate transmission of SARS-CoV-2 in acute healthcare settings, and to guide infection, prevention, and control (IPC) responses. AIM To systematically appraise available literature, published between January 1st, 2020 and June 30th, 2022, describing the implementation of WGS in acute healthcare settings to characterize nosocomial SARS-CoV-2 transmission. METHODS Searches of the PubMed, Embase, Ovid MEDLINE, EBSCO MEDLINE, and Cochrane Library databases identified studies in English reporting the use of WGS to investigate SARS-CoV-2 transmission in acute healthcare environments. Publications involved data collected up to December 31st, 2021, and findings were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. FINDINGS In all, 3088 non-duplicate records were retrieved; 97 met inclusion criteria, involving 62 outbreak analyses and 35 genomic surveillance studies. No publications from low-income countries were identified. In 87/97 (90%), WGS supported hypotheses for nosocomial transmission, while in 46 out of 97 (47%) suspected transmission events were excluded. An IPC intervention was attributed to the use of WGS in 18 out of 97 (18%); however, only three (3%) studies reported turnaround times ≤7 days facilitating near real-time IPC action, and none reported an impact on the incidence of nosocomial COVID-19 attributable to WGS. CONCLUSION WGS can elucidate transmission of SARS-CoV-2 in acute healthcare settings to enhance epidemiological investigations. However, evidence was not identified to support sequencing as an intervention to reduce the incidence of SARS-CoV-2 in hospital or to alter the trajectory of active outbreaks.
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Affiliation(s)
- D Hare
- UCD National Virus Reference Laboratory, University College Dublin, Ireland; School of Medicine, University of Limerick, Limerick, Ireland.
| | - K M Dembicka
- School of Medicine, University of Limerick, Limerick, Ireland
| | - C Brennan
- UCD National Virus Reference Laboratory, University College Dublin, Ireland
| | - C Campbell
- UCD National Virus Reference Laboratory, University College Dublin, Ireland
| | | | | | - C F De Gascun
- UCD National Virus Reference Laboratory, University College Dublin, Ireland
| | - C P Dunne
- School of Medicine, University of Limerick, Limerick, Ireland; Centre for Interventions in Infection, Inflammation & Immunity (4i), University of Limerick, Limerick, Ireland
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11
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Worp N, Subissi L, Perkins MD, Van Kerkhove MD, Agrawal A, Chand M, van Beek J, Oude Munnink BB, Koopmans MPG. Towards the development of a SARS-CoV-2 variant risk assessment tool: expert consultation on the assessment of scientific evidence on emerging variants. THE LANCET. MICROBE 2023; 4:e830-e836. [PMID: 37640039 DOI: 10.1016/s2666-5247(23)00179-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/26/2023] [Accepted: 06/05/2023] [Indexed: 08/31/2023]
Abstract
A systematic approach is required for the development of an evidence-based risk assessment tool to robustly estimate the risks and implications of SARS-CoV-2 variants. We conducted a survey among experts involved in technical advisory roles for WHO to capture their assessment of the robustness of different study types that provide evidence for potential changes in transmissibility, antigenicity, virulence, treatability, and detectability of SARS-CoV-2 variants. The views of 62 experts indicated that studies could be grouped on the basis of robustness and reliability for the different risk indicators mentioned. Several study types that experts scored as providing reliable evidence and that can be performed in a timely manner were identified. Although experts from different technical areas had varying responses, there was agreement on the highest and lowest scoring study types. These findings can help to prioritise, harmonise, and optimise study designs for the further development of a systematic, evidence-based, SARS-CoV-2 variant risk assessment tool.
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Affiliation(s)
- Nathalie Worp
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | | | | | - Anurag Agrawal
- Trivedi School of Biosciences, Ashoka University, Sonipat, India
| | | | - Janko van Beek
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Bas B Oude Munnink
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands.
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12
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Czorniej KP, Krajewska-Kułak E, Kułak W. Anxiety and Health Concerns among Healthcare Personnel Working with COVID-19 Patients: A Self-Assessment Study. Med Sci Monit 2023; 29:e940766. [PMID: 37742068 PMCID: PMC10537305 DOI: 10.12659/msm.940766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 07/28/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND Anxiety disorders are currently among the most common psychiatric diagnoses. This study aimed to analyze self-assessment of anxiety disorders, depression, and quality of life among healthcare personnel working during the COVID-19 pandemic, with a focus on sociodemographic sources and psychological indicators. MATERIAL AND METHODS The study covered a group of 318 healthcare professionals from Poland. The study used a self-created questionnaire, Beck Depression Inventory, WHOQOL-BREF, Generalised Anxiety Disorder Questionnaire (GAD-7), and Leibowitz Social Anxiety Scale. RESULTS In the study group, 71.1% of the respondents had coronavirus infection, and only 3.5% were not vaccinated. Almost half (45.6%) of the respondents in this group made independent decisions about performing work (45.6%), and 93.4% were satisfied with their work. Less than half of respondents (46.5%) felt work-related anxiety during the pandemic, 54.7% of respondents reported symptoms of depression, and 57% had a good quality of life. Nearly half (47.2%) of the respondents rated their health as good, but 53.1% feared deterioration after performing the aforementioned work, while 87.1% constantly or periodically felt anxious about their work. CONCLUSIONS Although the respondents usually made their own decisions about working with coronavirus-infected patients, most of them experienced anxiety related to their work during the pandemic and were afraid of damaging their health and contracting COVID-19. In self-assessment using standardized questionnaires, most respondents did not show an increase in generalized or social anxiety, but to a greater or lesser extent were diagnosed with a depressive episode. The majority of respondents had a good quality of life: the highest aspect regarded physical functioning and the lowest regarded social functioning.
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Affiliation(s)
- Klaudia Paula Czorniej
- Department of Pediatric Rehabilitation, Medical University of Białystok, Białystok, Poland
| | | | - Wojciech Kułak
- Department of Pediatric Rehabilitation, Medical University of Białystok, Białystok, Poland
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13
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Yang J, Sun D, Xia T, Shi S, Suo J, Kuang H, Sun N, Hu H, Zheng Z, Zhou Y, Li X, Chen S, Huang H, Yan Z. Monitoring Prevalence and Persistence of Environmental Contamination by SARS-CoV-2 RNA in a Makeshift Hospital for Asymptomatic and Very Mild COVID-19 Patients. Int J Public Health 2023; 68:1605994. [PMID: 37767017 PMCID: PMC10520216 DOI: 10.3389/ijph.2023.1605994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Objective: To investigate the details of environmental contamination status by SARS-CoV-2 in a makeshift COVID-19 hospital. Methods: Environmental samples were collected from a makeshift hospital. The extent of contamination was assessed by quantitative reverse transcription polymerase chain reaction (RT-qPCR) for SARS-CoV-2 RNA from various samples. Results: There was a wide range of total collected samples contaminated with SARS-CoV-2 RNA, ranging from 8.47% to 100%. Results revealed that 70.00% of sewage from the bathroom and 48.19% of air samples were positive. The highest rate of contamination was found from the no-touch surfaces (73.07%) and the lowest from frequently touched surfaces (33.40%). The most contaminated objects were the top surfaces of patient cubic partitions (100%). The median Ct values among strongly positive samples were 33.38 (IQR, 31.69-35.07) and 33.24 (IQR, 31.33-34.34) for ORF1ab and N genes, respectively. SARS-CoV-2 relic RNA can be detected on indoor surfaces for up to 20 days. Conclusion: The findings show a higher prevalence and persistence in detecting the presence of SARS-CoV-2 in the makeshift COVID-19 hospital setting. The contamination mode of droplet deposition may be more common than contaminated touches.
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Affiliation(s)
- Jinyan Yang
- Department of Disease Prevention and Control, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Dan Sun
- Department of Disease Prevention and Control, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Tingting Xia
- Department of Disease Prevention and Control, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Shi Shi
- Department of Disease Prevention and Control, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Jijiang Suo
- Department of Disease Prevention and Control, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Huihui Kuang
- Department of Laboratory Medicine, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Nana Sun
- Department of Laboratory Medicine, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Hongyan Hu
- Department of Laboratory Medicine, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Zhecheng Zheng
- Department of Health Economics Management, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Yang Zhou
- Department of Health Economics Management, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Xiaocui Li
- Department of Cardiology, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Shaojuan Chen
- Department of Cardiology, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Haiqiang Huang
- Department of Radiotherapy, Hainan Hospital of People’s Liberation Army of China General Hospital, Sanya, China
| | - Zhongqiang Yan
- Department of Disease Prevention and Control, The Second Medical Center of People’s Liberation Army of China General Hospital, Beijing, China
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14
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Zhou Y, Huang Y, Wu C, Yang H, Shan C, Zhou Z. Epidemiological and Clinical Characteristics of COVID-19 Outbreak in a Mental Hospital in Wenzhou, China, December 2022-January 2023. Infect Drug Resist 2023; 16:5719-5728. [PMID: 37667807 PMCID: PMC10475278 DOI: 10.2147/idr.s416565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 08/10/2023] [Indexed: 09/06/2023] Open
Abstract
Background Coronavirus disease (COVID-19) mainly caused by the Omicron virus strain currently is still prevalent worldwide, and many medical institutions have experienced COVID-19 outbreaks in the past three years. Objective This article reported COVID-19 outbreak among health care workers in a mental hospital to clarify the epidemiological and clinical characteristics of COVID-19 outbreak in a medical institution, to assess the susceptible factors related to COVID-19 among these personnel and to evaluate the effect of COVID-19 vaccine on the medical workers. Methods A uniform questionnaire was used to investigate all employees, including age, gender, department, time of onset, clinical symptoms, vaccination status. At the same, the results of laboratory testing, chest computed tomography (CT) and/or X-ray examination were collected. Results Among 1047 hospital employees, 842 cases were diagnosed as COVID-19, with a total attack rate of 80.42%. The attack rate of doctors, nurses, medical technicians, and administrators (83.50-90.67%) was higher than that of logistics departments (56.81%). Out of the 842 patients, 9 were hospitalized; 833 were non-hospitalized patients who belong to mild or moderate cases. No deaths were reported. The full vaccination rate and booster rate of COVID-19 vaccine were 78.26% and 80.87%, respectively. There was no significant correlation between the attack rate and COVID-19 vaccine (χ2 = 3.41 P > 0.05). Conclusion This is an outbreak of COVID-19 with a high attack rate among employees in a mental hospital. The attack rate of medical personnel is higher than that of logistics personnel, which may be related to opportunities and duration of contact with infected individuals. COVID-19 vaccine has no significant protective effect on patients with mild or moderate symptoms 13 months after the full vaccination. It is suggested that they should be timely boostered with COVID-19 vaccine to maintain their immunity to the disease.
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Affiliation(s)
- Yiwei Zhou
- Business School, University of Shanghai for Science and Technology, Shanghai, People’s Republic of China
| | - Yu Huang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
| | - Chunhua Wu
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
| | - Hongsheng Yang
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
| | - Chunyan Shan
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
| | - Zumu Zhou
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorders, Wenzhou, People’s Republic of China
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15
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Tsang KK, Ahmad S, Aljarbou A, Al Salem M, Baker SJC, Panousis EM, Derakhshani H, Rossi L, Nasir JA, Bulir DC, Surette MG, Lee RS, Smaill F, Mertz D, McArthur AG, Khan S. SARS-CoV-2 Outbreak Investigation Using Contact Tracing and Whole-Genome Sequencing in an Ontario Tertiary Care Hospital. Microbiol Spectr 2023; 11:e0190022. [PMID: 37093060 PMCID: PMC10269621 DOI: 10.1128/spectrum.01900-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 04/04/2023] [Indexed: 04/25/2023] Open
Abstract
Genomic epidemiology can facilitate an understanding of evolutionary history and transmission dynamics of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak. We used next-generation sequencing techniques to study SARS-CoV-2 genomes isolated from patients and health care workers (HCWs) across five wards of a Canadian hospital with an ongoing SARS-CoV-2 outbreak. Using traditional contact tracing methods, we show transmission events between patients and HCWs, which were also supported by the SARS-CoV-2 lineage assignments. The outbreak predominantly involved SARS-CoV-2 B.1.564.1 across all five wards, but we also show evidence of community introductions of lineages B.1, B.1.1.32, and B.1.231, falsely assumed to be outbreak related. Altogether, our study exemplifies the value of using contact tracing in combination with genomic epidemiology to understand the transmission dynamics and genetic underpinnings of a SARS-CoV-2 outbreak. IMPORTANCE Our manuscript describes a SARS-CoV-2 outbreak investigation in an Ontario tertiary care hospital. We use traditional contract tracing paired with whole-genome sequencing to facilitate an understanding of the evolutionary history and transmission dynamics of this SARS-CoV-2 outbreak in a clinical setting. These advancements have enabled the incorporation of phylogenetics and genomic epidemiology into the understanding of clinical outbreaks. We show that genomic epidemiology can help to explore the genetic evolution of a pathogen in real time, enabling the identification of the index case and helping understand its transmission dynamics to develop better strategies to prevent future spread of SARS-CoV-2 in congregate, clinical settings such as hospitals.
