COVID-19 Infections Among Healthcare Personnel in the United States Veterans Health Administration, March to August, 2020

Abstract

Objective: We investigated COVID-19 infection and death among healthcare personnel (HCP) in the United States Veterans Health Administration. Methods: HCP with positive Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction tests between March 1 and August 31, 2020 were included. Risk ratios were calculated for sex, age, race/ethnicity, Veteran status, occupation category, facility of employment by inpatient COVID-19 test percent positivity and death. Results: Five thousand nine hundred twenty five HCP were COVID-19-infected out of 131,606 tested (4.5% positivity). Highest risk for COVID-19 infection included: HCP working in hospitals with more than 15% inpatient COVID-19 test positivity, nursing staff, non-Hispanic Black, and Hispanic or Latino HCP and HCP who were Veterans. Among 18 HCP who died after COVID-19 infection, male sex, age more than or equal to 65 years, and Veteran status were significant risk factors. Conclusions: Robust national surveillance testing methods are needed to accurately monitor HCP COVID-19 infections and deaths to improve HCP safety.

The Use of a Video-Assisted Intubating Stylet Technique in a Critically Ill and Contagious COVID-19 Patient

“…Among these hospitalized HCW, 28% of these patients were admitted to an intensive care unit, 16% required invasive mechanical ventilation, and 4% died [ 1 ]. A 4.5% positivity was noted out of 131,606 United States HCW who were tested at 1225 Veterans Health Administration medical centers between 12 February and 16 July 2020; however, this total may be an underestimation [ 2 ]. When personal protective equipment (PPE) is adequate, available, and properly used, infection rates of COVID-19 among HCW drop below those reported rates among the general public [ 3 ].…”

Case-control study evaluating risk factors for SARS-CoV-2 outbreak amongst healthcare personnel at a tertiary care center

“…There have been several reports of increased SARS-CoV-2 infections among HCP worldwide since the beginning of the pandemic. 5 , 6 , 7 , 8 In a large prospective cohort study of over 2 million community individuals and nearly 100,000 HCP in the UK and USA, HCP were found to have a 3.4 times increased risk of SARS-CoV-2 infection compared to the general population. 6 Several SARS-CoV-2 outbreaks amongst healthcare workers have also been reported and directly linked to a single index patient, often a patient with a delayed diagnosis of COVID-19 due to negative tests early in the hospital course.…”

“… 15 In the US, nursing staff have been shown to have higher COVID-19 rates and associated hospitalizations compared to other HCP; other clinical HCP also had higher rates compared to non-clinical support and infrastructure personnel. 7 , 16 …”

Benchmarking SARS CoV-2 Infection in the Workplace to Support Continuity of Operations

“…21 Regarding health workers, a recent study reported a 0.3% death rate and a 4.5% positivity rate in Veterans Administration health workers. 22 In time, the Occupational Health and Safety Administration (OSHA) can be expected to clarify morbidity and mortality associated with the pandemic with publicly available data. However, at present, only a patchwork of reference group death rate data is available and estimates likely will change in time.…”