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Characteristics of Healthcare Personnel With COVID-19 in the US
TAKE-HOME MESSAGE
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In this review, the authors discuss COVID-19 cases and the attributable deaths worldwide, with a focus on healthcare personnel in the US.
- It is necessary to protect healthcare personnel against acquiring infection either at work or in the community.
abstract
This abstract is available on the publisher's site.
Access this abstract nowAs of April 9, 2020, the coronavirus disease 2019 (COVID-19) pandemic had resulted in 1,521,252 cases and 92,798 deaths worldwide, including 459,165 cases and 16,570 deaths in the United States (1,2). Health care personnel (HCP) are essential workers defined as paid and unpaid persons serving in health care settings who have the potential for direct or indirect exposure to patients or infectious materials (3). During February 12–April 9, among 315,531 COVID-19 cases reported to CDC using a standardized form, 49,370 (16%) included data on whether the patient was a health care worker in the United States; including 9,282 (19%) who were identified as HCP. Among HCP patients with data available, the median age was 42 years (interquartile range [IQR] = 32–54 years), 6,603 (73%) were female, and 1,779 (38%) reported at least one underlying health condition. Among HCP patients with data on health care, household, and community exposures, 780 (55%) reported contact with a COVID-19 patient only in health care settings. Although 4,336 (92%) HCP patients reported having at least one symptom among fever, cough, or shortness of breath, the remaining 8% did not report any of these symptoms. Most HCP with COVID-19 (6,760, 90%) were not hospitalized; however, severe outcomes, including 27 deaths, occurred across all age groups; deaths most frequently occurred in HCP aged ≥65 years. These preliminary findings highlight that whether HCP acquire infection at work or in the community, it is necessary to protect the health and safety of this essential national workforce.
Additional Info
Disclosure statements are available on the authors' profiles:
COVID-19 toll on healthcare personnel
Healthcare workers are on the front line of COVID-19 response, and, in this position, we are voluntarily placed into arenas of heightened risk. A couple of recent CDC assessments clarify this risk. The very nature of medical practice is communal; we come together to provide comprehensive and multidisciplinary care. This community of care is illustrated in a case study of one hospitalized COVID-19 patient in California.1 During a 4-day stay, no fewer than 121 healthcare personnel (HCP) were exposed to this individual; it should be said that COVID-19 was not suspected during this hospitalization. Of those exposed, 43 (36%) became symptomatic and 3 (2.4%) were found to be positive for SARS-CoV-2. All 3 of the secondary cases had unprotected patient contact. Moreover, they spent significantly longer time in the patient‘s hospital room than did those not contracting SARS-CoV-2.
In a larger analysis, the CDC COVID-19 Response Team analyzed data from nearly 50,000 COVID-19 cases associated with completed standardized data forms, of which 9282 (19%) were HCP.2 This percentage is likely inflated, however, by the likelihood of HCP to complete forms; in another population-based assessment, HCPs account for about 11% of COVID-19 cases. The median age of cases was 42 years, 73% were female, and 38% had an underlying health condition. Moreover, 55% of HCP cases reported that their only exposures to SARS-CoV-2 were within healthcare settings, with household exposures accounting for an additional 27%. Most cases (92%) reported fever, cough, and/or shortness of breath.
The great majority of HCP cases were not hospitalized (90%), but 2% to 5% were admitted to an ICU and 0.3% to 0.6% died of COVID-19. As noted elsewhere, increasing age was a significant factor in hospitalization, ICU admission, and death.
The take-home lessons for primary care clinicians and other HCP are summarized here:
Early recognition and isolation of COVID-19 cases are essential for safe care management.
Prolonged and unprotected exposures as well as some aerosol-generating procedures are associated with HCP acquisition of SARS-CoV-2 infection.
Consistent use of the appropriate PPE is required for patient care.
All HCP should be screened for fever and respiratory symptoms at the beginning of shifts or upon entry to healthcare facilities.
HCP should be prioritized for SARS-CoV-2 testing.
HCP should be discouraged from working while ill.
Older HCP and those with underlying health conditions should consult with their healthcare providers and employee health programs to better understand and manage risk.
References