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Affiliation(s)
- Kara K. Tsang
- Department of Infection Biology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Shehryar Ahmad
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Alanoud Aljarbou
- Department of Pediatrics, College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Mohammed Al Salem
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Sheridan J. C. Baker
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Emily M. Panousis
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Hooman Derakhshani
- Department of Animal Science, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Laura Rossi
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jalees A. Nasir
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - David C. Bulir
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Michael G. Surette
- Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Robyn S. Lee
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Fiona Smaill
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Dominik Mertz
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Andrew G. McArthur
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sarah Khan
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
- Michael G. DeGroote Institute for Infectious Disease Research, McMaster University, Hamilton, Ontario, Canada
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16
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Nyamuryekung'e KK, Amour M, Mboya I, Ndumwa H, Kengia J, Njiro BJ, Mhamilawa L, Shayo E, Ngalesoni F, Kapologwe N, Kalolo A, Metta E, Msuya S. Health care workers' self-perceived infection risk and COVID-19 vaccine uptake: A mixed methods study. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001223. [PMID: 37285332 DOI: 10.1371/journal.pgph.0001223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 05/06/2023] [Indexed: 06/09/2023]
Abstract
Vaccination is the most cost-effective way of preventing Coronavirus Disease 2019 (COVID-19) although there was a considerable delay in its institution in Tanzania. This study assessed health care workers' (HCWs) self-perceived infection risk and uptake of COVID-19 vaccines. A concurrent embedded, mixed methods design was utilized to collect data among HCWs in seven Tanzanian regions. Quantitative data was collected using a validated, pre-piloted, interviewer administered questionnaire whereas in-depth interviews (IDIs) and focus group discussions (FGDs) gathered qualitative data. Descriptive analyses were performed while chi-square test and logistic regression were used to test for associations across categories. Thematic analysis was used to analyze the qualitative data. A total of 1,368 HCWs responded to the quantitative tool, 26 participated in the IDIs and 74 in FGDs. About half of the HCW (53.6%) reported to have been vaccinated and three quarters (75.5%) self-perceived to be at a high risk of acquiring COVID-19 infection. High perceived infection risk was associated with increased COVID-19 vaccine uptake (OR 1.535). Participants perceived that the nature of their work and the working environment in the health facilities increased their infection risk. Limited availability and use of personal protective equipment (PPE) was reported to elevate the perceived infection risks. Participants in the oldest age group and from low and mid-level health care facilities had higher proportions with a high-risk perception of acquiring COVID-19 infection. Only about half of the HCWs reported to be vaccinated albeit the majority recounted higher perception of risk to contracting COVID-19 due to their working environment, including limited availability and use of PPE. Efforts to address heightened perceived-risks should include improving the working environment, availability of PPE and continue updating HCWs on the benefits of COVID-19 vaccine to limit their infection risks and consequent transmission to their patients and public.
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Affiliation(s)
- Kasusu Klint Nyamuryekung'e
- Department of Community Dentistry, School of Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Maryam Amour
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Innocent Mboya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Harrieth Ndumwa
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - James Kengia
- Presidents Office Regional Administration and Local Government, Dodoma, Tanzania
| | - Belinda J Njiro
- Department of Community Health, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lwidiko Mhamilawa
- Department of Parasitology and Medical Entomology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
- Department of Women's and Children's Health, International Maternal and Child Health (IMCH), Uppsala University, Uppsala, Sweden
| | - Elizabeth Shayo
- National Institute for Medical Research, Dar es Salaam, Tanzania
| | | | - Ntuli Kapologwe
- Presidents Office Regional Administration and Local Government, Dodoma, Tanzania
| | - Albino Kalolo
- Department of Public Health, St. Francis University College of Health and Allied Sciences, Morogoro, Tanzania
| | - Emmy Metta
- Department of Behavioral Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Sia Msuya
- Department of Epidemiology and Biostatistics, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Community Health Department, Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
- Department of Community Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
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17
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Wu M, Zhang Y, Markley M, Cassidy C, Newman N, Porter A. COVID-19 knowledge deconstruction and retrieval: an intelligent bibliometric solution. Scientometrics 2023:1-31. [PMID: 37360228 PMCID: PMC10230150 DOI: 10.1007/s11192-023-04747-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 05/16/2023] [Indexed: 06/28/2023]
Abstract
COVID-19 has been an unprecedented challenge that disruptively reshaped societies and brought a massive amount of novel knowledge to the scientific community. However, as this knowledge flood continues surging, researchers have been disadvantaged by not having access to a platform that can quickly synthesize emerging information and link the new knowledge to the latent knowledge foundation. Aiming to fill this gap, we propose a research framework and develop a dashboard that can assist scientists in identifying, retrieving, and understanding COVID-19 knowledge from the ocean of scholarly articles. Incorporating principal component decomposition (PCD), a knowledge mode-based search approach, and hierarchical topic tree (HTT) analysis, the proposed framework profiles the COVID-19 research landscape, retrieves topic-specific latent knowledge foundation, and visualizes knowledge structures. The regularly updated dashboard presents our research results. Addressing 127,971 COVID-19 research papers from PubMed, the PCD topic analysis identifies 35 research hotspots, along with their inner correlations and fluctuating trends. The HTT result segments the global knowledge landscape of COVID-19 into clinical and public health branches and reveals the deeper exploration of those studies. To supplement this analysis, we additionally built a knowledge model from research papers on the topic of vaccination and fetched 92,286 pre-Covid publications as the latent knowledge foundation for reference. The HTT analysis results on the retrieved papers show multiple relevant biomedical disciplines and four future research topics: monoclonal antibody treatments, vaccinations in diabetic patients, vaccine immunity effectiveness and durability, and vaccination-related allergic sensitization.
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Affiliation(s)
- Mengjia Wu
- Australian Artificial Intelligence Institute, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, Australia
| | - Yi Zhang
- Australian Artificial Intelligence Institute, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, Australia
| | | | | | | | - Alan Porter
- Search Technology, Inc., Norcross, USA
- Science, Technology & Innovation Policy, Georgia Institute of Technology, Atlanta, USA
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18
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Haanappel CP, Oude Munnink BB, Sikkema RS, Voor In 't Holt AF, de Jager H, de Boever R, Koene HHHT, Boter M, Chestakova IV, van der Linden A, Molenkamp R, Osbak KK, Arcilla MS, Vos MC, Koopmans MPG, Severin JA. Combining epidemiological data and whole genome sequencing to understand SARS-CoV-2 transmission dynamics in a large tertiary care hospital during the first COVID-19 wave in The Netherlands focusing on healthcare workers. Antimicrob Resist Infect Control 2023; 12:46. [PMID: 37165456 PMCID: PMC10170429 DOI: 10.1186/s13756-023-01247-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/29/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Healthcare facilities have been challenged by the risk of SARS-CoV-2 transmission between healthcare workers (HCW) and patients. During the first wave of the COVID-19 pandemic, infections among HCW were observed, questioning infection prevention and control (IPC) measures implemented at that time. AIM This study aimed to identify nosocomial transmission routes of SARS-CoV-2 between HCW and patients in a tertiary care hospital. METHODS All SARS-CoV-2 PCR positive HCW and patients identified between 1 March and 19 May 2020, were included in the analysis. Epidemiological data were collected from patient files and HCW contact tracing interviews. Whole genome sequences of SARS-CoV-2 were generated using Nanopore sequencing (WGS). Epidemiological clusters were identified, whereafter WGS and epidemiological data were combined for re-evaluation of epidemiological clusters and identification of potential transmission clusters. HCW infections were further classified into categories based on the likelihood that the infection was acquired via nosocomial transmission. Secondary cases were defined as COVID-19 cases in our hospital, part of a transmission cluster, of which the index case was either a patient or HCW from our hospital. FINDINGS The study population consisted of 293 HCW and 245 patients. Epidemiological data revealed 36 potential epidemiological clusters, with an estimated 222 (75.7%) HCW as secondary cases. WGS results were available for 195 HCW (88.2%) and 20 patients (12.8%) who belonged to an epidemiological cluster. Re-evaluation of the epidemiological clusters, with the available WGS data identified 31 transmission clusters with 65 (29.4%) HCW as secondary cases. Transmission clusters were all part of 18 (50.0%) previously determined epidemiological clusters, demonstrating that several larger outbreaks actually consisted, of several smaller transmission clusters. A total of 21 (7.2%) HCW infections were classified as from confirmed nosocomial, of which 18 were acquired from another HCW and 3 from a patient. CONCLUSION The majority of SARS-CoV-2 infections among HCW could be attributed to community-acquired infection. Infections among HCW that could be classified as due to nosocomial transmission, were mainly caused by HCW-to-HCW transmission rather than patient-to-HCW transmission. It is important to recognize the uncertainties of cluster analyses based solely on epidemiological data.
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Affiliation(s)
- Cynthia P Haanappel
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Bas B Oude Munnink
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Reina S Sikkema
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne F Voor In 't Holt
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Herbert de Jager
- Department of Occupational Health Services, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Rieneke de Boever
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Heidy H H T Koene
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Marjan Boter
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Irina V Chestakova
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Anne van der Linden
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Richard Molenkamp
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Kara K Osbak
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Maris S Arcilla
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Margreet C Vos
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Juliëtte A Severin
- Department of Medical Microbiology and Infectious Diseases, Erasmus MC University Medical Center Rotterdam, 3000 CA, Rotterdam, The Netherlands.
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19
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Izadi N, Najafi A, Sadeghniiat-Haghighi K, Mohammadi H. Characterization of Long COVID and Its Contributing Factors among a Population of Health Care Workers in a 6-Month Follow-up. Med J Islam Repub Iran 2023; 37:29. [PMID: 37180854 PMCID: PMC10167639 DOI: 10.47176/mjiri.37.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Indexed: 05/16/2023] Open
Abstract
Background Health care workers (HCWs) are at the frontline of the fight against the coronavirus disease 2019 (COVID-19). Long COVID is defined as "the persistence of some symptoms of COVID-19, more than 4 weeks after the initial infection." The aim of the present study was to investigate the prevalence of long COVID status among HCWs in the largest hospital complex of Iran. Methods In this cross-sectional study, all patients with COVID-19 who had taken sick leave were included in the study (n = 445). Data regarding sick leave characteristics were collected from the records of the nursing management department of the hospital. Study variables included demographic and occupational information, variables related to mental health assessment, organ systems involved in COVID-19, and duration of symptoms. Frequencies, percentage distributions, means, standard deviation, and range (minimum, maximum) were used as descriptive analysis methods. Associations between symptoms' persistency and clinical characteristics were assessed by logistic and linear regressions. Results Age, N95 mask use, and respiratory protection significantly contributed to the persistence of COVID-19 symptoms (P < 0.05). The prevalence of long COVID among HCWs was 9.44% among 445 participants. The loss of taste persisted longer than the other symptoms before returning to normal. Among the postrecovery complications asked, anxiety was the most common persistent mental symptom (58.5%), followed by gloomy mood (46.3%) and low interest (46.2%), respectively. Conclusion HCWs with COVID-19 symptoms had prolonged symptoms of COVID-19 that can affect their work performance, thus, we recommend evaluating COVID-19 symptoms in HCWs with infection history.
