Increased Bloodborne Pathogen Exposure Hotline Utilization During the COVID-19 Pandemic: An Unexpected Phenomenon.

Background: Mitigating bloodborne pathogen exposure (BBPE) risk among healthcare workers is a major focus of hospital-based occupational health programs. The COVID-19 pandemic has placed added demands on occupational health services for healthcare workers. Its impact on BBPE incidence is unreported. Methods: As part of quality improvement efforts, we examined BBPE case incidence at two affiliated health centers during a 24-month period, 12 months preceding and following the COVID-19 pandemic onset. We used Year 1 to Year 2 change in incidence at the larger health center as the referent value to generate predicted incidence rates at the study health center. We tested the ratio of observed to predicted values at the study health center as a Poisson variable to its expectation. We defined a BBPE consistent with the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard. Results: The BBPE case incidence at Health Center One (HC1), totaled 46 cases in Year 1, increasing 19% to 55 cases in Year 2. The cumulative incidence at Health Center Two (HC2), the referent facility, was 664 cases in Year 1, declining 24% to 503 in Year 2. The ratio of 55 events at HC1 to the expected incidence of 35, based on the experience at HC2, was 1.6 (p < .05). Discussion/Applications to Practice: The incidence of BBPE events at HC1 paradoxically increased during the COVID-19 pandemic, contrasting to the expected decrease that we observed at HC2. These data suggest that during times of increased stress to employee healthcare delivery from an infectious disease outbreak, the burden of ongoing practice demands may increase.

Testing for SARS-CoV-2 in Symptomatic Vaccinated and Unvaccinated Health Care Workers During the Delta Variant Surge.

BACKGROUND: Infection with SARS- CoV- 2 in health care workers (HCWs) challenges employee health services. METHODS: We analyzed telephone Coronavirus Disease 2019 (COVID-19) hotline data over 8 weeks in 2021 during SARS- CoV- 2 Delta variant surge. We calculated COVID-19 case rates among persons-under-investigation (PUIs) for illness at two health care centers (HCs). RESULTS: There were 41 COVID-19 cases among the 285 PUIs (14.4%) at the study HC and 549 (16.9%) of 3244 at the comparison HC. At the study HC, 11.7% of vaccinated PUIs versus 36.6% of unvaccinated PUIs were COVID-19 positive. The COVID-19 positivity rates among vaccinated and unvaccinated PUIs at the comparison HC were 16.1% and 33.3%, respectively. DISCUSSION: In the SARS-CoV-2 Delta variant surge, COVID-19 test positivity rates among unvaccinated symptomatic HCWs are dramatically elevated. Aggressive testing of HCW PUIs is particularly critical during periods of disease upsurge.

Temporal Trends in COVID-19 Incidence in Two Healthcare Worker Cohorts.

BACKGROUND: Health care workers (HCWs) experience increased occupational risk of contracting COVID-19, with temporal trends that might inform surveillance. METHODS: We analyzed data from a Veterans Affairs hospital-based COVID-19 worker telephone hotline collected over 40 weeks (2020). We calculated the proportion of COVID-19+ cases among persons-under-investigation (PUIs) for illness compared to rates from a nearby large university-based health care institution. RESULTS: We observed 740 PUIs, 65 (8.8%) COVID-19+. Time trends were similar at the study and comparison hospitals; only for the first of 10 four-week observation periods was the ratio for observed to expected COVID-19+ significant (P < 0.001). DISCUSSION: These data suggest that employee health COVID-19+ to PUI ratios could be utilized as a barometer of community trends. Pooling experience among heath care facilities may yield insights into occupational infectious disease outbreaks.