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Integration von SARS-CoV-2 als Erreger von Infektionen in der endemischen Situation in die Empfehlungen der KRINKO „Infektionsprävention im Rahmen der Pflege und Behandlung von Patienten mit übertragbaren Krankheiten“. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:1279-1301. [PMID: 37861707 DOI: 10.1007/s00103-023-03776-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2023]
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Boulos L, Curran JA, Gallant A, Wong H, Johnson C, Delahunty-Pike A, Saxinger L, Chu D, Comeau J, Flynn T, Clegg J, Dye C. Effectiveness of face masks for reducing transmission of SARS-CoV-2: a rapid systematic review. PHILOSOPHICAL TRANSACTIONS. SERIES A, MATHEMATICAL, PHYSICAL, AND ENGINEERING SCIENCES 2023; 381:20230133. [PMID: 37611625 PMCID: PMC10446908 DOI: 10.1098/rsta.2023.0133] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 05/23/2023] [Indexed: 08/25/2023]
Abstract
This rapid systematic review of evidence asks whether (i) wearing a face mask, (ii) one type of mask over another and (iii) mandatory mask policies can reduce the transmission of SARS-CoV-2 infection, either in community-based or healthcare settings. A search of studies published 1 January 2020-27 January 2023 yielded 5185 unique records. Due to a paucity of randomized controlled trials (RCTs), observational studies were included in the analysis. We analysed 35 studies in community settings (three RCTs and 32 observational) and 40 in healthcare settings (one RCT and 39 observational). Ninety-five per cent of studies included were conducted before highly transmissible Omicron variants emerged. Ninety-one per cent of observational studies were at 'critical' risk of bias (ROB) in at least one domain, often failing to separate the effects of masks from concurrent interventions. More studies found that masks (n = 39/47; 83%) and mask mandates (n = 16/18; 89%) reduced infection than found no effect (n = 8/65; 12%) or favoured controls (n = 1/65; 2%). Seven observational studies found that respirators were more protective than surgical masks, while five found no statistically significant difference between the two mask types. Despite the ROB, and allowing for uncertain and variable efficacy, we conclude that wearing masks, wearing higher quality masks (respirators), and mask mandates generally reduced SARS-CoV-2 transmission in these study populations. This article is part of the theme issue 'The effectiveness of non-pharmaceutical interventions on the COVID-19 pandemic: the evidence'.
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Affiliation(s)
- Leah Boulos
- Maritime SPOR SUPPORT Unit, Nova Scotia Health, 5790 University Avenue, Halifax, Nova Scotia B3H 1V7, Canada
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
| | - Janet A. Curran
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- School of Nursing, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Allyson Gallant
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Faculty of Health, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Helen Wong
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Faculty of Health, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Catherine Johnson
- IWK Health Centre, 5980 University Avenue, Halifax, Nova Scotia B3K 6R8, Canada
- Department of Health and Rehabilitation Services, Western University, 1151 Richmond Street, London, Ontario N6A 3K7, Canada
| | | | - Lynora Saxinger
- Division of Infectious Diseases, Departments of Medicine and Medical Microbiology and Immunology, University of Alberta, 116 Street & 85 Avenue, Edmonton, Alberta T6G 2R3, Canada
| | - Derek Chu
- Department of Health Research Methods, Evidence and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
- Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada
- The Research Institute of St Joe's Hamilton, St Joseph's Healthcare Hamilton, 50 Charlton Avenue East, Hamilton, Ontario L8N A46, Canada
| | - Jeannette Comeau
- Division of Infectious Diseases, Dalhousie University, 6299 South Street, Halifax, Nova Scotia B3H 4R2, Canada
| | - Trudy Flynn
- Patient/Public Partner, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
| | - Julie Clegg
- Patient/Public Partner, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
| | - Christopher Dye
- Department of Biology, University of Oxford, 11A Mansfield Road, Oxford OX1 3SZ, UK
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Bosserman RE, Farnsworth CW, O’Neil CA, Cass C, Park D, Ballman C, Wallace MA, Struttmann E, Stewart H, Arter O, Peacock K, Fraser VJ, Budge PJ, Olsen MA, Burnham CAD, Babcock HM, Kwon JH. Seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies among healthcare personnel in the Midwestern United States, September 2020-April 2021. ANTIMICROBIAL STEWARDSHIP & HEALTHCARE EPIDEMIOLOGY : ASHE 2023; 3:e133. [PMID: 37592963 PMCID: PMC10428156 DOI: 10.1017/ash.2022.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/15/2022] [Accepted: 12/15/2022] [Indexed: 08/19/2023]
Abstract