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Affiliation(s)
- Nazanin Izadi
- Center for Research on Occupational Disease, Tehran University of Medical
Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of
Medical Sciences, Tehran, Iran
| | | | - Hosein Mohammadi
- Department of Occupational Medicine, Faculty of Medicine, Tehran University of
Medical Sciences, Tehran, Iran
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20
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Park SY, Cheong HS, Kwon KT, Sohn KM, Heo ST, Lee S, Chung US, Lee SH. Guidelines for Infection Control and Burnout Prevention in Healthcare Workers Responding to COVID-19. Infect Chemother 2023; 55:150-165. [PMID: 37021430 PMCID: PMC10079438 DOI: 10.3947/ic.2022.0164] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/27/2023] [Indexed: 03/30/2023] Open
Abstract
During the coronavirus disease 2019 (COVID-19) pandemic, frontline healthcare workers (HCWs) suffered more distress from the possibility of contracting the virus, quarantine, social stigma, and prejudice against their families. Many studies have investigated the impact of the pandemic on HCWs; however, studies or guidelines presenting strategies to overcome these challenges are lacking. As part of a 2020 research project supported by the Ministry of Health and Welfare, titled "Health impact assessment of healthcare workers undertaking coronavirus disease 2019 treatment and management in Korea: Identifying problems and researching effective solutions" (HC20C0003), we created guidelines to respond to serious problems posed by infection control. and burnout among HCWs during COVID-19 response measures throughout the extended pandemic period. We formulated the guidelines by means of a systematic review and collated them with the latest literature. The guidelines will highlight the gravity and impact of infection control and burnout among HCWs responding to COVID-19 and include potential prevention strategies, and they can be used as a reference in the event of another emerging infectious disease outbreak in the future.
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Affiliation(s)
- Se Yoon Park
- Department of Hospital Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, Korea
- Centers for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
| | - Hae Suk Cheong
- Division of Infectious Diseases, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea
| | - Ki Tae Kwon
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Chilgok Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
| | - Kyung Mok Sohn
- Division of Infectious Diseases, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sang Taek Heo
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Shinwon Lee
- Department of Internal Medicine, Pusan National University School of Medicine and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Un Sun Chung
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea
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21
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Li Y, Yamamoto S, Oshiro Y, Inamura N, Nemoto T, Horii K, Takeuchi JS, Mizoue T, Konishi M, Ozeki M, Sugiyama H, Sugiura W, Ohmagari N. Comparison of risk factors for SARS-CoV-2 infection among healthcare workers during Omicron and Delta dominance periods in Japan. J Hosp Infect 2023; 134:97-107. [PMID: 36805085 PMCID: PMC9933573 DOI: 10.1016/j.jhin.2023.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/18/2023] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND The risk factors for coronavirus disease (COVID-19) among healthcare workers (HCWs) might have changed since the emergence of the highly immune evasive Omicron variant. AIM To compare the risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among HCWs during the Delta- and Omicron-predominant periods. METHODS Using data from repeated serosurveys among the staff of a medical research centre in Tokyo, two cohorts were established: Delta period cohort (N = 858) and Omicron period cohort (N = 652). The potential risk factors were assessed using a questionnaire. Acute/current or past SARS-CoV-2 infection was identified by polymerase chain reaction or anti-nucleocapsid antibody tests, respectively. Poisson regression was used to calculate the risk ratio (RR) of infection risk. FINDINGS The risk of SARS-CoV-2 infection during the early Omicron-predominant period was 3.4-fold higher than during the Delta-predominant period. Neither working in a COVID-19-related department nor having a higher degree of occupational exposure to SARS-CoV-2 was associated with an increased infection risk during both periods. During the Omicron-predominant period, infection risk was higher among those who spent ≥30 min in closed spaces, crowded spaces, and close-contact settings without wearing mask (≥3 times versus never: RR: 6.62; 95% confidence interval: 3.01-14.58), whereas no such association was found during the Delta period. CONCLUSION Occupational exposure to COVID-19-related work was not associated with the risk of SARS-CoV-2 infection in the Delta or Omicron period, whereas high-risk behaviours were associated with an increased infection risk during the Omicron period.
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Affiliation(s)
- Y Li
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - S Yamamoto
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Y Oshiro
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - N Inamura
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - T Nemoto
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - K Horii
- Infection Control Office, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - J S Takeuchi
- Department Academic-Industrial Partnerships Promotion, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan.
| | - M Konishi
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Ozeki
- Department of Laboratory Testing, Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - H Sugiyama
- Center Hospital of the National Center for Global Health and Medicine, Tokyo, Japan
| | - W Sugiura
- Center for Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - N Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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22
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Christ A, Staud CJ, Wielscher M, Resch A, Teufelsbauer M, Radtke C. Impact of the COVID-19 pandemic on the epidemiology of severe burns : A single center study from a specialized burn center in Vienna. Wien Klin Wochenschr 2023; 135:244-250. [PMID: 36757443 PMCID: PMC9909650 DOI: 10.1007/s00508-022-02149-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 12/27/2022] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Currently, very little detailed information on the epidemiological distribution and specificities of severely burned patients during the coronavirus disease 2019 (COVID-19) pandemic is available. This retrospective study aims to describe and compare this specific patient population based on 114 patients who were treated between March 2019 and March 2021 at the Center for Severe Burn Injuries at the Medical University of Vienna. METHODS To answer the research questions, a retrospective cohort study has been conducted over a period of 24 months, starting in March 2019 and ending in March 2021. To evaluate the epidemiological differences, the patients were divided into 2 observation periods of 12 months each. RESULTS In the period from 12 March 2020 to 11 March 2021, a total of 62 patients were admitted to the Center for Severe Burn Injuries. In comparison, only 52 patients were admitted in the same period of the previous year, which corresponds to an increase of 19.2%. In addition, it was noted that during the 2019-2020 observation period, 27% of patients were female and 73% male, whereas during the pandemic the gender distribution was 42% female and only 58% male. During the pre-pandemic observational period, 13 out of 52 patients admitted died (25%), whereas during the pandemic, 17 out of 62 patients succumbed to their injuries (27%). CONCLUSION Although the severity of the COVID-19 pandemic seems to be decreasing, especially due to the increasing availability of vaccines, there is a need for more data on the impact of the crisis on severely burned patients. In contrast to the current literature, we have seen a greater number of inpatient admissions to the Center for Severe Burn Injuries, as well as significant differences in gender distribution. Our data also suggest that the circumstances of the pandemic have no influence on the likelihood of survival for patients with severe burns.
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Affiliation(s)
- Alexandra Christ
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Clement J Staud
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Matthias Wielscher
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - Annika Resch
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Maryana Teufelsbauer
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Christine Radtke
- Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
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23
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Bastuji-Garin S, Brouard L, Bourgeon-Ghittori I, Zebachi S, Boutin E, Hemery F, Fourreau F, Oubaya N, De Roux Q, Mongardon N, Fourati S, Decousser JW. The Relative Contributions of Occupational and Community Risk Factors for COVID-19 among Hospital Workers: The HOP-COVID Cohort Study. J Clin Med 2023; 12:jcm12031208. [PMID: 36769854 PMCID: PMC9917902 DOI: 10.3390/jcm12031208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/27/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
The relative contributions of occupational and community sources of COVID-19 among health-care workers (HCWs) are still subject to debate. In a cohort study at a 2814-bed tertiary medical center (five hospitals) in the Paris area of France, we assessed the proportion of hospital-acquired cases among staff and identified risk factors. Between May 2020 and June 2021, HCWs were invited to complete a questionnaire on their COVID-19 risk factors. RT-PCR and serology test results were retrieved from the virology department. Mixed-effects logistic regression was used to account for clustering by hospital. The prevalence of COVID-19 was 15.6% (n = 213/1369 respondents) overall, 29.7% in the geriatric hospitals, and 56.8% of the infections were hospital-acquired. On multivariable analyses adjusted for COVID-19 incidence and contact in the community, a significantly higher risk was identified for staff providing patient care (especially nursing assistants), staff from radiology/functional assessment units and stretcher services, and staff working on wards with COVID-19 clusters among patients or HCWs. The likelihood of infection was greater in geriatric wards than in intensive care units. The presence of significant occupational risk factors after adjustment for community exposure is suggestive of a high in-hospital risk and emphasizes the need for stronger preventive measures-especially in geriatric settings. Clinicaltrials.gov NCT04386759.
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Affiliation(s)
- Sylvie Bastuji-Garin
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- Department of Public Health, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
- Correspondence: (S.B.-G.); (J.-W.D.)
| | - Ludivine Brouard
- Clinical Research Unit (URC Mondor), Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Irma Bourgeon-Ghittori
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- CARMAS, University Paris Est Creteil, 94010 Créteil, France
- DMU SAPHIRE, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Sonia Zebachi
- Clinical Research Unit (URC Mondor), Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Emmanuelle Boutin
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- Clinical Research Unit (URC Mondor), Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Francois Hemery
- Département d’Information Médicale, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Frédéric Fourreau
- Equipe Opérationnelle d’Hygiène, Département Prévention, Diagnostic, Traitement des Infections, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Nadia Oubaya
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- Department of Public Health, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Quentin De Roux
- Service D’Anesthésie-Réanimation Chirurgicale, DMU CARE, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Nicolas Mongardon
- IMRB, INSERM, University Paris Est Creteil, 94010 Créteil, France
- Service D’Anesthésie-Réanimation Chirurgicale, DMU CARE, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
- IMRB, EnvA, 94700 Maisons-Alfort, France
| | - Slim Fourati
- Département de Virologie, Bactériologie, Parasitologie-Mycologie, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
| | - Jean-Winoc Decousser
- Equipe Opérationnelle d’Hygiène, Département Prévention, Diagnostic, Traitement des Infections, Hôpitaux Universitaires Henri-Mondor AP-HP, 94010 Créteil, France
- DYNAMYC, University Paris Est Creteil, 94010 Créteil, France
- DYNAMYC, EnvA, 94700 Maisons-Alfort, France
- Correspondence: (S.B.-G.); (J.-W.D.)
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24
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Healthcare worker safety program in a coronavirus disease 2019 (COVID-19) alternate care site: The Javits New York Medical Station experience. Infect Control Hosp Epidemiol 2023; 44:268-276. [PMID: 35431014 PMCID: PMC9509795 DOI: 10.1017/ice.2022.80] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE In March 2020, New York City became the epicenter of the coronavirus disease 2019 (COVID-19) pandemic in the United States. Because healthcare facilities were overwhelmed with patients, the Jacob K. Javits Convention Center was transformed into the nation's largest alternate care site: Javits New York Medical Station (hereafter termed Javits). Protecting healthcare workers (HCWs) during a global shortage of personal protective equipment (PPE) in a nontraditional healthcare setting posed unique challenges. We describe components of the HCW safety program implemented at Javits. SETTING Javits, a large convention center transformed into a field hospital, with clinical staff from the US Public Health Service Commissioned Corps and the US Department of Defense. METHODS Key strategies to ensure HCW safety included ensuring 1-way flow of traffic on and off the patient floor, developing a matrix detailing PPE required for each work activity and location, PPE extended use and reuse protocols, personnel training, and monitoring adherence to PPE donning/doffing protocols when entering or exiting the patient floor. Javits staff who reported COVID-19 symptoms were immediately isolated, monitored, and offered a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction (RT-PCR) test. CONCLUSIONS A well-designed and implemented HCW safety plan can minimize the risk of SARS-CoV-2 infection for HCWs. The lessons learned from operating the nation's largest COVID-19 alternate care site can be adapted to other environments during public health emergencies.
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25
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Sharma S, Gupta V, Bawa A, Kumar A, Pooni PA, Gautam PL, Chaudhary AK, Chhina RS. Contact Tracing of Healthcare Workers Exposed to COVID-19 Infection in a Tertiary-Care Hospital: Containing the Contagion. Indian J Community Med 2023; 48:155-160. [PMID: 37082385 PMCID: PMC10112743 DOI: 10.4103/ijcm.ijcm_1523_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 09/21/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Healthcare workers (HCWs) are at higher risk of getting infected with COVID-19 infection due to their close proximity to COVID-19-positive patients. We studied the risk stratification and positivity rate in HCWs at risk of getting COVID-19 infection as well as the possible factors responsible for their being at risk of COVID-19 infection during the study period. Material and Methods This prospective study was conducted after approval by the institutional ethics committee. The data regarding demographic variables, risk stratification, COVID-19 (reverse-transcription polymerase chain reaction) report, and possible sources of exposure for HCWs were recorded in a proforma by personal/telephonic interviews as well as from hospital records from March 2020 to June 2021. The data generated were entered into Microsoft Excel® software and analyzed using percentages, proportions, and Chi-square tests for qualitative variables. Results COVID-19 infection's positivity rate was 19.5% among high-risk and 0.6% among low-risk HCW contacts. HCWs working in non-COVID-19 areas (67.9%) were more at risk than those working in COVID-19 areas (32.1%). In contrast, the COVID-19 positivity rate was significantly higher among high-risk contact HCWs from COVID-19 areas (34.2%) than in non-COVID-19 areas (12.6%). The maximum COVID-19 positivity rate was seen in high-risk contacts with body fluid exposure (21%), performing aerosol-generating procedures (20%), and close exposure in operation theaters (18%). Conclusions Risk stratification is an important tool to contain infection among HCWs who had unprotected close contact with a COVID-19-positive case. With appropriate contact tracing, we were able to avoid over- and under-quarantine, save many man-hours as well as contain the spread of infection. HCWs should not only wear appropriate personal protective equipment (PPE) during work hours but should also practice mask-wearing and social distancing while they are in the community.
