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Jabs JM, Schwabe A, Wollkopf AD, Gebel B, Stadelmaier J, Erdmann S, Radicke F, Grundmann H, Kramer A, Monsef I, Rücker G, Rupp J, Scheithauer S, Schmucker C, Simon A, Mutters NT. The role of routine SARS-CoV-2 screening of healthcare-workers in acute care hospitals in 2020: a systematic review and meta-analysis. BMC Infect Dis 2022; 22:587. [PMID: 35780088 PMCID: PMC9250183 DOI: 10.1186/s12879-022-07554-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 06/08/2022] [Indexed: 02/08/2023] Open
Abstract
Background Healthcare workers (HCW) are at increased risk of infection with SARS-CoV-2. Vulnerable patient populations in particular must be protected, and clinics should not become transmission hotspots to avoid delaying medical treatments independent of COVID. Because asymptomatic transmission has been described, routine screening of asymptomatic HCW would potentially be able to interrupt chains of infection through early detection. Methods A systematic search was conducted in the Cochrane COVID-19 Study Register, Web of Science and WHO COVID‐19 Global literature on coronavirus with regard to non-incident related testing of healthcare workers using polymerase chain reaction on May 4th 2021. Studies since January 2020 were included. An assessment of risk of bias and representativeness was performed. Results The search identified 39 studies with heterogeneous designs. Data collection of the included studies took place from January to August 2020. The studies were conducted worldwide and the sample size of the included HCW ranged from 70 to 9449 participants. In total, 1000 of 51,700 (1.9%) asymptomatic HCW were tested positive for SARS-CoV-2 using PCR testing. The proportion of positive test results ranged between 0 and 14.3%. No study reported on HCW-screening related reductions in infected person-days. Discussion and conclusions The heterogeneous proportions might be explained by different regional incidences, lock-downs, and pre-analytical pitfalls that reduce the sensitivity of the nasopharyngeal swab. The very high prevalence in some studies indicates that screening HCW for SARS-CoV-2 may be important particularly in geographical regions and pandemic periods with a high-incidence. With low numbers and an increasing rate of vaccinated HCW, a strict cost–benefit consideration must be made, especially in times of low incidences. Since we found no studies that reported on HCW-screening related reductions in infected person-days, re-evaluation should be done when these are available. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07554-5.
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Affiliation(s)
- J M Jabs
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A Schwabe
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - A D Wollkopf
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - B Gebel
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - J Stadelmaier
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Breisacher Str. 86, 79110, Freiburg, Germany
| | - S Erdmann
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - F Radicke
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - H Grundmann
- Institute for Infection Prevention and Hospital Hygiene, Faculty of Medicine and Medical Center, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - A Kramer
- Institute for Hygiene and Environmental Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Germany
| | - I Monsef
- Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, Cochrane Haematology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - G Rücker
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Zinkmattenstraße 6a, 79108, Freiburg, Germany
| | - J Rupp
- Department of Infectious Diseases and Microbiology, University Hospital Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany
| | - S Scheithauer
- Institute of Infection Control and Infectious Diseases, University Medical Center Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - C Schmucker
- Institute for Evidence in Medicine, Faculty of Medicine and Medical Center, University of Freiburg, Breisacher Str. 86, 79110, Freiburg, Germany
| | - A Simon
- Clinic for Pediatric Oncology and Hematology, Saarland University Hospital, Kirrberger Straße, 66421, Homburg, Saar, Germany
| | - Nico T Mutters
- Institute for Hygiene and Public Health, Bonn University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany.
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Somboro AM, Cissoko Y, Camara I, Kodio O, Tolofoudie M, Dembele E, Togo ACG, Ba DM, Sarro YDS, Baya B, Samake S, Diallo IB, Kumar A, Traore M, Kone B, Kone A, Diarra B, Dabitao DK, Wague M, Dabo G, Doumbia S, Holl JL, Murphy RL, Diallo S, Maiga AI, Maiga M, Dao S. High SARS-CoV-2 Seroprevalence among Healthcare Workers in Bamako, Mali. Viruses 2022; 14:102. [PMID: 35062306 PMCID: PMC8780908 DOI: 10.3390/v14010102] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/25/2021] [Accepted: 12/27/2021] [Indexed: 02/05/2023] Open
Abstract
In Mali, a country in West Africa, cumulative confirmed COVID-19 cases and deaths among healthcare workers (HCWs) remain enigmatically low, despite a series of waves, circulation of SARS-CoV-2 variants, the country's weak healthcare system, and a general lack of adherence to public health mitigation measures. The goal of the study was to determine whether exposure is important by assessing the seroprevalence of anti-SARS-CoV-2 IgG antibodies in HCWs. The study was conducted between November 2020 and June 2021. HCWs in the major hospitals where COVID-19 cases were being cared for in the capital city, Bamako, Mali, were recruited. During the study period, vaccinations were not yet available. The ELISA of the IgG against the spike protein was optimized and quantitatively measured. A total of 240 HCWs were enrolled in the study, of which seropositivity was observed in 147 cases (61.8%). A continuous increase in the seropositivity was observed, over time, during the study period, from 50% at the beginning to 70% at the end of the study. HCWs who provided direct care to COVID-19 patients and were potentially highly exposed did not have the highest seropositivity rate. Vulnerable HCWs with comorbidities such as obesity, diabetes, and asthma had even higher seropositivity rates at 77.8%, 75.0%, and 66.7%, respectively. Overall, HCWs had high SARS-CoV-2 seroprevalence, likely reflecting a "herd" immunity level, which could be protective at some degrees. These data suggest that the low number of cases and deaths among HCWs in Mali is not due to a lack of occupational exposure to the virus but rather related to other factors that need to be investigated.
