COVID-19 in health care workers, Australia 2020

Abstract

Background Health care workers are at increased risk of SARS-CoV-2 infection due to potential exposure to patients or staff in health care settings. Australian health care services and health care workers experienced intense pressure to prepare for and respond to SARS-CoV-2 infections. We summarise national data on health care worker infections and associated outbreaks during 2020. Methods We collected aggregated data on infected health care workers and outbreaks in health care facilities from all jurisdictions. Health care workers working solely in residential aged care and outbreaks in residential aged care facilities were excluded. Jurisdictions provided data on the number of health care setting outbreaks, confirmed cases, hospitalisation, source of infection, and health care worker role. We analysed data for two periods that aligned with two distinct peaks in the epidemic relative to 1 June 2020, referred to here as the first wave (23 January – 31 May 2020) and the second wave (1 June – 18 September 2020). Results Jurisdictions reported a total of 2,163 health care worker infections with SARS-CoV-2 during the surveillance period. Source of acquisition was known for 81.0% of cases (1,667/2,059). The majority of cases in the first wave were acquired overseas, shifting to locally-acquired cases in the second wave. The odds of infection in the second wave compared to the first wave were higher for nurses/midwives (odds ratio, OR: 1.61; 95% confidence interval (95% CI): 1.32–2.00), lower for medical practitioners (OR: 0.36; 95% CI: 0.28–0.47) and did not differ for ‘other’ health care workers (OR: 1.07; 95% CI: 0. 87–1.32). The odds of infection in the second wave were higher in a health care setting (OR: 1.76; 95% CI: 1.28–2.41) than in the community. There were 120 outbreaks in health care settings with 1,428 cases, of which 56.7% (809/1,428) were health care workers. The majority (88/120; 73.8%) of outbreaks in health care settings occurred in the second wave of the epidemic, with 90.9% of these (80/88) occurring in Victoria. Conclusions In the second wave of the epidemic, when there was heightened community transmission, health care workers were more likely to be infected in the workplace. Throughout the epidemic, nurses were more likely to be infected than staff in other roles.

Key lessons from the COVID-19 public health response in Australia

“…Supporting local manufacturers of PPE and hand hygiene supplies is important to improve health security, but a difficult problem that requires urgent attention is the excessive environmental footprint generated by PPE waste. High rates of health and residential care worker infection were reported, with associated workforce shortages, low morale and burn out, 38 , 39 , 40 resulting in healthcare worker strikes around the country. New waves of SARS CoV-2 transmission, combined with the renewed circulation of traditional respiratory viruses that were suppressed by COVID-19 containment measures, present considerable ongoing workforce challenges with viral transmission now recognised as an important work health and safety issue.…”

Risk factors for SARS-CoV-2 infection in healthcare workers following an identified nosocomial COVID-19 exposure during waves 1–3 of the pandemic in Ireland

“…Variability in SARS-CoV-2 infection by job role has been demonstrated in a number of studies, with nursing staff and HCAs [ 5 , 6 , 13 , 14 , 30 ] often cited as being at increased risk of infection. In our findings, no individual job role was determined to have consistently increased risk of infection following a given in-work COVID-19 exposure.…”

Quantifying the reduction of airborne infectious viral load using a ventilated patient hood

“…In lieu of this, much focus has been placed upon correct PPE use by HCWs (e.g., N95 mask and barrier gowns) to reduce spread of SARS-CoV-2 to HCWs and other patients [ 3 ]. However, despite these measures, HCWs have remained at high risk of nosocomial illness following SARS-CoV-2 exposure in healthcare settings [ 6 ].…”