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Affiliation(s)
- Sarit Sharma
- Department of Community Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Vikas Gupta
- Department of Rheumatology and Immunology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ashvind Bawa
- Department of Surgery, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Ajay Kumar
- Department of Anatomy, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Puneet Aulakh Pooni
- Department of Paediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Parshotam Lal Gautam
- Department of Critical Care Medicine, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | | | - Rajoo Singh Chhina
- Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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Benoit P, Jolicoeur G, Point F, Soucy C, Normand K, Morency-Potvin P, Gagnon S, Kaufmann DE, Tremblay C, Coutlée F, Harrigan PR, Hardy I, Smith M, Savard P, Grandjean Lapierre S. On-demand, hospital-based, severe acute respiratory coronavirus virus 2 (SARS-CoV-2) genomic epidemiology to support nosocomial outbreak investigations: A prospective molecular epidemiology study. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e45. [PMID: 36960087 PMCID: PMC10028942 DOI: 10.1017/ash.2023.119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 01/12/2023] [Accepted: 01/18/2023] [Indexed: 03/10/2023]
Abstract
Objectives We evaluated the added value of infection control-guided, on demand, and locally performed severe acute respiratory coronavirus virus 2 (SARS-CoV-2) genomic sequencing to support outbreak investigation and control in acute-care settings. Design and setting This 18-month prospective molecular epidemiology study was conducted at a tertiary-care hospital in Montreal, Canada. When nosocomial transmission was suspected by local infection control, viral genomic sequencing was performed locally for all putative outbreak cases. Molecular and conventional epidemiology data were correlated on a just-in-time basis to improve understanding of coronavirus disease 2019 (COVID-19) transmission and reinforce or adapt control measures. Results Between April 2020 and October 2021, 6 outbreaks including 59 nosocomial infections (per the epidemiological definition) were investigated. Genomic data supported 7 distinct transmission clusters involving 6 patients and 26 healthcare workers. We identified multiple distinct modes of transmission, which led to reinforcement and adaptation of infection control measures. Molecular epidemiology data also refuted (n = 14) suspected transmission events in favor of community acquired but institutionally clustered cases. Conclusion SARS-CoV-2 genomic sequencing can refute or strengthen transmission hypotheses from conventional nosocomial epidemiological investigations, and guide implementation of setting-specific control strategies. Our study represents a template for prospective, on site, outbreak-focused SARS-CoV-2 sequencing. This approach may become increasingly relevant in a COVID-19 endemic state where systematic sequencing within centralized surveillance programs is not available. Trial registration clinicaltrials.gov identifier: NCT05411562.
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Affiliation(s)
- Patrick Benoit
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada
| | - Gisèle Jolicoeur
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Floriane Point
- Immunopathology Axis, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Chantal Soucy
- Infection Prevention and Control Service, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Karine Normand
- Infection Prevention and Control Service, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
| | - Philippe Morency-Potvin
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada
- Infectious Diseases Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
| | - Simon Gagnon
- Molecular Biology Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
| | - Daniel E. Kaufmann
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
- Immunopathology Axis, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Infectious Diseases Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
| | - Cécile Tremblay
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada
- Immunopathology Axis, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Infectious Diseases Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
| | - François Coutlée
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada
- Immunopathology Axis, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Infectious Diseases Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
- Molecular Biology Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
| | - P. Richard Harrigan
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Isabelle Hardy
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada
- Immunopathology Axis, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Molecular Biology Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
| | - Martin Smith
- Department of Biochemistry and Molecular Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Patrice Savard
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada
- Immunopathology Axis, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Infection Prevention and Control Service, Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Infectious Diseases Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
| | - Simon Grandjean Lapierre
- Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, Montréal, Québec, Canada
- Immunopathology Axis, Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Montréal, Québec, Canada
- Infectious Diseases Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
- Molecular Biology Service, Centre Hospitalier de l’Université de Montréal, Saint-Denis, Montréal, Québec, Canada
- Author for correspondence: Simon Grandjean Lapierre, MD, MSc, FRCPC, Department of Microbiology, Infectious Diseases and Immunology, Université de Montréal, 2900 Boul Edouard-Montpetit, Montréal, Québec, H3T 1J4, Canada. E-mail:
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Sheng WH, Chang HC, Chang SY, Hsieh MJ, Chen YC, Wu YY, Pan SC, Wang JT, Chen YC. SARS-CoV-2 infection among healthcare workers whom already received booster vaccination during epidemic outbreak of omicron variant in Taiwan. J Formos Med Assoc 2022; 122:376-383. [PMID: 36564300 PMCID: PMC9755014 DOI: 10.1016/j.jfma.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/22/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND/PURPOSE Healthcare workers (HCWs) are at risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to occupational exposure. We aim to investigate the prevalence and risk factors of SARS-CoV-2 infection among HCWs during epidemic outbreak of omicron variant in Taiwan. METHODS Sequential reserved serum samples collected from our previous study during December 2021 and July 2022 were tested for antibodies against SARS-CoV-2 nucleocapsid protein (NP). Diagnosis of SARS-CoV-2 infection was defined as positive either of anti-SARS-CoV-2 nucleoprotein, rapid antigen test or polymerase chain reaction. Retrospective chart review and a questionnaire were used to access the symptoms and risk factors for SARS-CoV-2 infection. RESULTS Totally 300 participants (69.3% female) with a median age of 37.9 years were enrolled. A significant increase incidence of SARS-CoV-2 infection was found before and during community outbreak (11.91 versus 230.93 per 100,000 person-days, P < 0.001), which was a trend paralleling that observed in the general population. For 61 SARS-CoV-2 infected participants, nine (14.8%) were asymptomatic. Multivariate analysis revealed recent contact with a SARS-CoV-2 infected household (odds ratio [OR], 7.01; 95% confidence interval [95% CI], 3.70-13.30; P < 0.001) and co-existed underlying autoimmune diseases (OR, 4.46; 95% CI, 1.28-15.51; P = 0.019) were significant risk factors associated with acquisition of SARS-CoV-2 infection among HCWs. CONCLUSION Community factors, such as closely contact with SARS-CoV-2 infected individuals and underlying immune suppression status, were significant factors for acquisition of SARS-CoV-2 infection among HCWs. We suggest the application of appropriate infection control measures for HCWs should be maintained to reduce risk of SARS-CoV-2 infection.
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Affiliation(s)
- Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan,Corresponding author. Department of Internal Medicine, National Taiwan University Hospital, 7, Chung Shan South Road, Taipei City, 10002, Taiwan. Fax: +886 2 23710615
| | - Hao-Chun Chang
- Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu County, Taiwan
| | - Sui-Yuan Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan,Department of Laboratory Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Ming-Ju Hsieh
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan,Occupational Safety and Health Office, National Taiwan University Hospital, Taipei, Taiwan
| | - Yu-Cheng Chen
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Yun Wu
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Sung-Ching Pan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,Infection Control Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Jann-Tay Wang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,School of Medicine, National Taiwan University College of Medicine, Taipei City, Taiwan
| | - Yee-Chun Chen
- Department of Internal Medicine, National Taiwan University Hospital, Taipei City, Taiwan,Infection Control Center, National Taiwan University Hospital, Taipei, Taiwan
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28
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Tami A, van der Gun BTF, Wold KI, Vincenti-González MF, Veloo ACM, Knoester M, Harmsma VPR, de Boer GC, Huckriede ALW, Pantano D, Gard L, Rodenhuis-Zybert IA, Upasani V, Smit J, Dijkstra AE, de Haan JJ, van Elst JM, van den Boogaard J, O’ Boyle S, Nacul L, Niesters HGM, Friedrich AW. The COVID HOME study research protocol: Prospective cohort study of non-hospitalised COVID-19 patients. PLoS One 2022; 17:e0273599. [PMID: 36327223 PMCID: PMC9632784 DOI: 10.1371/journal.pone.0273599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Guidelines on COVID-19 management are developed as we learn from this pandemic. However, most research has been done on hospitalised patients and the impact of the disease on non-hospitalised and their role in transmission are not yet well understood. The COVID HOME study conducts research among COVID-19 patients and their family members who were not hospitalised during acute disease, to guide patient care and inform public health guidelines for infection prevention and control in the community and household. METHODS An ongoing prospective longitudinal observational study of COVID-19 outpatients was established in March 2020 at the beginning of the COVID-19 pandemic in the Netherlands. Laboratory confirmed SARS-CoV-2 infected individuals of all ages that did not merit hospitalisation, and their household (HH) members, were enrolled after written informed consent. Enrolled participants were visited at home within 48 hours after initial diagnosis, and then weekly on days 7, 14 and 21 to obtain clinical data, a blood sample for biochemical parameters/cytokines and serological determination; and a nasopharyngeal/throat swab plus urine, stool and sperm or vaginal secretion (if consenting) to test for SARS-CoV-2 by RT-PCR (viral shedding) and for viral culturing. Weekly nasopharyngeal/throat swabs and stool samples, plus a blood sample on days 0 and 21 were also taken from HH members to determine whether and when they became infected. All participants were invited to continue follow-up at 3-, 6-, 12- and 18-months post-infection to assess long-term sequelae and immunological status.
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Affiliation(s)
- Adriana Tami
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bernardina T. F. van der Gun
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Karin I. Wold
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - María F. Vincenti-González
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alida C. M. Veloo
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marjolein Knoester
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Valerie P. R. Harmsma
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Gerolf C. de Boer
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Anke L. W. Huckriede
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Daniele Pantano
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Lilli Gard
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Izabela A. Rodenhuis-Zybert
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Vinit Upasani
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jolanda Smit
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Akkelies E. Dijkstra
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jacco J. de Haan
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jip M. van Elst
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Shennae O’ Boyle
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Luis Nacul
- Department of Clinical Research, Faculty of Medicine and London School of Hygiene and Tropical Medicine, University of British Columbia, Vancouver, Canada
| | - Hubert G. M. Niesters
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alex W. Friedrich
- Department of Medical Microbiology and Infection Prevention, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Alsaedi A, Alharbi M, Ossenkopp J, Farahat F, Taguas R, Algarni M, Alghamdi A, Okdah L, Alhayli S, Alswaji A, Doumith M, El-Saed A, Alzahrani M, Alshamrani M, Alghoribi MF. Epidemiological and molecular description of nosocomial outbreak of COVID-19 Alpha (B.1.1.7) variant in Saudi Arabia. J Infect Public Health 2022; 15:1279-1286. [PMID: 36274368 PMCID: PMC9557135 DOI: 10.1016/j.jiph.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/29/2022] [Accepted: 10/03/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Nosocomial outbreaks frequently occurred during the Coronavirus disease 2019 (COVID-19) pandemic; however, sharing experiences on outbreak containment is vital to reduce the related burden in different locations. OBJECTIVES This article aims at sharing a practical experience on COVID-19 outbreak containment, including contact tracing, screening of target population, testing including molecular analysis, and preventive modalities. It also provides an epidemiological and molecular analysis of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‑CoV‑2) infection outbreak in a tertiary care hospital in Saudi Arabia. METHODS The outbreak occurred in a non-COVID medical ward at a tertiary care hospital in Jeddah, Saudi Arabia, from 22nd March and 15th April 2021. The multidisciplinary outbreak response team performed clinical and epidemiological investigations. Whole-Genome Sequencing (WGS) was implemented on selected isolates for further molecular characterization. RESULTS A total of eight nurses (20 % of the assigned ward nurses) and six patients (16.2 % of the ward admitted patients at the time of the outbreak) tested positive for the SARS-CoV-2 virus based on PCR testing. The outbreak investigation identified strong evidence of an epidemiologic link between the affected cases. WGS revealed a set of spike mutations and deletions specific to the Alpha variant (B.1.1.7 lineage). All the nurses had mild symptoms, and the fatality among the patients was 50 % (three out of the six patients). CONCLUSIONS The current nosocomial COVID-19 outbreak, caused by the Alpha variant, revealed multiple breaches in the adherence to the hospital infection control recommended measures. Containment strategies were successful in controlling the outbreak and limiting infection spread. Molecular analysis and genome sequencing are essential tools besides epidemiological investigation to inform appropriate actions, especially with emerging pathogens.