Objective To determine the prevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) IgG nucleocapsid (N) antibodies among healthcare personnel (HCP) with no prior history of COVID-19 and to identify factors associated with seropositivity. Design Prospective cohort study. Setting An academic, tertiary-care hospital in St. Louis, Missouri. Participants The study included 400 HCP aged ≥18 years who potentially worked with coronavirus disease 2019 (COVID-19) patients and had no known history of COVID-19; 309 of these HCP also completed a follow-up visit 70-160 days after enrollment. Enrollment visits took place between September and December 2020. Follow-up visits took place between December 2020 and April 2021. Methods At each study visit, participants underwent SARS-CoV-2 IgG N-antibody testing using the Abbott SARS-CoV-2 IgG assay and completed a survey providing information about demographics, job characteristics, comorbidities, symptoms, and potential SARS-CoV-2 exposures. Results Participants were predominately women (64%) and white (79%), with median age of 34.5 years (interquartile range [IQR], 30-45). Among the 400 HCP, 18 (4.5%) were seropositive for IgG N-antibodies at enrollment. Also, 34 (11.0%) of 309 were seropositive at follow-up. HCP who reported having a household contact with COVID-19 had greater likelihood of seropositivity at both enrollment and at follow-up. Conclusions In this cohort of HCP during the first wave of the COVID-19 pandemic, ∼1 in 20 had serological evidence of prior, undocumented SARS-CoV-2 infection at enrollment. Having a household contact with COVID-19 was associated with seropositivity.
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Affiliation(s)
- Rachel E. Bosserman
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Christopher W. Farnsworth
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Caroline A. O’Neil
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Candice Cass
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Daniel Park
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Claire Ballman
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Meghan A. Wallace
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Emily Struttmann
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Henry Stewart
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Olivia Arter
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Kate Peacock
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Victoria J. Fraser
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Philip J. Budge
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Margaret A. Olsen
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Carey-Ann D. Burnham
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
| | - Hilary M. Babcock
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
| | - Jennie H. Kwon
- Division of Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
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Gregersen R, Jacobsen RK, Laursen J, Mobech R, Ostrowski SR, Iversen K, Petersen J. Association of COVID-19 Infection With Wearing Glasses in a High-Prevalence Area in Denmark and Sweden. JAMA Ophthalmol 2022; 140:957-964. [PMID: 36006635 DOI: 10.1001/jamaophthalmol.2022.3234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Observational studies have indicated that glasses might protect against contracting COVID-19 through reduced airborne and contact transmission. Objective To investigate the association between wearing one's own glasses with contracting COVID-19 when adjusting for relevant confounders. Design, Setting, and Participants This cohort study was conducted during the first wave of the COVID-19 pandemic (June to August 2020) in Denmark and Sweden, where personal protective equipment was not recommended for the general population at the time. Employees at Falck, an international rescue corps with different job functions (ambulance, health care, office, and field staff, firefighters, and roadside assistance) participated in the study. Exposures The main exposure was wearing glasses (also including contact lenses and reading glasses), which was assessed in a questionnaire. Persons wearing glasses were compared with those who did not wear glasses (ie, nonusers). To adjust for potential confounders, information on age, sex, job function, and number of workday contacts were included. Main Outcomes and Measures The outcome was COVID-19 infection before (positive polymerase chain reaction test) or during the study period (biweekly voluntary tests with a rapid test). The investigated hypothesis was formulated after collecting the data. Results A total of 1279 employees in Denmark and 841 in Sweden were included (839 [39.6%] female and 1281 [60.4%] male; 20.5% were aged <40 years; 57.0%, 40-60 years, and 22.5%, >60 years). Of these, 829 individuals (64.8%) in Denmark and 619 (73.6%) in Sweden wore glasses. Wearing glasses was inversely associated with COVID-19 infection in the Swedish cohort (odds ratio [OR], 0.61 [95% CI, 0.37-0.99]; P = .047; seroprevalence, 9.3%) but not in the Danish cohort (OR, 1.14 [95% CI, 0.53-2.45]; P = .73; seroprevalence, 2.4%). Adjusting for age, sex, job function, and number of workday contacts in Sweden, wearing glasses no longer was associated with COVID-19 infection (OR, 0.64 [95% CI, 0.37-1.11]; P = .11). When stratifying by job function, a large difference was observed among office staff (OR, 0.20 [95% CI, 0.06-0.70]; P = .01) but not ambulance staff (OR, 0.83 [95% CI, 0.41-1.67]; P = .60) nor health care staff (OR, 0.89 [95% CI, 0.35-2.30]; P = .81). Conclusions and Relevance While wearing one's glasses was inversely associated with COVID-19 in Sweden in an unadjusted analysis, an association no longer was identified when adjusting for confounders. These results provide inconclusive findings regarding whether wearing one's own glasses is associated with a decreased risk of COVID-19 infections.
