Regional variation in trajectories of healthcare worker infections during the COVID-19 pandemic in Italy

Abstract

To the Editor-Healthcare workers (HCWs) have been key in the current global response against the COVID-19 epidemic; their safety can help address the clinical and public health challenges associated with SARS-CoV-2 infection. 1 As of late March, infections of HCWs in Italy reached a peak of 10.0% of the total COVID-19 cases, 2 representing a potential amplifier of the epidemic following the viral transmission within and outside the health facility environment, to HCWs, visitors, inpatients, and outpatients. The Italian National Health Institute (Istituto Superiore di Sanita, ISS), has been issuing a biweekly bulletin on the COVID-19-update since March 19, 2020. These bulletins report on Italian regional data collected by local laboratories, stratified by demographic and epidemiological variables (eg, age, province, etc). Until April 2, bulletins were also reporting the cumulative number of SARS-CoV-2-positive HCWs. 3-7 Unfortunately, no data on incident infections among HCWs have been published in the most recent reports. The available data show wide regional disparities, both in terms of HCW infection prevalence and in trajectories over the 4 weeks of monitoring (Fig. 1). On March 19, 2020, the cumulative number of positive individuals ranged from 7 in Valle d'Aosta to 19,882 in Lombardy, with a proportional attributable contribution to the total amount of cases varying from 0.2% (n = 1) in Campania to 41.5% (n = 44) in Sardinia. Although the overall national trend of positive healthcare workers out of the total cases showed a slight decrease (from 9.5% to 8.4%) from March 19 to April 2, several regional patterns were also described in the same period (Fig. 1). Some regions (eg,

Importance of mitigation measures for hospital transmission of SARS-CoV-2 at the onset of the epidemic: the experience of Brescia, Northern Italy

“…This is in contrast with studies performed in Wuhan at the beginning of the epidemic which showed a higher risk of infection in low-risk units, where workers were less trained on the use of PPE [ 6 , 21 ]. Conversely, more recent Italian [ 22 – 24 ] and American studies [ 25 ] showed results similar to ours, alongside the Denmark study on seroprevalence (thus identifying also asymptomatic cases) that demonstrated a higher prevalence for workers in COVID-19 units than other frontline workers [ 26 ]. Besides, another retrospective survey conducted in our hospital found no correlation between working in COVID units and positive serostatus, presumably due to a higher risk awareness [ 27 ].…”

Decontamination of common healthcare facility surfaces contaminated with SARS-CoV-2 using peracetic acid dry fogging

“…The burden of COVID-19 among healthcare workers has been enormous during the ongoing COVID-19 pandemic [ [1] , [2] , [3] , [4] , [5] ]. Environmental sampling has demonstrated the presence of SARS-CoV-2, the causative agent of COVID-19, in indoor air and on various surfaces in healthcare settings [ [6] , [7] , [8] ].…”

Response to COVID-19: was Italy (un)prepared?

“…The shortage of nurses and medical doctors front lining the emergency response, also in light of the high number of nurses and medical professionals testing positive to COVID-19 (Bellizzi et al ., 2020 ), forced the Government to introduce several measures (DL, 2020a , 2020b ; DPCM, 2020b ) in order to face the rapidly rising demand of extra medical and other health care personnel. These measures included inter-regional redistribution of health care personnel, the re-hiring of retired medics, nurses and other health care professionals, the creation of faster recruitment tracks, the possibility to employ personnel on a freelance basis, the hiring of 20,000 health care professionals (3.5% growth in the health workforce): the new hires comprised of more than 4300 additional medical doctors, mainly anaesthesiologists; around 9700 nurses; and 6000 other health care professionals, mainly technical personnel (Aimone Gigio et al ., 2020 ).…”