Strategies for infection control and prevalence of anti-SARS-CoV-2 IgG in 4,554 employees of a university hospital in Munich, Germany

Abstract

Background Hospital staff are at high risk of infection during the coronavirus disease (COVID-19) pandemic. We analysed the exposure characteristics, efficacy of protective measures, and transmission dynamics in this hospital-wide prospective seroprevalence study. Methods and Findings Overall, 4554 individuals were tested for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG antibodies using a chemiluminescent immunoassay. Individual risk factors, use of personal protective equipment (PPE), occupational exposure, previous SARS-CoV-2 infection, and symptoms were assessed using a questionnaire and correlated to anti-SARS-CoV-2 IgG antibody titres and PCR testing results. Odds ratios with corresponding exact 95% confidence intervals were used to evaluate associations between individual factors and seropositivity. Spatio-temporal trajectories of SARS-CoV-2-infected patients and staff mobility within the hospital were visualised to identify local hotspots of virus transmission. The overall seroprevalence of anti-SARS-CoV-2-IgG antibody was 2.4% [95% CI 1.9-2.9]. Patient-facing staff, including those working in COVID-19 areas, had a similar probability of being seropositive as non-patient-facing staff. Prior interaction with SARS-CoV-2-infected co-workers or private contacts and unprotected exposure to COVID-19 patients increased the probability of seropositivity. Loss of smell and taste had the highest positive predictive value for seropositivity. The rate of asymptomatic SARS-CoV-2 infections was 25.9%, and higher anti-SARS-CoV-2 IgG antibody titres were observed in symptomatic individuals. Spatio-temporal hotspots of SARS-CoV-2-positive staff and patients only showed partial overlap. Conclusions Patient-facing work in a healthcare facility during the SARS-CoV-2 pandemic may be safe if adequate PPE and hygiene measures are applied. The high numbers of asymptomatic SARS-CoV-2 infections that escaped detection by symptomatic testing underline the value of cross-sectional seroprevalence studies. Unprotected contact is a major risk factor for infection and argues for the rigorous implementation of hygiene measures.

Characterization and evolution of infection control practices among severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–infected healthcare workers in acute-care hospitals and long-term care facilities in Québec, Canada, Spring 2020

“…Interaction with SARS-CoV-2-infected coworkers increased risk of infection by 74% in a large German study. 27 All of these risk factors appear to have decreased during the first pandemic wave but remained fairly common, even at the end of the study period.…”

COVID-19 Vaccination Acceptance and Hesitancy among Healthcare Workers in Germany

“…This might be explained by the perception of a higher transmission risk in the family setting than in the professional setting, where personal protective equipment and strict testing of patients and staff are used routinely, especially in COVID-19 treatment units, where HCWs treat COVID-19 patients daily. Additionally, it could be speculated that HCWs in German hospitals were sufficiently supplied with professional protective equipment, and therefore the threat of becoming infected with COVID-19 was judged as low [ 52 ].…”

COVID-19 Prevention and Control Measures in Workplace Settings: A Rapid Review and Meta-Analysis

“…Fifteen studies were performed in the United States (USA) [28,36,38,41,45,49,51,52,55,69,72,[78][79][80][81]. Other included studies were performed in India [32], France [72], Canada [29,63], Italy [22,42,44,57,60,62,74], the United King-dom (UK) [35,40,50,53,58,65,75,76], Belgium [21,39], Korea [30,31,54,56], Taiwan [73], Germany [33,37,59,67,68,71] China [48], Finland [25], Spain [26], Japan …”

“…The effectiveness of PPE in reducing workplace COVID-19 transmission was assessed in 12 studies [26,27,32,33,41,43,45,52,58,66,70]. In the healthcare setting, three studies assessed the effectiveness of general PPE [26,33,43], and three assessed universal masking policies [41,45,55]. One study looked at the effectiveness of using N95 respirators in the hospital setting compared to surgical masks [27].…”