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Affiliation(s)
- Rasmus Gregersen
- Department of Emergency Medicine, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Rikke Kart Jacobsen
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jannie Laursen
- Department of Global Business Quality Management, Falck, Copenhagen, Denmark
| | - Regine Mobech
- Department of Global Business Quality Management, Falck, Copenhagen, Denmark
| | - Sisse Rye Ostrowski
- Department of Clinical Immunology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kasper Iversen
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.,Department of Emergency Medicine, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark.,Department of Cardiology, Copenhagen University Hospital-Herlev and Gentofte, Herlev, Denmark
| | - Janne Petersen
- Center for Clinical Research and Prevention, Copenhagen University Hospital-Bispebjerg and Frederiksberg, Copenhagen, Denmark.,Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Farah W, Breeher L, Shah V, Wang Z, Hainy C, Swift M. Coworkers are more likely than patients to transmit SARS-CoV-2 infection to healthcare personnel. Occup Environ Med 2022; 79:713-716. [PMID: 35927001 DOI: 10.1136/oemed-2022-108276] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 07/11/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the impact of occupational exposures to SARS-CoV-2 positive patients and SARS-CoV-2 positive coworkers, by comparing the frequency of occupational exposure incidents and the rate of healthcare personnel (HCP) who developed a positive PCR test for SARS-COV-2 after occupational exposure to the two different types of infectious individuals. METHODS A retrospective analysis of all confirmed higher risk occupational exposure incidents that occurred in HCP from 20 March 2020 to 31 December 2020 at a large multisite US academic medical centre. Comparisons between groups for source type were performed using unpaired Student's t-test for continuous variables and the χ2 test for categorical variables, regression analysis was conducted to assess the associations between source type and risk of positive COVID-19 test after occupational exposure. RESULTS In total, 2253 confirmed medium or high-risk occupational exposures occurred during the study period. 57% were exposures from coworker sources. Each source individual exposed a mean of 2.6 (95% CI 2.3 to 2.9) HCP; during postexposure surveillance, 4.5% of exposed HCP tested positive within 14 days. A coworker source on average exposed 2.2 (95% CI 2.01 to 2.4) other HCP and infected 0.14 (95% CI 0.1 to 0.17) HCP, while patient sources exposed a mean of 3.4 (95% CI 2.6 to 4.2) HCP but only infected 0.07 (95% CI 0.04 to 0.11) HCP. The multivariate analysis demonstrated that exposure to a coworker source carried a higher risk of testing positive compared with exposure to a patient source (OR 3.22; 95% CI 1.72 to 6.04). CONCLUSION Occupational exposures to coworker sources were not only more frequent but also associated with triple the risk of developing COVID-19 infection, compared with exposures to patient sources.