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Affiliation(s)
- Asim Alsaedi
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Maher Alharbi
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - John Ossenkopp
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia
| | - Fayssal Farahat
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Roxanne Taguas
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia
| | - Mousa Algarni
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia
| | - Ahmad Alghamdi
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia
| | - Liliane Okdah
- Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Sadeem Alhayli
- Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Abdulrahman Alswaji
- Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Michel Doumith
- Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Aiman El-Saed
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Mohammed Alzahrani
- King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia; Department of Surgery, King Abdulaziz Medical City, Saudi Arabia
| | - Majid Alshamrani
- Infection Prevention and Control Program, King Abdulaziz Medical City, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia
| | - Majed F Alghoribi
- Infectious Diseases Research Department, King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.
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30
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Sansom SE, Barbian H, Hayden MK, Fukuda C, Moore NM, Thotapalli L, Baied EJ, Kim DY, Snitkin E, Lin MY. Genomic Investigation to Identify Sources of Severe Acute Respiratory Syndrome Coronavirus 2 Infection Among Healthcare Personnel in an Acute Care Hospital. Open Forum Infect Dis 2022; 9:ofac581. [PMID: 36467294 PMCID: PMC9709631 DOI: 10.1093/ofid/ofac581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/28/2022] [Indexed: 12/05/2022] Open
Abstract
Background Identifying the source of healthcare personnel (HCP) coronavirus disease 2019 (COVID-19) is important to guide occupational safety efforts. We used a combined whole genome sequencing (WGS) and epidemiologic approach to investigate the source of HCP COVID-19 at a tertiary-care center early in the COVID-19 pandemic. Methods Remnant nasopharyngeal swab samples from HCP and patients with polymerase chain reaction-proven COVID-19 from a period with complete sample retention (14 March 2020 to 10 April 2020) at Rush University Medical Center in Chicago, Illinois, underwent viral RNA extraction and WGS. Genomes with >90% coverage underwent cluster detection using a 2 single-nucleotide variant genetic distance cutoff. Genomic clusters were evaluated for epidemiologic linkages, with strong linkages defined by evidence of time/location overlap. Results We analyzed 1031 sequences, identifying 49 clusters that included ≥1 HCP (265 patients, 115 HCP). Most HCP infections were not healthcare associated (88/115 [76.5%]). We did not identify any strong epidemiologic linkages for patient-to-HCP transmission. Thirteen HCP cases (11.3%) were attributed to a potential patient source (weak evidence involving nonclinical staff that lacked location data to prove or disprove contact with patients in same cluster). Fourteen HCP cases (12.2%) were attributed to HCP source (11 with strong evidence). Conclusions Using genomic and epidemiologic data, we found that most HCP severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections were not healthcare associated. We did not find strong evidence of patient-to-HCP transmission of SARS-CoV-2.
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Affiliation(s)
- Sarah E Sansom
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Hannah Barbian
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Mary K Hayden
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Christine Fukuda
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Nicholas M Moore
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Lahari Thotapalli
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Elias J Baied
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Do Young Kim
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
| | - Evan Snitkin
- Department of Medicine, Division of Infectious Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Michael Y Lin
- Department of Internal Medicine, Division of Infectious Diseases, Rush University Medical Center, Chicago, Illinois, USA
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van Beek J, Teesing G, Oude Munnink BB, Meima A, Vriend HJ, Elzakkers J, de Graaf M, Langeveld J, Medema GJ, Molenkamp R, Voeten H, Fanoy E, Koopmans M. Population-based screening in a municipality after a primary school outbreak of the SARS-CoV-2 Alpha variant, the Netherlands, December 2020-February 2021. PLoS One 2022; 17:e0276696. [PMID: 36301829 PMCID: PMC9612486 DOI: 10.1371/journal.pone.0276696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/11/2022] [Indexed: 11/18/2022] Open
Abstract
An outbreak of SARS-CoV-2 Alpha variant (Pango lineage B.1.1.7) was detected at a primary school (School X) in Lansingerland, the Netherlands, in December 2020. The outbreak was studied retrospectively, and population-based screening was used to assess the extent of virus circulation and decelerate transmission. Cases were SARS-CoV-2 laboratory confirmed and were residents of Lansingerland (November 16th 2020 until February 22th 2021), or had an epidemiological link with School X or neighbouring schools. The SARS-CoV-2 variant was determined using variant PCR or whole genome sequencing. A questionnaire primarily assessed clinical symptoms. A total of 77 Alpha variant cases were found with an epidemiological link to School X, 16 Alpha variant cases linked to the neighbouring schools, and 146 Alpha variant cases among residents of Lansingerland without a link to the schools. The mean number of self-reported symptoms was not significantly different among Alpha variant infected individuals compared to non-Alpha infected individuals. The secondary attack rate (SAR) among Alpha variant exposed individuals in households was 52% higher compared to non-Alpha variant exposed individuals (p = 0.010), with the mean household age, and mean number of children and adults per household as confounders. Sequence analysis of 60 Alpha variant sequences obtained from cases confirmed virus transmission between School X and neighbouring schools, and showed that multiple introductions of the Alpha variant had already taken place in Lansingerland at the time of the study. The alpha variant caused a large outbreak at both locations of School X, and subsequently spread to neighbouring schools, and households. Population-based screening (together with other public health measures) nearly stopped transmission of the outbreak strain, but did not prevent variant replacement in the Lansingerland municipality.
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Affiliation(s)
- Janko van Beek
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- * E-mail:
| | - Gwen Teesing
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
- The Netherlands Organization for Health Research and Development (ZonMw), The Hague, The Netherlands
| | - Bas B. Oude Munnink
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Abraham Meima
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Henrike J. Vriend
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Jessica Elzakkers
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Miranda de Graaf
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jeroen Langeveld
- KWR Water Research Institute, Nieuwegein, The Netherlands
- Partners4UrbanWater, Nijmegen, The Netherlands
| | - Gert-Jan Medema
- KWR Water Research Institute, Nieuwegein, The Netherlands
- Sanitary Engineering, Delft University of Technology, Delft, The Netherlands
| | - Richard Molenkamp
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Helene Voeten
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ewout Fanoy
- Department of Infectious Disease Control, Public Health Service Rotterdam-Rijnmond, Rotterdam, The Netherlands
| | - Marion Koopmans
- Department of Viroscience, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Marmo R, Pascale F, Diana L, Sicignano E, Polverino F. Lessons learnt for enhancing hospital resilience to pandemics: A qualitative analysis from Italy. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2022; 81:103265. [PMID: 36061241 PMCID: PMC9419438 DOI: 10.1016/j.ijdrr.2022.103265] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/18/2022] [Accepted: 08/19/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has outlined the need to strengthen the resilience of healthcare systems. It has cost millions of human lives and has had indirect health impacts too. Hospital buildings have undergone extensive modifications and adaptations to ensure infection control and prevention measures, and, as it is happened following past epidemics, the COVID-19 experience might change the design of hospital buildings in the future. This paper aims to capitalise on the knowledge developed by the stakeholders directly involved with the hospital response during the pandemic to generate new evidence that will enhance resilience of hospital buildings to pandemics. The research adopted qualitative research methods, namely literature review and interviews with Italian experts including doctors and facility managers to collect data which were analysed through a thematic analysis. The findings include the identification of new needs for hospital buildings and the related actions to be taken or already performed at hospital building and service level which are viable for long term implementation and are aimed at improving hospital resilience to pandemics. The results specify how to improve resilience by means of structural modifications (e.g. placing filter zones among different wards, ensuring the presence of airborne infection isolation rooms at least in the emergency departments), technological changes (e.g. oversizing capacity such as medical gases, information technology improvement for delivering healthcare services remotely), and operational measures (e.g. assessing the risk of infection before admission, dividing acute-care from low-care assets). The needs discussed in this paper substantiate the urge to renovate the Italian healthcare infrastructures and they can be considered useful elements of knowledge for enhancing hospital resilience to pandemics in the extended and in the post-COVID-19 era.
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Affiliation(s)
- Rossella Marmo
- Department of Civil Engineering, University of Salerno, 84084, Fisciano, Italy
| | - Federica Pascale
- Faculty of Science and Engineering, Anglia Ruskin University, CM1 1SQ, Chelmsford, UK
| | - Lorenzo Diana
- Department of Civil, Building and Environmental Engineering, University of Naples "Federico II", 80138, Naples, Italy
| | - Enrico Sicignano
- Department of Civil Engineering, University of Salerno, 84084, Fisciano, Italy
| | - Francesco Polverino
- Department of Civil, Building and Environmental Engineering, University of Naples "Federico II", 80138, Naples, Italy
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Lohiniva AL, Toura S, Arifulla D, Ollgren J, Lyytikäinen O. Exploring behavioural factors influencing COVID-19-specific infection prevention and control measures in Finland: a mixed-methods study, December 2020 to March 2021. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2022; 27. [PMID: 36205170 DOI: 10.2807/1560-7917.es.2022.27.40.2100915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BackgroundCompliance with infection prevention and control (IPC) measures is critical to preventing COVID-19 transmission in healthcare settings.AimTo identify and explain factors influencing compliance with COVID-19-specific IPC measures among healthcare workers (HCWs) in long-term care facilities (LTCF) in Finland.MethodsThe study included a web-based survey and qualitative study based on the Theoretical Domains Framework (TDF). The link to the anonymous survey was distributed via email to LTCFs through regional IPC experts in December 2020. Outcome was modelled using ordinary logistic regression and penalised ridge logistic regression using regrouped explanatory variables and an original, more correlated set of explanatory variables, respectively. In-depth interviews were conducted among survey participants who volunteered during January-March 2021. Data were analysed thematically using qualitative data analysis software (NVIVO12).ResultsA total of 422 HCWs from 17/20 regions responded to the survey. Three TDF domains were identified that negatively influenced IPC compliance: environmental context and resources, reinforcement and beliefs about capabilities. Twenty HCWs participated in interviews, which resulted in identification of several themes: changes in professional duties and lack of staff planning for emergencies (domain: environmental context and resources); management culture and physical absence of management (domain: reinforcement), knowledge of applying IPC measures, nature of tasks and infrastructure that supports implementation (domain: beliefs about capabilities), that explained how the domains negatively influenced their IPC behaviour.ConclusionsThis study provides insights into behavioural domains that can be used in developing evidence-based behaviour change interventions to support HCW compliance with pandemic-specific IPC measures in LTCFs.
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Affiliation(s)
| | - Saija Toura
- The Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Dinah Arifulla
- The Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Jukka Ollgren
- The Finnish Institute for Health and Welfare, Helsinki, Finland
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Linde KJ, Wouters IM, Kluytmans JAJW, Kluytmans-van den Bergh MFQ, Pas SD, GeurtsvanKessel CH, Koopmans MPG, Meier M, Meijer P, Raben CR, Spithoven J, Tersteeg-Zijderveld MHG, Heederik DJJ, Dohmen W. Detection of SARS-CoV-2 in Air and on Surfaces in Rooms of Infected Nursing Home Residents. Ann Work Expo Health 2022; 67:129-140. [PMID: 36068657 PMCID: PMC9834894 DOI: 10.1093/annweh/wxac056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/12/2022] [Accepted: 07/29/2022] [Indexed: 01/14/2023] Open
Abstract
There is an ongoing debate on airborne transmission of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) as a risk factor for infection. In this study, the level of SARS-CoV-2 in air and on surfaces of SARS-CoV-2 infected nursing home residents was assessed to gain insight in potential transmission routes. During outbreaks, air samples were collected using three different active and one passive air sampling technique in rooms of infected patients. Oropharyngeal swabs (OPS) of the residents and dry surface swabs were collected. Additionally, longitudinal passive air samples were collected during a period of 4 months in common areas of the wards. Presence of SARS-CoV-2 RNA was determined using RT-qPCR, targeting the RdRp- and E-genes. OPS, samples of two active air samplers and surface swabs with Ct-value ≤35 were tested for the presence of infectious virus by cell culture. In total, 360 air and 319 surface samples from patient rooms and common areas were collected. In rooms of 10 residents with detected SARS-CoV-2 RNA in OPS, SARS-CoV-2 RNA was detected in 93 of 184 collected environmental samples (50.5%) (lowest Ct 29.5), substantially more than in the rooms of residents with negative OPS on the day of environmental sampling (n = 2) (3.6%). SARS-CoV-2 RNA was most frequently present in the larger particle size fractions [>4 μm 60% (6/10); 1-4 μm 50% (5/10); <1 μm 20% (2/10)] (Fischer exact test P = 0.076). The highest proportion of RNA-positive air samples on room level was found with a filtration-based sampler 80% (8/10) and the cyclone-based sampler 70% (7/10), and impingement-based sampler 50% (5/10). SARS-CoV-2 RNA was detected in 10 out of 12 (83%) passive air samples in patient rooms. Both high-touch and low-touch surfaces contained SARS-CoV-2 genome in rooms of residents with positive OPS [high 38% (21/55); low 50% (22/44)]. In one active air sample, infectious virus in vitro was detected. In conclusion, SARS-CoV-2 is frequently detected in air and on surfaces in the immediate surroundings of room-isolated COVID-19 patients, providing evidence of environmental contamination. The environmental contamination of SARS-CoV-2 and infectious aerosols confirm the potential for transmission via air up to several meters.
