COVID-19 in healthcare workers driven by community exposure

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In a well-resourced health system with adequate personal protection equipment (PPE), healthcare worker risk for SARS-CoV-2 infection, the virus that causes the novel coronavirus (COVID-19) was more strongly driven by community exposure than patient exposure early in the pandemic, according to a new Northwestern Medicine study published in the journal Open Forum Infectious Diseases.

The cohort study included a total of 6,510 healthcare workers in the United States, including 1,794 nurses, 1,260 doctors, 904 non-patient facing administrators, and 2,552 other staff members. The academic healthcare system included 10 hospitals, 18 immediate care centers, and 325 outpatient practices in the Chicago area and surrounding Illinois.

Data from the U.S. Centers for Disease Control and Prevention (CDC) found 11 percent of the total number of reported COVID-19 cases in the U.S. were healthcare workers. As of November 2020, there have been 797 deaths among healthcare workers in the U.S. The authors said it is a high priority to identify factors associated with SARS-CoV-2 infection in healthcare settings to protect the essential workforce that delivers care.

Nurses were the only occupation group with higher risks once community exposure was accounted for, the study said. Participation in high-flow oxygen therapy and hemodialysis were associated with a higher likelihood for having antibodies to SARS-CoV-2, but other high-risk procedures were not associated with higher risk, according to the study.

"This suggests that PPE is highly effective in acute exposures to SARS-CoV-2, but some longer exposures may still expose health care workers to increased risks for infection," said John Wilkins, MD, co-lead author physician at Northwestern Medicine, in a statement. "Fortunately, with adequate PPE and vigilant infection control policies, we can keep most providers safe while they are at work."

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