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Affiliation(s)
- Wigdan Farah
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Laura Breeher
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Occupational Health Service, Mayo Clinic, Rochester, Minnesota, USA
| | - Vishal Shah
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Zhen Wang
- Evidence-Based Practice Research Program, Mayo Clinic, Rochester, Minnesota, USA
| | - Caitlin Hainy
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Occupational Health Service, Mayo Clinic, Rochester, Minnesota, USA
| | - Melanie Swift
- Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, Minnesota, USA .,Occupational Health Service, Mayo Clinic, Rochester, Minnesota, USA
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Clair V, Chan E, Paiero A, Fraser E, Gunvaldsen R, Newhouse E. One Health response to SARS-CoV-2-associated risk from mink farming in British Columbia, Canada, October 2020 to October 2021. CANADA COMMUNICABLE DISEASE REPORT = RELEVE DES MALADIES TRANSMISSIBLES AU CANADA 2022; 48:261-273. [PMID: 37333574 PMCID: PMC10274535 DOI: 10.14745/ccdr.v48i06a04] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Background Mink farms are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks and carry an associated risk of novel SARS-CoV-2 variant emergence and non-human reservoir creation. In Denmark, control measures were insufficient to prevent onward transmission of a mink-associated variant, contributing to the nation-wide culling of farmed mink. To date, British Columbia (BC) is the only Canadian province to report mink farm SARS-CoV-2 outbreaks. The objective of this study is to describe BC's One Health response to SARS-CoV-2-associated risk from mink farming, its outcomes, and insights from implementation. Methods The detection of two mink farm outbreaks in December 2020 catalyzed BC's risk mitigation response for both infected and uninfected farms, including the following: farm inspections and quarantines; Public Health Orders mandating mink mortality surveillance, enhanced personal protective equipment, biosafety measures and worker coronavirus disease 2019 vaccination, at-a-minimum weekly worker viral testing, and wildlife surveillance. Results A One Health approach enabled a timely, evidence-informed and coordinated response as the situation evolved, including the use of various legislative powers, consistent messaging and combined human and mink phylogenetic analysis. Ongoing mink and worker surveillance detected asymptomatic/subclinical infections and facilitated rapid isolation/quarantine to minimize onward transmission. Voluntary testing and mandatory vaccination for workers were acceptable to industry; enhanced personal protective equipment requirements were challenging. Regular farm inspections helped to assess and improve compliance. Conclusion British Columbia's One Health response reduced the risk of additional outbreaks, viral evolution and reservoir development; however, a third outbreak was detected in May 2021 despite implemented measures, and long-term sustainability of interventions proved challenging for both industry and governmental agencies involved.
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Affiliation(s)
- Veronic Clair
- British Columbia Centre for Disease Control, Vancouver, BC
- School of Population and Public Health, University of British Columbia, Vancouver, BC
- Department of Family Practice, University of British Columbia, Vancouver, BC
| | - Elaine Chan
- British Columbia Centre for Disease Control, Vancouver, BC
- Canadian Field Epidemiology Program, Centre for Emergency Preparedness and Response, Public Health Agency of Canada, Ottawa, ON
| | | | - Erin Fraser
- British Columbia Centre for Disease Control, Vancouver, BC
- School of Population and Public Health, University of British Columbia, Vancouver, BC
| | | | - Emily Newhouse
- School of Population and Public Health, University of British Columbia, Vancouver, BC
- Fraser Health Authority, Surrey, BC
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Winkler ML, Hooper DC, Shenoy ES. Infection Prevention and Control of Severe Acute Respiratory Syndrome Coronavirus 2 in Health Care Settings. Infect Dis Clin North Am 2022; 36:309-326. [PMID: 35636902 PMCID: PMC8806155 DOI: 10.1016/j.idc.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The authors describe infection prevention and control approaches to severe acute respiratory syndrome coronavirus 2 in the health care setting, including a review of the chain of transmission and the hierarchy of controls, which are cornerstones of infection control and prevention. The authors also discuss lessons learned from nosocomial transmission events.
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Affiliation(s)
- Marisa L. Winkler
- Infection Control Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 334, Boston, MA 02114, USA,Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA,Corresponding author. Massachusetts General Hospital, 55 Fruit Street, Bulfinch 334, Boston, MA, 02114
| | - David C. Hooper
- Infection Control Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 334, Boston, MA 02114, USA,Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Erica S. Shenoy
- Infection Control Unit, Massachusetts General Hospital, 55 Fruit Street, Bulfinch 334, Boston, MA 02114, USA,Division of Infectious Diseases, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA,Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
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Madran B, Akbulut Z, Akbaba G, Taş E, Güçlüoğlu T, Şencanlı Ö, Bozkurt İ, Keske Ş, Ergönül Ö. COVID-19 Severity among Healthcare Workers: Overweight Male Physicians at Risk. Infect Dis Rep 2022; 14:310-314. [PMID: 35645215 PMCID: PMC9149914 DOI: 10.3390/idr14030036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/18/2022] [Accepted: 04/23/2022] [Indexed: 12/10/2022] Open
Abstract
We performed a prospective longitudinal cohort study in two healthcare settings. In total, 909 HCWs out of 3982 (23.35%) were diagnosed with COVID-19 before the vaccination era. Eighty-five per cent of COVID-19 positive HCWs (n = 774) were asymptomatic or mild, and 15% were moderate or severe. The mean age of the infected HCWs in the moderate or severe group was higher than the mild or asymptomatic group (35.4 vs. 31.3 years, p < 0.001). Thirty-two per cent of HCWs were male and the rate of male gender was more frequent in the moderate/severe group (p = 0.009). The rate of those who have cardiovascular diseases (p = 0.003) and diabetes mellitus (p = 0.044) were significantly higher among the HCWs with moderate or severe COVID-19. In multivariate analysis, male gender (OR:1.65, CI:1.11−2.46, p = 0.013), BMI > 30 (OR: 1.9, CI: 1.09−3.51, p = 0.024), and being physician (OR: 2.56, CI:1.45−4.52, p = 0.001) were found to be associated with moderate or severe COVID-19.