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Affiliation(s)
- Kimberly J Linde
- Author to whom correspondence should be addressed. Tel: +31302535358; e-mail:
| | - Inge M Wouters
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jan A J W Kluytmans
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Marjolein F Q Kluytmans-van den Bergh
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands,Department of Infection Control, Amphia Hospital, Breda, The Netherlands
| | - Suzan D Pas
- Microvida Location Amphia/Bravis, Breda/Roosendaal, The Netherlands
| | | | | | | | - Patrick Meijer
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Ceder R Raben
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Jack Spithoven
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | | | - Dick J J Heederik
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Wietske Dohmen
- Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
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Hendy A, Soliman SM, Al-Sharkawi SS, Alruwaili MF, Hassani R, Reshia FAA. Effect of Clustering Nursing Care on Spreading COVID-19 Infection Among Nurses: A Retrospective Study. Int J Gen Med 2022; 15:6801-6809. [PMID: 36051567 PMCID: PMC9426869 DOI: 10.2147/ijgm.s376726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/15/2022] [Indexed: 12/15/2022] Open
Abstract
Background The nurse’s first and most important responsibility is to protect themselves from contracting or spreading COVID-19. Purpose Investigate the effect of applying clustering nursing care on spreading COVID-19 infection and fatigue level among nurses who provide nursing care for COVID-19 patients. Methods Retrospective case–control study, where cases had a COVID-19 infection in the previous six months and controls were free. Internet-based survey sent to nurses at eight hospitals. Findings A total of 100 cases and 250 controls. About 36.8% of nurses who did not apply clustering care suffered from COVID-19 infection. Meanwhile, 83.3% and 93.3% of those who clustered three and four procedures, were free of COVID-19 infection. Discussion Applying clustering for nurses’ care decreases spreading of infection among nurses and decreases fatigue level related to work. Female nurses, increased fatigue, and a lack of training are all factors that may contribute to the spread of CVID-19 infection among nurses.
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Affiliation(s)
- Abdelaziz Hendy
- Pediatric Nursing Department, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | - Sahar M Soliman
- Department of Maternal & Neonatal Health Nursing, Faculty of Nursing, Ain Shams University, Cairo, Egypt
| | - Sabah Saad Al-Sharkawi
- Pediatric Nursing Department, Faculty of Nursing, Ain Shams University, Cairo, Egypt.,Faculty of Nursing, October 6 University, Cairo, Egypt
| | - Manar Fayez Alruwaili
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia.,College of Nursing and Health Sciences, Barry University, Miami, Florida, United states of America
| | - Rym Hassani
- Nursing department, University College of Sabya, Jazan University, Jazan, Saudi Arabia
| | - Fadia Ahmed Abdelkader Reshia
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakaka, Saudi Arabia.,Critical Care and Emergency Nursing, Faculty of Nursing, Mansoura University, Mansoura, Egypt
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Attwood SW, Hill SC, Aanensen DM, Connor TR, Pybus OG. Phylogenetic and phylodynamic approaches to understanding and combating the early SARS-CoV-2 pandemic. Nat Rev Genet 2022; 23:547-562. [PMID: 35459859 PMCID: PMC9028907 DOI: 10.1038/s41576-022-00483-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 01/05/2023]
Abstract
Determining the transmissibility, prevalence and patterns of movement of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is central to our understanding of the impact of the pandemic and to the design of effective control strategies. Phylogenies (evolutionary trees) have provided key insights into the international spread of SARS-CoV-2 and enabled investigation of individual outbreaks and transmission chains in specific settings. Phylodynamic approaches combine evolutionary, demographic and epidemiological concepts and have helped track virus genetic changes, identify emerging variants and inform public health strategy. Here, we review and synthesize studies that illustrate how phylogenetic and phylodynamic techniques were applied during the first year of the pandemic, and summarize their contributions to our understanding of SARS-CoV-2 transmission and control.
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Affiliation(s)
- Stephen W Attwood
- Department of Zoology, University of Oxford, Oxford, UK.
- Pathogen Genomics Unit, Public Health Wales NHS Trust, Cardiff, UK.
| | - Sarah C Hill
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, UK
| | - David M Aanensen
- Centre for Genomic Pathogen Surveillance, Wellcome Genome Campus, Hinxton, UK
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Thomas R Connor
- Pathogen Genomics Unit, Public Health Wales NHS Trust, Cardiff, UK
- School of Biosciences, Cardiff University, Cardiff, UK
| | - Oliver G Pybus
- Department of Zoology, University of Oxford, Oxford, UK.
- Department of Pathobiology and Population Sciences, Royal Veterinary College, University of London, London, UK.
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Turcinovic J, Schaeffer B, Taylor BP, Bouton TC, Odom-Mabey AR, Weber SE, Lodi S, Ragan EJ, Connor JH, Jacobson KR, Hanage WP. Understanding early pandemic SARS-CoV-2 transmission in a medical center by incorporating public sequencing databases to mitigate bias. J Infect Dis 2022; 226:1704-1711. [PMID: 35993116 PMCID: PMC9452097 DOI: 10.1093/infdis/jiac348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/19/2022] [Indexed: 11/28/2022] Open
Abstract
Background Throughout the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, healthcare workers (HCWs) have faced risk of infection from within the workplace via patients and staff as well as from the outside community, complicating our ability to resolve transmission chains in order to inform hospital infection control policy. Here we show how the incorporation of sequences from public genomic databases aided genomic surveillance early in the pandemic when circulating viral diversity was limited. Methods We sequenced a subset of discarded, diagnostic SARS-CoV-2 isolates between March and May 2020 from Boston Medical Center HCWs and combined this data set with publicly available sequences from the surrounding community deposited in GISAID with the goal of inferring specific transmission routes. Results Contextualizing our data with publicly available sequences reveals that 73% (95% confidence interval, 63%–84%) of coronavirus disease 2019 cases in HCWs are likely novel introductions rather than nosocomial spread. Conclusions We argue that introductions of SARS-CoV-2 into the hospital environment are frequent and that expanding public genomic surveillance can better aid infection control when determining routes of transmission.
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Affiliation(s)
- Jacquelyn Turcinovic
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA.,Bioinformatics Program, Boston University, Boston, MA, USA
| | - Beau Schaeffer
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Bradford P Taylor
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Tara C Bouton
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Aubrey R Odom-Mabey
- Bioinformatics Program, Boston University, Boston, MA, USA.,Division of Computational Biomedicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Sarah E Weber
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - Sara Lodi
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Elizabeth J Ragan
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - John H Connor
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts, USA.,Bioinformatics Program, Boston University, Boston, MA, USA.,Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Karen R Jacobson
- Section of Infectious Diseases, Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts, USA
| | - William P Hanage
- Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
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Hâncean MG, Lerner J, Perc M, Oană I, Bunaciu DA, Stoica AA, Ghiţă MC. Occupations and their impact on the spreading of COVID-19 in urban communities. Sci Rep 2022; 12:14115. [PMID: 35982107 PMCID: PMC9387884 DOI: 10.1038/s41598-022-18392-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 08/10/2022] [Indexed: 11/09/2022] Open
Abstract
The current pandemic has disproportionally affected the workforce. To improve our understanding of the role that occupations play in the transmission of COVID-19, we analyse real-world network data that were collected in Bucharest between August 1st and October 31st 2020. The data record sex, age, and occupation of 6895 patients and the 13,272 people they have interacted with, thus providing a social network from an urban setting through which COVID-19 has spread. Quite remarkably, we find that medical occupations have no significant effect on the spread of the virus. Instead, we find common transmission chains to start with infected individuals who hold jobs in the private sector and are connected with non-active alters, such as spouses, siblings, or elderly relatives. We use relational hyperevent models to assess the most likely homophily and network effects in the community transmission. We detect homophily with respect to age and anti-homophily with respect to sex and employability. We note that, although additional data would be welcomed to perform more in-depth network analyses, our findings may help public authorities better target under-performing vaccination campaigns.
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Affiliation(s)
- Marian-Gabriel Hâncean
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania.
| | - Jürgen Lerner
- Department of Computer and Information Science, University of Konstanz, 78457, Konstanz, Germany.,Human Technology Center, RWTH Aachen University, 52062, Aachen, Germany
| | - Matjaž Perc
- Faculty of Natural Sciences and Mathematics, University of Maribor, Koroška cesta 160, 2000, Maribor, Slovenia.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, 404332, Taiwan.,Alma Mater Europaea, Slovenska ulica 17, 2000, Maribor, Slovenia.,Complexity Science Hub Vienna, Josefstädterstraße 39, 1080, Vienna, Austria
| | - Iulian Oană
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
| | - David-Andrei Bunaciu
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
| | | | - Maria-Cristina Ghiţă
- Department of Sociology, University of Bucharest, Panduri 90-92, 050663, Bucharest, Romania
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Mohan Y, Charumathi B, Anantha Eashwar VM, Jain T, Abiramasundari VK. Incidence and Source of COVID-19 Infection Among Health Care Workers in a Tertiary Hospital in South India-A Prospective Cohort Study. Int J Prev Med 2022; 13:108. [PMID: 36247191 PMCID: PMC9564233 DOI: 10.4103/ijpvm.ijpvm_687_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 09/21/2021] [Indexed: 11/04/2022] Open
Abstract
Background Data for COVID-19 incidence and the source of infection among health care workers (HCWs) in Indian population are limited. The main objective of the study was to assess the incidence of COVID-19 infection and identify the source of infection among the HCWs in a tertiary teaching hospital. Methods A prospective cohort study was conducted among the 2134 HCWs recruited by purposive sampling from a tertiary teaching hospital from May to August 2020 (4-month period-123 days). Over the 4-month period, all the HCWs who had symptoms or those were close contacts of COVID positive patients were traced and tested using validated COVID diagnostic test (reverse transcription-polymerase chain reaction [RT-PCR] test). A semi-structured questionnaire was used to interview each positive HCW to identify the source of exposure of the infection. Results Incidence proportion was 9.3% among HCWs and was two times higher among males compared to females. Hazard ratio was found to be higher among males and HCWs working in the non-COVID areas. Test positivity rate was found to highest (around 57.8%) among those aged less than 30 years. The most common source of infection was infected HCW colleagues (40.9%) followed by exposure to patients in non-COVID areas (27.3%). Only 5.1% of total infection was found in HCWs who had worked in COVID zones. Conclusions People working in non-COVID areas, those using shared workplace, dining halls, and staff hostels, must follow strict COVID protocols by using appropriate Personal Protective Equipment (PPE) and following social distancing measures.
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Affiliation(s)
- Yogesh Mohan
- Department of Community Medicine, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
| | - B. Charumathi
- Department of Community Medicine, Saveetha Medical College and Hospital, Chennai, Tamil Nadu, India
| | - V. M. Anantha Eashwar
- Department of Community Medicine, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India,Address for correspondence: Dr. V. M. Anantha Eashwar, 158/6 Washer Varadappa Street, New Washermanpet – 81, Chennai, Tamil Nadu, India. E-mail:
| | - Timsi Jain
- Department of Community Medicine, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
| | - V. K. Abiramasundari
- Department of Microbiology, Saveetha Medical College and Hospital, Thandalam, Chennai, Tamil Nadu, India
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Alishaq M, Nafady-Hego H, Jeremijenko A, Al Ajmi JA, Elgendy M, Al Ansari NAA, Elgendy H, Abou-Samra AB, Butt AA. Seroprevalence of SARS-CoV-2 Infection Among Working Women and Impact of Workplace Restrictions. Infect Drug Resist 2022; 15:3871-3879. [PMID: 35903580 PMCID: PMC9315056 DOI: 10.2147/idr.s360241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Accepted: 07/05/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To determine the prevalence of SARS-CoV-2 virus infection among female workers who were restricted to working from home compared with those who continued to attend in-person work. Methods As part of national surveillance program, serum samples for SARS-CoV-2 antibody testing and nasopharyngeal swabs for SARS-CoV-2 PCR were obtained on 1636 female school staff and salon/spa workers who were restricted to work remotely (restricted group) and 1190 female health-care workers who continued in-person work (unrestricted group). Results Seropositivity rate was 5.1% among the restricted and 22.7% among the unrestricted group (P < 0.0001). Presence of symptoms at baseline (adjusted odds ratio [aOR], 2.88; 95% CI 2.09–3.97), contact with a confirmed case (aOR 2.34; 95% CI 1.37–3.98), and unrestricted work type (aOR 4.71; 95% CI 3.24–6.86) were associated with a higher risk of infection, while increasing age was associated with a lower risk of infection. Conclusion Prevalence of SARS-CoV-2 infection as determined by seropositivity was higher among women who were not subject to workplace restrictions.