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Affiliation(s)
- Anou M. Somboro
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
- School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Private Bag X5, Durban 4001, South Africa
| | - Yacouba Cissoko
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
- Department of Infectious Diseases and Tropical Medicine, Point “G” University Teaching Hospital, Bamako PB 1805, Mali
| | - Issiaka Camara
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Ousmane Kodio
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Mohamed Tolofoudie
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Etienne Dembele
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Antieme C. G. Togo
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Djibril M. Ba
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Yeya dit Sadio Sarro
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Bocar Baya
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Seydou Samake
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Ibrahim B. Diallo
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Alisha Kumar
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Mohamed Traore
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Bourahima Kone
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Amadou Kone
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Bassirou Diarra
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Djeneba K. Dabitao
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Mamadou Wague
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Garan Dabo
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Seydou Doumbia
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Jane L. Holl
- Department of Neurology and Center for Healthcare Delivery Science and Innovation, University of Chicago, Chicago, IL 60611, USA;
| | - Robert L. Murphy
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Souleymane Diallo
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Almoustapha I. Maiga
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
| | - Mamoudou Maiga
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
- Institute for Global Health, Northwestern University, Chicago, IL 60611, USA; (E.D.); (A.K.); (M.T.); (R.L.M.)
| | - Sounkalo Dao
- University Clinical Research Center (UCRC) Laboratory, University of Sciences, Techniques and Technologies of Bamako (USTTB), Bamako PB 1805, Mali; (Y.C.); (I.C.); (O.K.); (M.T.); (A.C.G.T.); (Y.d.S.S.); (B.B.); (S.S.); (I.B.D.); (B.K.); (A.K.); (B.D.); (D.K.D.); (M.W.); (G.D.); (S.D.); (S.D.); (A.I.M.); (S.D.)
- Department of Infectious Diseases and Tropical Medicine, Point “G” University Teaching Hospital, Bamako PB 1805, Mali
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Gifford L, Johnson CC, Haque N, Passalacqua KD, Swiderek J, Kalkanis S. COVID-19 in the hotspot of Metropolitan Detroit: A multi-faceted health system experience. Int J Health Plann Manage 2021; 37:657-672. [PMID: 34859491 PMCID: PMC9015618 DOI: 10.1002/hpm.3392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/02/2021] [Accepted: 11/14/2021] [Indexed: 12/02/2022] Open
Abstract
Health systems were abruptly plunged into a crisis as SARS‐CoV‐2 exploded into a pandemic in spring 2020. In March‐April 2020, Metropolitan Detroit was a US “hotspot.” As a large health system with five hospitals and two behavioural health inpatient facilities, a health insurance company, a medical group and physician network, and 41 ambulatory clinics normally hosting over 10,000 daily patient encounters, the Henry Ford Health System deployed numerous strategies in the management of this upheaval. As hospitals and Emergency Departments were inundated with COVID‐19 patients, other services and activities needed to shut down as state‐mandated policies were promulgated, new internal and external communication networks established, and management of employees and resources such as ventilators, ICU beds, personal protective equipment, and laboratory supplies became critical challenges. We describe herein the system‐wide strategies implemented and lessons learned in the operation of a health system in the initial throes of a global pandemic. A pandemic rapid response requires coordination of multiple facets of a health system, best led by a highly centralised incident command model. Regular and frequent (at least daily) communication with a wide range of leaders is paramount. Early and constant attention to IT infrastructure for data and communications is essential. Frequent coordination and communication with the local community and local and regional health care organisations and government agencies are critical. Establishment of a pandemic‐specific structure for education and research activities is crucial, including a system for ongoing monitoring of public data and pandemic‐related literature on topics ranging from epidemiology to infection control to treatment. Continuing attention needs to be paid to acknowledging and mitigating the psychological impacts of a pandemic on patients, families and staff.
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Affiliation(s)
- Linda Gifford
- Henry Ford Medical Group AdministrationHenry Ford Health SystemDetroitMIUSA
| | | | - Nadia Haque
- Department of NeurosurgeryHenry Ford Health SystemDetroitMIUSA
| | | | - Jennifer Swiderek
- Department of Internal Medicine, Division of Pulmonary & Critical Care MedicineHenry Ford Health SystemDetroitMIUSA
| | - Steven Kalkanis
- Henry Ford Medical Group AdministrationHenry Ford Health SystemDetroitMIUSA
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