Contact Screening for Healthcare Workers Exposed to Patients with COVID-19

Abstract

In China and Italy, many cases of coronavirus disease 2019 (COVID-19) have occurred among healthcare workers (HCWs). Prompt identification, isolation and contact tracing of COVID-19 cases are key elements in controlling the COVID-19 pandemic. The aim of this study was to evaluate the rate of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among HCWs exposed to patients with COVID-19 in relation to the main determinants of exposure. To assess the risk of exposure, we performed active symptom monitoring in 1006 HCWs identified as contacts of COVID19 cases. The presence of symptoms was statistically associated with a positive nasopharyngeal swab result. Only one subject was asymptomatic at the time of positive test. These data suggest that clinical history may help in the selection of subjects to be investigated by means of reverse transcriptase-polymerase chain reaction (RT-PCR) in the case of a shortage of diagnostic resources. We found that close contact (within 2 m for 15 min or more) was not statistically related to contagion. Regarding the use of personal protective equipment (PPE), only the use of facial masks was inversely related to the chance of becoming infected (p < 0.01). In conclusion, our data show that unprotected contacts between HCWs should be considered a major route of HCW contagion, suggesting that the use of facial masks should be implemented even in settings where known patients with COVID-19 are not present.

Asymptomatic SARS-CoV-2 infection: A systematic review and meta-analysis

“…These studies included a total of 104,058 laboratory-confirmed COVID-19 cases, of which 25,050 exhibited no symptoms at the time of testing and 7,220 remained asymptomatic. We identified 170 studies that reported asymptomatic infections ( 11 – 13 , 17 – 183 ), 332 studies that reported silent infections at the time of testing ( 10 – 12 , 14 , 17 – 20 , 23 – 27 , 31 , 32 , 35 – 40 , 42 – 44 , 46 , 47 , 49 , 50 , 52 , 53 , 56 – 58 , 60 – 66 , 68 , 69 , 73 – 75 , 77 – 79 , 81 , 84 , 87 , 90 – 94 , 97 , 99 , 101 , 103 , 104 , 106 , 111 , 113 – 116 , 118 , 119 , 121 – 123 , 125 , 127 , 128 , …”

Intention to Be Vaccinated for COVID-19 among Italian Nurses during the Pandemic

“…Although the percentage of participants willing to be vaccinated in our survey appears to be high, the presence of a non-insignificant number of nurses who were opposed or undecided can compromise hospital health policies and put the safety of fragile patients with whom they come into contact at risk. In previous studies regarding post-exposure screening for COVID-19, it was found that contact between healthcare workers is the main source of intrahospital infection rather than contact through assisting hospitalized patients [ 27 ]. Although there have been heated debates surrounding the potential compulsory use of the COVID-19 vaccine among healthcare workers, no real decision has been taken by the Italian government to date.…”

COVID-19 Pandemic and Equal Access to Vaccines

“…Inequality as regards the risk of contracting COVID-19 is due to the fact that certain individuals, communities, and populations are at a higher risk of contracting the infection or of contracting a particularly severe infection [ 4 ] than others. The first risk is linked to individual circumstances [ 5 ] (immunodepression), social circumstances [ 6 ] (community living, close living quarters, homelessness), and work-related circumstances [ 7 , 8 ] (frequent contact with the public, poor protection in the work environment) [ 9 ]. The second risk seems predominantly linked to biological conditions (pre-existing illnesses), but it is clear that prohibitive socioeconomic factors are also pivotal, such as limited access to diagnosis and appropriate early treatment [ 10 , 11 ].…”