Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19

Jones, Nick K; Rivett, Lucy; Sparkes, Dominic; Forrest, Sally; Sridhar, Sushmita; Young, Jamie; Pereira-Dias, Joana; Cormie, Claire; Gill, Harmeet K.; Reynolds, Nicola; Wantoch, Michelle; Routledge, Matthew; Warne, Ben; Levy, Jack; Jiménez, William David Córdova; Samad, Fathima Nisha Begum; McNicholas, Chris; Ferris, Mark; Gray, Jane; Gill, Michael B.; Baker, Stephen; Bradley, John R.; Dougan, Gordon; Goodfellow, Ian; Gupta, Ravi; Lehner, Paul J.; Lyons, Paul; Matheson, Nicholas J; Smith, Kenneth; Török, M. Estée; Toshner, Mark; Weekes, Michael P.; Jones, Nicholas K.; Kean, Iain; Caddy, Sarah; Caller, Laura G; Feltwell, Theresa; Hall, Grant; Hamilton, William L.; Hosmillo, Myra; Houldcroft, Charlotte J.; Jahun, Aminu S.; Khokhar, Fahad; Meredith, Luke W.; Yakovleva, Anna; Butcher, Helen; Caputo, Daniela; Clapham-Riley, Debra; Dolling, Helen; Furlong, Anita; Graves, Barbara; Gresley, Emma Le; Kingston, Nathalie; Papadia, Sofia; Stark, Hannah; Stirrups, Kathleen; Webster, Jennifer; Calder, Joanna; Harris, Julie; Hewitt, Sarah; Kennet, Jane; Meadows, Anne; Rastall, Rebecca; Brien, Criona O; Price, Jessica; Publico, Cherry; Rowlands, Jane; Ruffolo, Valentina; Tordesillas, Hugo; Hannon, Greg; Brookes, Karen; Canna, Laura; Cruz, Isabel Cf da; Dempsey, Katie; Elmer, Anne; Escoffery, Naidine; Fuller, Stewart; Jones, Heather; Ribeiro, Carla M. S.; Saunders, Caroline; Wright, Angela; Nyagumbo, Rutendo; Roberts, Anne M.; Bucke, Ashlea; Hargreaves, Simone; Johnson, Danielle; Narcorda, Aileen; Read, Debbie; Sparke, Christian; Worboys, Lucy; Lagadu, Kirsty; Mactavous, Lenette; Gould, T; Raine, Tim; Shaw, Ashley; Mather, Claire; Ramenatte, Nicola; Vallier, Anne-Laure; Kasanicki, Mary; Eames, Penelope-Jane; Thake, Lisa; Bartholomew, Neil; Brown, Nicholas M.; Curran, Martin D.; Parmar, Surendra; Zhang, Hongyi; Bowring, Ailsa; Martell, Geraldine; Quinnell, Natalie; Wright, Giles; Wright, Jo; Murphy, Helen; Dunmore, Benjamin J.; Legchenko, Ekaterina; Graf, Stefan Ting; Huang, Christopher L.‐H.; Hodgson, Josh; Hunter, Kelvin; Martin, Jennifer; Mescia, Federica; O’Donnell, Ciara; Pointon, Linda; Shih, Joy; Sutcliffe, Rachel; Tilly, Tobias; Tong, Zhen; Treacy, Carmen; Wood, Jennifer; Bergamaschi, Laura; Betancourt, Ariana; Bowyer, Georgie; De, Aloka; Epping, Maddie; Hinch, Andrew; Huhn, Oisín; Jarvis, Isobel; Lewis, Daniel; Marsden, Joe; McCallum, Simon; Nice, Francescsa; Omarjee, Ommar; Perera, Marianne; Romashova, Nika; Strezlecki, Mateusz; Yarkoni, Natalia Savoinykh; Turner, Lori; Bailey, Barrie; Chaudhry, Afzal; Doughton, Rachel; Workman, Christopher T.; Trotter, Caroline; David, William S.; Jiménez, Cordova; Samad, Fatima

doi:10.7554/elife.59391

Cited by 46 publications

(45 citation statements)

References 11 publications

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“…Out of these 14 individuals and within 3 weeks after testing, 7 did not develop any symptoms and 7 of them became symptomatic, suggesting that the true asymptomatic carriage rate was 7/413 (1,7%). Our data is comparable to that of recent studies testing HCWs in hospitals of USA and UK, which show asymptomatic infection rates close to 3% [ 12 , 13 ].…”