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Affiliation(s)
- Moza Alishaq
- Department of Quality and Clinical Transformation, Hamad Medical Corporation, Doha, Qatar
| | - Hanaa Nafady-Hego
- Microbiology and Immunology Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | | | | | - Mohamed Elgendy
- Faculty of Medicine, Universiti Sains of Malaysia, Kelantan, Malaysia
| | | | - Hamed Elgendy
- Hamad Medical Corporation, Doha, Qatar.,Anesthesia Department, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdul-Badi Abou-Samra
- Department of Quality and Clinical Transformation, Hamad Medical Corporation, Doha, Qatar.,Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Adeel A Butt
- Hamad Medical Corporation, Doha, Qatar.,Departments of Medicine and Population Health Sciences, Weill Cornell Medical College, New York, NY, USA.,Departments of Medicine and Population Health Sciences, Weill Cornell Medical College, Doha, Qatar
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Nakwa FL, Thomas R, van Kwawegen A, Ntuli N, Seake K, Kesting SJ, Kamanga NHB, Kgwadi DM, Chami N, Mogajane T, Ondongo-Ezhet C, Maphosa TN, Jones S, Baillie VL, Madhi SA, Velaphi S. An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting. Front Pediatr 2022; 10:933982. [PMID: 35967580 PMCID: PMC9366465 DOI: 10.3389/fped.2022.933982] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/24/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction The provision of kangaroo mother care (KMC) involving continuous skin-to-skin care (SSC) is an important intervention in neonatal care, which is recommended even when women are infected with severe acute respiratory syndrome coronavirus (SARS-CoV-2). We report on a nosocomial outbreak of SARS-CoV-2 infections in a KMC ward. Methods Contact tracing was conducted following the diagnosis of SARS-CoV-2 in a mother lodging in the KMC ward. All mother-newborn dyads in the KMC and healthcare workers (HCW) were tested for SARS-CoV-2 within 24-72 h of diagnosing the index case. Nasopharyngeal swab samples were obtained and tested from contacts, with a nucleic acid amplification test (NAAT) assay. Next-generation sequencing was done on positive samples. The secondary attack rate (SAR) was calculated assuming that the mother who presented with symptoms was the source of infection. Results Twelve (70.6%) of 17 mothers and 8 (42.1%) of 19 neonates who were in the KMC ward with the index case were found to be positive with SARS-CoV-2. Seven (87.5%) of the 8 neonates who tested positive had mothers who also tested positive. Seventy-five percent (9/12) of the mothers and 62.5% (5/8) of the neonates who tested positive were asymptomatic. Eight (27.6%) of 29 HCW were found to be positive and were all asymptomatic. One neonate died from Acinetobacter baumannii sepsis, and his post-mortem lung histopathology showed features compatible with SARS-CoV-2 pneumonia. The sequencing of 13 specimens, which included 1 mother-newborn dyad, indicated clustering to the same phylogenetic lineage with identical mutations. In assessing for factors contributing to this outbreak, it was found that spaces between beds were less than 1 m and mothers had their meals around the same table at the same time. Conclusion We report on a nosocomial outbreak of SARS-CoV-2 in a KMC ward, affecting a high number of mothers and neonates, and to a lesser extent HCWs. Although it is difficult to point to the index case as the source of this outbreak, as asymptomatic individuals can spread infection, the inadequate adherence to non-pharmaceutical interventions was assessed to have contributed to the spread of infection. This highlights the need for awareness and adherence to mitigation strategies to avoid SARS-CoV-2 outbreaks.
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Affiliation(s)
- Firdose Lambey Nakwa
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Reenu Thomas
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Alison van Kwawegen
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nandi Ntuli
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karabo Seake
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Samantha Jane Kesting
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Noela Holo Bertha Kamanga
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Dikeledi Maureen Kgwadi
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Neema Chami
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Tshiamo Mogajane
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Claude Ondongo-Ezhet
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Thulisile Nelly Maphosa
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephanie Jones
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Vicky Lynne Baillie
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shabir Ahmed Madhi
- South African Medical Research Council, Vaccines and Infectious Diseases Analytics Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- African Leadership in Vaccinology Expertise, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sithembiso Velaphi
- Department of Paediatrics and Child Health, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Clinical and occupational risk factors for coronavirus disease 2019 (COVID-19) in healthcare personnel. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2022; 2:e123. [PMID: 36505949 PMCID: PMC9727206 DOI: 10.1017/ash.2022.250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/25/2022] [Accepted: 04/28/2022] [Indexed: 12/15/2022]
Abstract
Objective To identify characteristics associated with positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests in healthcare personnel. Design Retrospective cohort study. Setting A multihospital healthcare system. Participants Employees who reported SARS-CoV-2 exposures and/or symptoms of coronavirus disease 2019 (COVID-19) between March 30, 2020, and September 20, 2020, and were subsequently referred for SARS-CoV-2 PCR testing. Methods Data from exposure and/or symptom reports were linked to the corresponding SARS-CoV-2 PCR test result. Employee demographic characteristics, occupational characteristics, SARS-CoV-2 exposure history, and symptoms were evaluated as potential risk factors for having a positive SARS-CoV-2 PCR test. Results Among 6,289 employees who received SARS-CoV-2 PCR testing, 873 (14%) had a positive test. Independent risk factors for a positive PCR included: working in a patient care area (relative risk [RR], 1.82; 95% confidence interval [CI], 1.37-2.40), having a known SARS-CoV-2 exposure (RR, 1.20; 95% CI, 1.04-1.37), reporting a community versus an occupational exposure (RR, 1.87; 95% CI, 1.49-2.34), and having an infected household contact (RR, 2.47; 95% CI, 2.11-2.89). Nearly all HCP (99%) reported symptoms. Symptoms associated with a positive PCR in a multivariable analysis included loss of sense of smell (RR, 2.60; 95% CI, 2.09-3.24) or taste (RR, 1.75; 95% CI, 1.40-2.20), cough (RR, 1.95; 95% CI, 1.40-2.20), fever, and muscle aches. Conclusions In this cohort of >6,000 healthcare system and academic medical center employees early in the pandemic, community exposures, and particularly household exposures, were associated with greater risk of SARS-CoV-2 infection than occupational exposures. This work highlights the importance of COVID-19 prevention in the community and in healthcare settings to prevent COVID-19.
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Agaku IT, Dimaggio A, Fishelov A, Brathwaite A, Ahmed S, Malinowski M, Long T. SARS-CoV-2 infections and attitudes towards COVID-19 vaccines among healthcare workers in the New York Metropolitan area, USA. Fam Med Community Health 2022; 10:e001692. [PMID: 35896283 PMCID: PMC9334692 DOI: 10.1136/fmch-2022-001692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE Because of their increased interaction with patients, healthcare workers (HCWs) face greater vulnerability to COVID-19 exposure than the general population. We examined prevalence and correlates of ever COVID-19 diagnosis and vaccine uncertainty among HCWs. DESIGN Cross-sectional data from the Household Pulse Survey (HPS) conducted during July to October 2021. SETTING HPS is designed to yield representative estimates of the US population aged ≥18 years nationally, by state and across selected metropolitan areas. PARTICIPANTS Our primary analytical sample was adult HCWs in the New York Metropolitan area (n=555), with HCWs defined as individuals who reported working in a 'Hospital'; 'Nursing and residential healthcare facility'; 'Pharmacy' or 'Ambulatory healthcare setting'. In the entire national sample, n=25 909 HCWs completed the survey. Descriptive analyses were performed with HCW data from the New York Metropolitan area, the original epicentre of the pandemic. Multivariable logistic regression analyses were performed on pooled national HCW data to explore how HCW COVID-19-related experiences, perceptions and behaviours varied as a function of broader geographic, clinical and sociodemographic characteristics. RESULTS Of HCWs surveyed in the New York Metropolitan area, 92.3% reported being fully vaccinated, and 20.9% had ever been diagnosed of COVID-19. Of the subset of HCWs in the New York Metropolitan area not yet fully vaccinated, 41.8% were vaccine unsure, 4.5% planned to get vaccinated for the first time soon, 1.6% had got their first dose but were not planning to receive the remaining dose, while 52.1% had got their first dose and planned to receive the remaining dose. Within pooled multivariable analysis of the national HCW sample, personnel in nursing/residential facilities were less likely to be fully vaccinated (adjusted OR, AOR 0.79, 95% CI 0.63 to 0.98) and more likely to report ever COVID-19 diagnosis (AOR 1.35, 95% CI 1.13 to 1.62), than those working in hospitals. Of HCWs not yet vaccinated nationally, vaccine-unsure individuals were more likely to be White and work in pharmacies, whereas vaccine-accepting individuals were more likely to be employed by non-profit organisations and work in ambulatory care facilities. Virtually no HCW was outrightly vaccine-averse, only unsure. CONCLUSIONS Differences in vaccination coverage existed by individual HCW characteristics and healthcare operational settings. Targeted efforts are needed to increase vaccination coverage.
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Affiliation(s)
- Israel T Agaku
- Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, Massachusetts, USA
- COVID-19 Test and Trace Corps, New York, New York, USA
| | | | | | | | - Saief Ahmed
- COVID-19 Test and Trace Corps, New York, New York, USA
| | | | - Theodore Long
- COVID-19 Test and Trace Corps, New York, New York, USA
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Czech-Sioli M, Günther T, Robitaille A, Roggenkamp H, Büttner H, Indenbirken D, Christner M, Lütgehetmann M, Knobloch J, Aepfelbacher M, Grundhoff A, Fischer N. Integration of Sequencing and Epidemiologic Data for Surveillance of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infections in a Tertiary-Care Hospital. Clin Infect Dis 2022; 76:e263-e273. [PMID: 35717654 PMCID: PMC9214157 DOI: 10.1093/cid/ciac484] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The ongoing coronavirus disease 2019 pandemic significantly burdens hospitals and other healthcare facilities. Therefore, understanding the entry and transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical for effective prevention and preparedness measures. We performed surveillance and analysis of testing and transmission of SARS-CoV-2 infections in a tertiary-care hospital in Germany during the second and third pandemic waves in fall/winter 2020. METHODS Between calendar week 41 in 2020 and calendar week 1 in 2021, 40%, of all positive patient and staff samples (284 total) were subjected to full-length viral genome sequencing. Clusters were defined based on similar genotypes indicating common sources of infection. We integrated phylogenetic, spatial, and temporal metadata to detect nosocomial infections and outbreaks, uncover transmission chains, and evaluate containment measures' effectiveness. RESULTS Epidemiologic data and contact tracing readily recognize most healthcare-associated (HA) patient infections. However, sequencing data reveal that temporally preceding index cases and transmission routes can be missed using epidemiologic methods, resulting in delayed interventions and serially linked outbreaks being counted as independent events. While hospital-associated transmissions were significantly elevated at a moderate rate of community transmission during the second wave, systematic testing and high vaccination rates among staff have led to a substantial decrease in HA infections at the end of the second/beginning of the third wave despite high community transmissions. CONCLUSIONS While epidemiologic analysis is critical for immediate containment of HA SARS-CoV-2 outbreaks, integration of genomic surveillance revealed weaknesses in identifying staff contacts. Our study underscores the importance of high testing frequency and genomic surveillance to detect, contain and prevent SARS-CoV-2-associated infections in healthcare settings.
