ABSTRACT
Protecting healthcare professionals is crucial in maintaining a functioning healthcare system. The risk of infection and optimal preventive strategies for healthcare workers during the COVID-19 pandemic remain poorly understood. Here we report the results of a cohort study that included pre- and asymptomatic healthcare workers. A weekly testing regime has been performed in this cohort since the beginning of the COVID-19 pandemic to identify infected healthcare workers. Based on these observations we have developed a mathematical model of SARS-CoV-2 transmission that integrates the sources of infection from inside and outside the hospital. The data were used to study how regular testing and a desynchronisation protocol are effective in preventing transmission of COVID-19 infection at work, and compared both strategies in terms of workforce availability and cost-effectiveness. We showed that case incidence among healthcare workers is higher than would be explained solely by community infection. Furthermore, while testing and desynchronisation protocols are both effective in preventing nosocomial transmission, regular testing maintains work productivity with implementation costs.
Subject(s)
Asymptomatic Infections , COVID-19 Testing/methods , COVID-19/diagnosis , COVID-19/economics , Health Personnel , SARS-CoV-2 , Algorithms , Cost-Benefit Analysis , Cross Infection , Data Collection , Delivery of Health Care , Hospitals , Humans , Mass Screening/methods , Models, Theoretical , Occupational Exposure , Pandemics , Risk , Stochastic Processes , Switzerland/epidemiologyABSTRACT
Protection of the healthcare workforce is of paramount importance for the care of patients in the setting of a pandemic such as coronavirus disease 2019 (COVID-19). Healthcare workers are at increased risk of becoming infected. The ideal organisational strategy to protect the workforce in a situation in which social distancing cannot be maintained remains to be determined. In this study, we have mathematically modelled strategies for the employment of the hospital workforce with the goal of simulating the health and productivity of the workers. The models were designed to determine if desynchronization of medical teams by dichotomizing the workers may protect the workforce. Our studies model workforce productivity and the efficiency of home office applied to the case of COVID-19. The results reveal that a desynchronization strategy in which two medical teams work alternating for 7 days increases the available workforce.