The COVID-19 Impact in Hospital Healthcare Workers: Development of an Occupational Health Risk Management Program

Abstract

As with the SARS-CoV-1 outbreak in 2003–2004 and the MERS outbreak in 2012, there were early reports of frequent transmission to healthcare workers (HCW) in the SARS-CoV-2 pandemic. Our hospital center identified its first COVID-19 confirmed case on March 9, 2020, in a 6-day hospitalized patient. The first confirmed COVID-19 case in a HCW happened 3 days later, in a nurse with a probable epidemiological link related to the first confirmed patient. Our study’s first objective is to describe and characterize the impact of the first 3 months of the SARS-CoV-2 pandemic on the Centro Hospitalar Universitário Lisboa Norte (CHULN). Our second objective is to report the performance of the CHULN Occupational Health Department (OHD) and the impact of the pandemic on CHULN HCW and its adaptation across national, regional, and institutional epidemiological evolution. Over the first 3 months, 2,152 HCW were screened (which represent 29.8% of the total HCW population), grouped in 100 separate identifiable clusters, each one ranging from 2 to 98 HCW. The most prevalent profession screened were nurses (<i>n</i> = 800; 37.2%) followed by doctors (<i>n</i> = 634; 29.5%). The main source of potential infection and cluster generating screening procedures was co-worker related (<i>n</i> = 1,216; 56.5%). A patient source or a combined patient co-worker source was only accountable for 559 (26%) and 43 (2%) of cases, respectively. Our preliminary results demonstrate a lower infection rate among HCW than the ones commonly found in the literature. The main source of infection seemed to be co-worker related rather than patient related. New preventive strategies would have to be implemented in order to control SARS-CoV-2 spread.

Characteristics of Diabetic Foot Ulcer Patients Pre- and During COVID-19 Pandemic: Lessons Learnt From a National Referral Hospital in Indonesia

“…A previous study conducted in Indonesia and Portugal showed that positivity rate in medical workers during March-June 2020 was about 5.8% and 6.8%, respectively. 18 , 19 In addition, many patients also limit their visit to the hospital due to risk of COVID-19 infection and limit access to transportation. Consent for surgery also could not be obtained immediately from the patient due to several of the factors mentioned above.…”

“…). While major amputations were also higher in the pandemic group (20.2% vs 39.4%, P = .014, Figure 3C), no differences in length of stay (19 (12-24) days vs 16 (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) days, P = .16, Figure 2B) and mortality (14.3% vs 11.3%, P = .76, Figure 3D) were observed between pre-and during the pandemic group. During the pandemic, those with COVID-19 infection (7/71, 9.8%) had more severe infections, worse kidney function, longer waiting time-tosurgery, and higher mortality (Table 3).…”

Time Analysis of an Emergent Infection Spread Among Healthcare Workers: Lessons Learned from Early Wave of SARS-CoV-2

“…A study suggests a higher chance of infection spread among co-workers in healthcare setting compared to patient-HCW spread. 41 This is the second lesson that can be learned from our study. If HCWs are the first population that spread an emergent infection, stricter work rules need to be applied to them as soon as a new infection is discovered in the area.…”