Section: Discussionsupporting

confidence: 90%

SARS-CoV-2 infection in asymptomatic healthcare workers at a clinic in Chile

et al. 2021

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Asymptomatic SARS-CoV-2 infection of healthcare workers (HCWs) has been reported as a key player in the nosocomial spreading of COVID-19. Early detection of infected HCWs can prevent spreading of the virus in hospitals among HCWs and patients. We conducted a cross-sectional study to determine the asymptomatic infection of HCWs in a private clinic in the city of Santiago, Chile. Our study was conducted during a period of 5 weeks at the peak of transmission of SARS-CoV-2 in Chile. Nasopharyngeal samples were obtained from 413 HCWs and tested for the presence of SARS-CoV-2 using RT-qPCR. We found that a 3.14% of HCWs were positive for the presence of SARS-CoV-2 (14/413). Out of these, 7/14 were completely asymptomatic and did not develop symptoms within 3 weeks of testing. Sequencing of viral genomes showed the predominance of the GR clade; however, sequence comparison demonstrated numerous genetic differences among them suggesting community infection as the main focus of transmission among HCWs. Our study demonstrates that the protocols applied to protect HCWs and patients have been effective as no infection clusters due to asymptomatic carriers were found in the clinic. Together, these data suggest that infection with SARS-CoV-2 among HCWs of this health center is not nosocomial.

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Section: Discussionsupporting

confidence: 90%

SARS-CoV-2 infection in asymptomatic healthcare workers at a clinic in Chile

et al. 2021

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“…The infective risk is not a minor concern for patients and HWs [ 31 – 33 ], first of all because the patients with an Endocrine conditions could be an asymptomatic carrier [ 2 ]. However, all HWs of the AOU of Padova underwent a routine molecular swab for SARS-CoV-2 every 3 weeks, and nowadays none of those working in the Endocrine Outpatient Service is positive.…”

Section: Discussionmentioning

confidence: 99%

Tele-medicine versus face-to-face consultation in Endocrine Outpatients Clinic during COVID-19 outbreak: a single-center experience during the lockdown period

Ceccato

Voltan²,

Sabbadin³

et al. 2020

J Endocrinol Invest

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Context The COVID-19 outbreak in Italy is the major concern of Public Health in 2020: measures of containment were progressively expanded, limiting Outpatients’ visit. Objective We have developed and applied an emergency plan, tailored for Outpatients with endocrine diseases. Design Cross-sectional study from March to May 2020. Setting Referral University-Hospital center. Patients 1262 patients in 8 weeks. Interventions The emergency plan is based upon the endocrine triage, the stay-safe procedures and the tele-Endo. During endocrine triage every patient was contacted by phone to assess health status and define if the visit will be performed face-to-face (F2F) or by tele-Medicine (tele-Endo). In case of F2F, targeted stay-safe procedures have been adopted. Tele-Endo, performed by phone and email, is dedicated to COVID-19-infected patients, to elderly or frail people, or to those with a stable disease. Main outcome measure To assess efficacy of the emergency plan to continue the follow-up of Outpatients. Results The number of visits cancelled after endocrine triage (9%) is lower than that cancelled independently by the patients (37%, p < 0.001); the latter reduced from 47 to 19% during the weeks of lockdown (p = 0.032). 86% of patients contacted by endocrine-triage received a clinical response (F2F and tele-Endo visits). F2F visit was offered especially to young patients; tele-Endo was applied to 63% of geriatric patients (p < 0.001), visits’ outcome was similar between young and aged patients. Conclusions The emergency plan respects the WHO recommendations to limit viral spread and is useful to continue follow-up for outpatients with endocrine diseases.

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“…Metadata were uploaded weekly to the MRC CLIMB system as part of the COG-UK Consortium. Samples included healthcare workers (HCW) tested in the CUH HCW screening programme ( Jones et al, 2020a ; Rivett et al, 2020 ), all of which were nanopore sequenced on site.…”

Section: Methodsmentioning

confidence: 99%

Genomic epidemiology of COVID-19 in care homes in the east of England

Hamilton

Tonkin‐Hill

Smith

et al. 2021

eLife

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COVID-19 poses a major challenge to care homes, as SARS-CoV-2 is readily transmitted and causes disproportionately severe disease in older people. Here, 1,167 residents from 337 care homes were identified from a dataset of 6,600 COVID-19 cases from the East of England. Older age and being a care home resident were associated with increased mortality. SARS-CoV-2 genomes were available for 700 residents from 292 care homes. By integrating genomic and temporal data, 409 viral clusters within the 292 homes were identified, indicating two different patterns - outbreaks among care home residents and independent introductions with limited onward transmission. Approximately 70% of residents in the genomic analysis were admitted to hospital during the study, providing extensive opportunities for transmission between care homes and hospitals. Limiting viral transmission within care homes should be a key target for infection control to reduce COVID-19 mortality in this population.

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Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19

Cited by 46 publications

References 11 publications

SARS-CoV-2 infection in asymptomatic healthcare workers at a clinic in Chile

SARS-CoV-2 infection in asymptomatic healthcare workers at a clinic in Chile

Tele-medicine versus face-to-face consultation in Endocrine Outpatients Clinic during COVID-19 outbreak: a single-center experience during the lockdown period

Genomic epidemiology of COVID-19 in care homes in the east of England

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