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Affiliation(s)
- Bahar Madran
- Infection Control Unit, VKV American Hospital, Istanbul 34365, Turkey;
- Correspondence:
| | - Zeliha Akbulut
- Infection Control Unit, Koç University Hospital, Istanbul 34010, Turkey; (Z.A.); (E.T.); (T.G.)
| | - Gözde Akbaba
- Infection Control Unit, VKV American Hospital, Istanbul 34365, Turkey;
| | - Emre Taş
- Infection Control Unit, Koç University Hospital, Istanbul 34010, Turkey; (Z.A.); (E.T.); (T.G.)
| | - Tuğba Güçlüoğlu
- Infection Control Unit, Koç University Hospital, Istanbul 34010, Turkey; (Z.A.); (E.T.); (T.G.)
| | - Özgür Şencanlı
- Occupational Safety Unit, VKV American Hospital, Istanbul 34365, Turkey;
| | - İsmail Bozkurt
- Hospital Management Department, VKV American Hospital, Istanbul 34365, Turkey;
| | - Şiran Keske
- Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul 34010, Turkey; (Ş.K.); (Ö.E.)
- İşbank Center for Infectious Diseases, Koç University, Istanbul 34010, Turkey
| | - Önder Ergönül
- Infectious Diseases and Clinical Microbiology, School of Medicine, Koç University, Istanbul 34010, Turkey; (Ş.K.); (Ö.E.)
- İşbank Center for Infectious Diseases, Koç University, Istanbul 34010, Turkey
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Abstract
COVID-19 is a nonspecific viral illness caused by a novel coronavirus, SARS-CoV-2, and led to an ongoing global pandemic. Transmission is primarily human-to-human via contact with respiratory particles containing infectious virus. The risk of transmission to health care personnel is low with proper use of personal protective equipment, including gowns, gloves, N95 or surgical mask, and eye protection. Additional measures affecting the risk of transmission include physical distancing, hand hygiene, routine cleaning and disinfection, appropriate air handling and ventilation, and public health interventions such as universal masking and stay-at-home orders.
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Affiliation(s)
- Patrick Reich
- Department of Pediatrics, Division of Pediatric Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8116, St Louis, MO 63110-1093, USA.
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Occupational risk factors for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel: A 6-month prospective analysis of the COVID-19 Prevention in Emory Healthcare Personnel (COPE) Study. Infect Control Hosp Epidemiol 2022; 43:1664-1671. [PMID: 35156597 PMCID: PMC8886081 DOI: 10.1017/ice.2021.518] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: To determine the incidence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare personnel (HCP) and to assess occupational risks for SARS-CoV-2 infection. Design: Prospective cohort of healthcare personnel (HCP) followed for 6 months from May through December 2020. Setting: Large academic healthcare system including 4 hospitals and affiliated clinics in Atlanta, Georgia. Participants: HCP, including those with and without direct patient-care activities, working during the coronavirus disease 2019 (COVID-19) pandemic. Methods: Incident SARS-CoV-2 infections were determined through serologic testing for SARS-CoV-2 IgG at enrollment, at 3 months, and at 6 months. HCP completed monthly surveys regarding occupational activities. Multivariable logistic regression was used to identify occupational factors that increased the risk of SARS-CoV-2 infection. Results: Of the 304 evaluable HCP that were seronegative at enrollment, 26 (9%) seroconverted for SARS-CoV-2 IgG by 6 months. Overall, 219 participants (73%) self-identified as White race, 119 (40%) were nurses, and 121 (40%) worked on inpatient medical-surgical floors. In a multivariable analysis, HCP who identified as Black race were more likely to seroconvert than HCP who identified as White (odds ratio, 4.5; 95% confidence interval, 1.3–14.2). Increased risk for SARS-CoV-2 infection was not identified for any occupational activity, including spending >50% of a typical shift at a patient’s bedside, working in a COVID-19 unit, or performing or being present for aerosol-generating procedures (AGPs). Conclusions: In our study cohort of HCP working in an academic healthcare system, <10% had evidence of SARS-CoV-2 infection over 6 months. No specific occupational activities were identified as increasing risk for SARS-CoV-2 infection.
