Impact of the Early Phase of the COVID-19 Pandemic on US Healthcare Workers: Results from the HERO Registry

Abstract

Background The HERO registry was established to support research on the impact of the COVID-19 pandemic on US healthcare workers. Objective Describe the COVID-19 pandemic experiences of and effects on individuals participating in the HERO registry. Design Cross-sectional, self-administered registry enrollment survey conducted from April 10 to July 31, 2020. Setting Participants worked in hospitals (74.4%), outpatient clinics (7.4%), and other settings (18.2%) located throughout the nation. Participants A total of 14,600 healthcare workers. Main Measures COVID-19 exposure, viral and antibody testing, diagnosis of COVID-19, job burnout, and physical and emotional distress. Key Results Mean age was 42.0 years, 76.4% were female, 78.9% were White, 33.2% were nurses, 18.4% were physicians, and 30.3% worked in settings at high risk for COVID-19 exposure (e.g., ICUs, EDs, COVID-19 units). Overall, 43.7% reported a COVID-19 exposure and 91.3% were exposed at work. Just 3.8% in both high- and low-risk settings experienced COVID-19 illness. In regression analyses controlling for demographics, professional role, and work setting, the risk of COVID-19 illness was higher for Black/African-Americans (aOR 2.32, 99% CI 1.45, 3.70, p < 0.01) and Hispanic/Latinos (aOR 2.19, 99% CI 1.55, 3.08, p < 0.01) compared with Whites. Overall, 41% responded that they were experiencing job burnout. Responding about the day before they completed the survey, 53% of participants reported feeling tired a lot of the day, 51% stress, 41% trouble sleeping, 38% worry, 21% sadness, 19% physical pain, and 15% anger. On average, healthcare workers reported experiencing 2.4 of these 7 distress feelings a lot of the day. Conclusions Healthcare workers are at high risk for COVID-19 exposure, but rates of COVID-19 illness were low. The greater risk of COVID-19 infection among race/ethnicity minorities reported in the general population is also seen in healthcare workers. The HERO registry will continue to monitor changes in healthcare worker well-being during the pandemic. Trial Registration ClinicalTrials.gov identifier NCT04342806 Supplementary Information The online version contains supplementary material available at 10.1007/s11606-020-06529-z.

Update Alert 10: Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers

“…New evidence was consistent with prior updates in finding no consistent association between risk for SARS-CoV-2 infection in HCWs and age (13 studies [ 6 , 8 , 10 , 11 , 14–17 , 19 , 22–25 ]), sex (13 studies [ 6 , 8 , 10 , 11 , 13 , 14 , 16 , 17 , 19 , 22–25 ]), or HCW role (15 studies [ 6 , 7 , 11–16 , 19–25 ]) ( Supplement Table 2 ). Also consistent with prior updates, 5 studies done in the United States, Canada, or Ireland found that non-White race (Black, Asian or Asian/Pacific Islander, or combined non-White races) or Hispanic ethnicity was associated with increased risk for infection ( Supplement Table 2 ) ( 6 , 8 , 11 , 15 , 16 ).…”

The German Translation of the Stress and Anxiety to Viral Epidemics-9 (SAVE-9) Scale: Results from Healthcare Workers during the Second Wave of COVID-19

“…Healthcare workers (HCW) are at the forefront of dealing with the pandemic; they share in the burdens borne by everyone (e.g., curfews, restrictions in activities), but in addition, face specific stressors due to their profession (e.g., increased risk of infection, increased workload). Even though some researchers did not find evidence that more exposure to COVID-19 patients conferred a higher risk of infection in this group [1][2][3][4][5], there is strong evidence for markedly increased rates of COVID-19 in HCW compared to the general public [6][7][8][9][10][11][12][13][14].…”

Hydroxychloroquine for pre-exposure prophylaxis of COVID-19 in health care workers: a randomized, multicenter, placebo-controlled trial (HERO-HCQ)

“…Participants were prescreened through the HERO Registry, and eligibility was confirmed by the site by phone or in person. 5 Participants were able to electronically consent through the portal, which was done at the time of the site visit or in advance. There were two on-site visits -one at baseline and another at 30 days.…”

“…The Healthcare Worker Exposure Response and Outcomes (HERO) Registry (NCT04342806) was created as a community of HCW from across the United States to learn about issues impacting frontline workers and to offer opportunities to participate in research studies. 5 The HERO-HCQ trial was one of the first studies in the United States to test the safety and efficacy of HCQ as pre-exposure prophylaxis in frontline HCW. HERO-HCQ leveraged both the HERO Registry as well as its relationship with PCORnet®, The National Patient-Centered Clinical Research Network as a pragmatic and largely remote clinical trial, using a patient-facing online portal to capture frequent patient-reported outcomes.…”