ABSTRACT
Many healthcare workers received inadequate infection prevention and control training while facing shortages of personal protective equipment. Community exposure, however, is often overlooked when exposure assessment of infection risk is applied. The overall level of exposure of healthcare workers in Kuwait remains understudied. This study aimed at identifying and quantifying the risks of COVID-19 exposure to healthcare workers using the WHO-developed risk assessment tool before an in-house online training. A cross-sectional survey was conducted in July 2020. Healthcare workers from governmental hospitals in Kuwait were recruited by convenience due to lockdowns. The recruited individuals were offered in-house comprehensive online training. Out of 115 healthcare workers, 68.7% were female, 47.8% were aged 31-40 and 44.4% were doctors. Community exposure was identified in 53% of participants. About 80.8% were considered highly exposed to COVID-19. During interactions with patients, 95.5% wore N95 masks and 59.5% wore face shields ‘always as recommended’ and only 11.8% wore gloves ‘most of the time’. Removal of PPEs according to IPC protocol was reported by 72.2% of healthcare workers. Healthcare workers in Kuwait face an extra risk of exposure to COVID-19 from the community, not only from healthcare facilities. The causes of the suboptimal level of adherence to PPEs warrants further investigation. The COVID-19 pandemic has illuminated the significant additive biohazard risk healthcare workers face from the community. Many countries including Kuwait are following through on the International Labor Organization and the World Health Organization recommendation to establish an occupational health and safety program for healthcare workers. © 2021 Teikyo University School of Medicine. All rights reserved.
ABSTRACT
Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging zoonotic coronavirus that has a tendency to cause significant healthcare outbreaks among patients with serious comorbidities. We analyzed hospital data from the MERS-CoV outbreak in King Abdulaziz Medical Center, Riyadh, Saudi Arabia, June-August 2015 using the susceptible-exposed-infectious-recovered (SEIR) ward transmission model. The SEIR compartmental model considers several areas within the hospital where transmission occurred. We use a system of ordinary differential equations that incorporates the following units: emergency department (ED), out-patient clinic, intensive care unit, and hospital wards, where each area has its own carrying capacity and distinguishes the transmission by three individuals in the hospital: patients, health care workers (HCW), or mobile health care workers. The emergency department, as parameterized has a large influence over the epidemic size for both patients and health care workers. Trend of the basic reproduction number (R0), which reached a maximum of 1.39 at the peak of the epidemic and declined to 0.92 towards the end, shows that until added hospital controls are introduced, the outbreak would continue with sustained transmission between wards. Transmission rates where highest in the ED, and mobile HCWs were responsible for large part of the outbreak.