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The effect of eye protection on SARS-CoV-2 transmission: a systematic review. Antimicrob Resist Infect Control 2021; 10:156. [PMID: 34736533 PMCID: PMC8567128 DOI: 10.1186/s13756-021-01025-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 10/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2. METHODS We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2. RESULTS We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, goggles, and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case-control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low. CONCLUSIONS Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations.
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Stein ML, Park RS, Afshari A, Disma N, Fiadjoe JE, Matava CT, McNarry AF, von Ungern-Sternberg BS, Kovatsis PG, Peyton JM. Lessons from COVID-19: A reflection on the strengths and weakness of early consensus recommendations for pediatric difficult airway management during a respiratory viral pandemic using a modified Delphi method. Paediatr Anaesth 2021; 31:1074-1088. [PMID: 34387013 DOI: 10.1111/pan.14272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 08/06/2021] [Accepted: 08/11/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND The authors recognized a gap in existing guidelines and convened a modified Delphi process to address novel issues in pediatric difficult airway management raised by the COVID-19 pandemic. METHODS The Pediatric Difficult Intubation Collaborative, a working group of the Society for Pediatric Anesthesia, assembled an international panel to reach consensus recommendations on pediatric difficult airway management during the COVID-19 pandemic using a modified Delphi method. We reflect on the strengths and weaknesses of this process and ways care has changed as knowledge and experience have grown over the course of the pandemic. RECOMMENDATIONS In the setting of the COVID-19 pandemic, the Delphi panel recommends against moving away from the operating room solely for the purpose of having a negative pressure environment. The Delphi panel recommends supplying supplemental oxygen and using videolaryngoscopy during anticipated difficult airway management. Direct laryngoscopy is not recommended. If the patient meets extubation criteria, extubate in the OR, awake, at the end of the procedure. REFLECTION These recommendations remain valuable guidance in caring for children with anticipated difficult airways and infectious respiratory pathology when reviewed in light of our growing knowledge and experience with COVID-19. The panel initially recommended minimizing involvement of additional people and trainees and minimizing techniques associated with aerosolization of viral particles. The demonstrated effectiveness of PPE and vaccination at reducing the risk of exposure and infection to clinicians managing the airway makes these recommendations less relevant for COVID-19. They would likely be important initial steps in the face of novel respiratory viral pathogens. CONCLUSIONS The consensus process cannot and should not replace evidence-based guidelines; however, it is encouraging to see that the panel's recommendations have held up well as scientific knowledge and clinical experience have grown.
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Affiliation(s)
- Mary Lyn Stein
- Department of Anesthesiology, Critical Care, and Pain Management, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Raymond S Park
- Department of Anesthesiology, Critical Care, and Pain Management, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Arash Afshari
- Department of Pediatric and Obstetric Anesthesia, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Nicola Disma
- Unit for Research and Innovation, Department of Paediatric Anaesthesia, Istituto Giannina Gaslini, Genova, Italy
| | - John E Fiadjoe
- Department of Anesthesiology, Critical Care, and Pain Management, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - Clyde T Matava
- Department of Anesthesia and Pain Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | | | - Britta S von Ungern-Sternberg
- Department of Anaesthesia and Pain Management, Perth Children's Hospital, Perth, WA, Australia.,Division of Emergency Medicine, Anaesthesia and Pain Medicine, Medical School, The University of Western Australia, Perth, WA, Australia.,Team Perioperative Medicine, Telethon Kids Institute, Perth, WA, Australia
| | - Pete G Kovatsis
- Department of Anesthesiology, Critical Care, and Pain Management, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
| | - James M Peyton
- Department of Anesthesiology, Critical Care, and Pain Management, Boston Children's Hospital, Boston, Massachusetts, USA.,Department of Anaesthesia, Harvard Medical School, Boston, Massachusetts, USA
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Finding a needle in a haystack: The hidden costs of asymptomatic testing in a low incidence setting. Infect Control Hosp Epidemiol 2021; 43:1525-1526. [PMID: 34162461 PMCID: PMC8280392 DOI: 10.1017/ice.2021.288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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