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Affiliation(s)
| | - Thomas Günther
- Virus Genomics Unit, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Alexis Robitaille
- Virus Genomics Unit, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Hannes Roggenkamp
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Henning Büttner
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Daniela Indenbirken
- Virus Genomics Unit, Leibniz Institute for Experimental Virology, Hamburg, Germany
| | - Martin Christner
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Mark Lütgehetmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Johannes Knobloch
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | - Martin Aepfelbacher
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg Eppendorf, Hamburg, Germany
| | | | - Nicole Fischer
- Corresponding author: Nicole Fischer, Institute for Medical Microbiology, Virology and Hygiene University Medical Center Hamburg-Eppendorf Martinistrasse 52 20246 Hamburg, Germany
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COVID-19 cases among medical laboratory services staff in South Africa, 2020–2021: A cohort study. PLoS One 2022; 17:e0268998. [PMID: 35714075 PMCID: PMC9205487 DOI: 10.1371/journal.pone.0268998] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 05/13/2022] [Indexed: 11/23/2022] Open
Abstract
Medical laboratory workers may have an increased risk of COVID-19 due to their interaction with biological samples received for testing and contamination of documents. Records of COVID-19 laboratory-confirmed positive cases within the medical laboratory service were routinely collected in the company’s Occupational Health and Safety Information System (OHASIS). Surveillance data from the OHASIS system were extracted from 1 April 2020 to 31 March 2021. An epidemic curve was plotted and compared to that for the country, along with prevalence proportions and incidence rates. The odds of COVID-19 infection were categorised by job and compared to the US Occupational Risk Scores. A logistic regression model assessed the risk of COVID-19 infection per occupational group. A total of 2091 (26% of staff) COVID-19 positive cases were reported. The number of COVID-19 cases was higher in the first wave at 46% (967/2091) of cases, than in the second wave 40% (846/2091) of cases. There was no significant difference in COVID-19 prevalence between male and female employees. The job categories with the most increased risk were laboratory managers [AOR 3.2 (95%CI 1.9–5.1)] and laboratory support clerks [AOR 3.2 (95%CI 1.9–5.2)]. Our study confirms that some categories of medical laboratory staff are at increased risk for COVID-19; this is a complex interaction between workplace risk factors, community interaction, socioeconomic status, personal habits, and behaviour. Targeted interventions are recommended for high-risk groups. OHASIS has the potential to generate data for surveillance of health care workers and contribute towards a South African risk profile.
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El Moussaoui M, Maes N, Hong SL, Lambert N, Gofflot S, Dellot P, Belhadj Y, Huynen P, Hayette MP, Meex C, Bontems S, Defêche J, Godderis L, Molenberghs G, Meuris C, Artesi M, Durkin K, Rahmouni S, Grégoire C, Beguin Y, Moutschen M, Dellicour S, Darcis G. Evaluation of Screening Program and Phylogenetic Analysis of SARS-CoV-2 Infections among Hospital Healthcare Workers in Liège, Belgium. Viruses 2022; 14:v14061302. [PMID: 35746774 PMCID: PMC9227503 DOI: 10.3390/v14061302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/16/2022] Open
Abstract
Healthcare workers (HCWs) are known to be at higher risk of developing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections although whether these risks are equal across all occupational roles is uncertain. Identifying these risk factors and understand SARS-CoV-2 transmission pathways in healthcare settings are of high importance to achieve optimal protection measures. We aimed to investigate the implementation of a voluntary screening program for SARS-CoV-2 infections among hospital HCWs and to elucidate potential transmission pathways though phylogenetic analysis before the vaccination era. HCWs of the University Hospital of Liège, Belgium, were invited to participate in voluntary reverse transcriptase-polymerase chain reaction (RT-PCR) assays performed every week from April to December 2020. Phylogenetic analysis of SARS-CoV-2 genomes were performed for a subgroup of 45 HCWs. 5095 samples were collected from 703 HCWs. 212 test results were positive, 15 were indeterminate, and 4868 returned negative. 156 HCWs (22.2%) tested positive at least once during the study period. All SARS-CoV-2 test results returned negative for 547 HCWs (77.8%). Nurses (p < 0.05), paramedics (p < 0.05), and laboratory staff handling respiratory samples (p < 0.01) were at higher risk for being infected compared to the control non-patient facing group. Our phylogenetic analysis revealed that most positive samples corresponded to independent introduction events into the hospital. Our findings add to the growing evidence of differential risks of being infected among HCWs and support the need to implement appropriate protection measures based on each individual’s risk profile to guarantee the protection of both HCWs and patients. Furthermore, our phylogenetic investigations highlight that most positive samples correspond to distinct introduction events into the hospital.
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Affiliation(s)
- Majdouline El Moussaoui
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
- Correspondence:
| | - Nathalie Maes
- Department of Biostatistics and Medico-Economic Information, University Hospital of Liège, 4000 Liege, Belgium;
| | - Samuel L. Hong
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; (S.L.H.); (S.D.)
| | - Nicolas Lambert
- Department of Neurology, University Hospital of Liège, 4000 Liege, Belgium;
| | - Stéphanie Gofflot
- Department of Biothèque Hospitalo-Universitaire de Liège (BHUL), University Hospital of Liège, 4000 Liege, Belgium;
| | - Patricia Dellot
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Yasmine Belhadj
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Pascale Huynen
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Marie-Pierre Hayette
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Cécile Meex
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Sébastien Bontems
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Justine Defêche
- Department of Clinical Microbiology, University Hospital of Liège, 4000 Liege, Belgium; (P.H.); (M.-P.H.); (C.M.); (S.B.); (J.D.)
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, Katholieke Universiteit Leuven, 3000 Leuven, Belgium;
| | - Geert Molenberghs
- Institute for Biostatistics and Statistical Bioinformatics, Katholieke Universiteit Leuven, 3000 Leuven, Belgium;
| | - Christelle Meuris
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Maria Artesi
- Laboratory of Human Genetics, GIGA-Institute, University of Liège, 4000 Liege, Belgium; (M.A.); (K.D.)
| | - Keith Durkin
- Laboratory of Human Genetics, GIGA-Institute, University of Liège, 4000 Liege, Belgium; (M.A.); (K.D.)
| | - Souad Rahmouni
- Laboratory of Animal Genomics, GIGA-Medical Genomics, GIGA-Institute, University of Liège, 4000 Liege, Belgium;
| | - Céline Grégoire
- Department of Haematology, University Hospital of Liège, 4000 Liege, Belgium; (C.G.); (Y.B.)
| | - Yves Beguin
- Department of Haematology, University Hospital of Liège, 4000 Liege, Belgium; (C.G.); (Y.B.)
| | - Michel Moutschen
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
| | - Simon Dellicour
- Department of Microbiology, Immunology and Transplantation, Rega Institute, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; (S.L.H.); (S.D.)
- Spatial Epidemiology Lab, Université Libre de Bruxelles, 1000 Brussels, Belgium
| | - Gilles Darcis
- Department of Infectious Diseases and General Internal Medicine, University Hospital of Liège, 4000 Liege, Belgium; (P.D.); (Y.B.); (C.M.); (M.M.); (G.D.)
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Bi Y, Aganovic A, Mathisen HM, Cao G. Experimental study on the exposure level of surgical staff to SARS-CoV-2 in operating rooms with mixing ventilation under negative pressure. BUILDING AND ENVIRONMENT 2022; 217:109091. [PMID: 35469260 PMCID: PMC9021120 DOI: 10.1016/j.buildenv.2022.109091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/06/2022] [Accepted: 04/10/2022] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to reveal the exposure level of surgical staff to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from the patient's nose and wound during operations on COVID-19 patients. The tracer gas N2O is used to simulate SARS-CoV-2 from the patient's nose and wound. In this study, concentration levels of tracer gas were measured in the breathing zones of these surgical staff in the operating room under three pressure difference conditions: -5 pa-15 pa and -25 pa compared to the adjunction room. These influencing factors on exposure level are analyzed in terms of ventilation efficiency and the thermal plume distribution characteristics of the patient. The results show that the assistant surgeon faces 4 to 12 times higher levels of exposure to SARS-CoV-2 than other surgical staff. Increasing the pressure difference between the OR lab and adjunction room can reduce the level of exposure for the main surgeon and assistant surgeon. Turning on the cooling fan of the endoscope imager may result in a higher exposure level for the assistant surgeon. Surgical nurses outside of the surgical microenvironment are exposed to similar contaminant concentration levels in the breathing zone as in the exhaust. However, the ventilation efficiency is not constant near the surgical patient or in the rest of the room and will vary with a change in pressure difference. This may suggest that the air may not be fully mixed in the surgical microenvironment.
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Affiliation(s)
- Yang Bi
- Norwegian University of Science and Technology, Trondheim, Norway
| | | | | | - Guangyu Cao
- Norwegian University of Science and Technology, Trondheim, Norway
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Ramsay I, Sharrocks K, Warne B, Sithole N, Ravji P, Bousfield R, Jones N, Leong CE, Suliman M, Tsui R, Toleman MS, Moody C, Smith R, Whitehorn J, Gouliouris T, Penciu F, Hofling C, Cunningham C, Enoch DA, Moore E. Investigation of healthcare-associated SARS-CoV-2 infection: Learning outcomes from an investigative process in the initial phase of the pandemic. J Infect Prev 2022; 23:197-205. [PMID: 36003131 PMCID: PMC9117956 DOI: 10.1177/17571774221092553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 02/21/2022] [Indexed: 11/17/2022] Open
Abstract
Background Healthcare-associated (HCA) SARS-CoV-2 infection is a significant contributor
to the spread of the 2020 pandemic. Timely review of HCA cases is essential
to identify learning to inform infection prevention and control (IPC)
policies and organisational response. Aim To identify key areas for improvement through rapid investigation of HCA
SARS-CoV-2 cases and to implement change. Methods Cases were identified based on date of first positive SARS-CoV-2 PCR sample
in relation to date of hospital admission. Cases were reviewed using a
structured gap analysis tool to identify key learning points. These were
discussed in weekly multidisciplinary meetings to gain consensus on learning
outcomes, level of harm incurred by the patient and required actions.
Learning was then promptly fed back to individual teams and the
organisation. Findings Of the 489 SARS-CoV-2 cases admitted between 10th March and
23rd June 2020, 114 suspected HCA cases (23.3%) were
reviewed; 58/489 (11.8%) were ultimately deemed to be HCA. Five themes were
identified: individual patient vulnerability, communication, IPC
implementation, policy issues and organisational response. Adaptations to
policies based on these reviews were completed within the course of the
initial phase of the pandemic. Conclusion This approach enabled timely learning and implementation of control measures
and policy development.
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Affiliation(s)
- Isobel Ramsay
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Katherine Sharrocks
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ben Warne
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Nyarie Sithole
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Pooja Ravji
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rachel Bousfield
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Nick Jones
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Clare E Leong
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mohamed Suliman
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Rachel Tsui
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
| | | | - Christine Moody
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
| | - Richard Smith
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
| | - James Whitehorn
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Theodore Gouliouris
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Christian Hofling
- Infectious Diseases, Universidade Estadual de Campinas, Campinas, Brazil
| | - Chris Cunningham
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - David A Enoch
- Clinical Microbiology & Public Health Laboratory, Cambridge, UK
| | - Elinor Moore
- Infectious Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Sá R, Isidro J, Borges V, Duarte S, Vieira L, Gomes JP, Tedim S, Matias J, Leite A. Unravelling the hurdles of a large COVID-19 epidemiological investigation by viral genomics. J Infect 2022; 85:64-74. [PMID: 35609706 PMCID: PMC9123803 DOI: 10.1016/j.jinf.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/16/2022] [Accepted: 05/17/2022] [Indexed: 11/25/2022]
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Zhussupov B, Suleimenova Z, Amanova G, Saliev T, Tanabayeva S, Sarybayeva G, Iskakova G, Fakhradiyev I, Aukenov N. The Study of the Outbreak of Coronavirus Infection in a General Hospital in Almaty. Hosp Top 2022; 101:326-335. [PMID: 35435796 DOI: 10.1080/00185868.2022.2063774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The study aimed to identify the possible causes of COVID-19 outbreak and its development in a general hospital in Almaty (from April 11 to May 6, 2020), where 682 persons were identified with a COVID-19. 546 were hospital employees (48.9%), including doctors (57.8%), nurses (53.4%), junior medical personnel (54.4%) and other personnel (23.3%), and also among 136 patients. The attack rate among women was 50.0%, and incidence rate was higher amongst young employees < 30 years old (57.0%). The analysis showed that there was a failure of the management of the medical personnel in such critical situation.
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Affiliation(s)
- Baurzhan Zhussupov
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Zhanar Suleimenova
- National Scientific and Practical Centre for Sanitary and Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Gulzhan Amanova
- National Scientific and Practical Centre for Sanitary and Epidemiological Expertise and Monitoring, Almaty, Kazakhstan
| | - Timur Saliev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Shynar Tanabayeva
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | | | | | - Ildar Fakhradiyev
- S.D. Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
| | - Nurlan Aukenov
- Ministry of Healthcare of the Republic of Kazakhstan, Nur-Sultan, Kazakhstan
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