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1.
BMJ Open ; 12(1): e053638, 2022 01 04.
Article in English | MEDLINE | ID: covidwho-1606269

ABSTRACT

OBJECTIVE: To compare global health, mental health impact of work stressors and psychosocial perception of healthcare workers (HCWs) and non-HCWs in a hospital after the first peak of the COVID-19 outbreak in France. METHODS: A validated version of the SATIN (Santé Au Travail Inrs université Nancy 2)questionnaire with adapted scoring was used to collect data on health and impact of work stressors. This questionnaire was sent to all workers at a hospital in July 2020 and was self-administered online. In a multinomial regression model, we included HCW status, age, gender and front-line worker status as covariates. RESULTS: Data from a total of 1405 participants were included. We found that being an HCW, male and front-line worker was a risk factor for negative perception of work demand (OR 7.35, 95% CI 4.2 to 11.47; OR 2.55, 95% CI 1.11 to 5.89; OR 1.78, 95% CI 1.04 to 3.06). Being an HCW was a predictive factor for stress (OR 1.47, 95% CI 1.04 to 2.08), poor global health (OR 1.71, 95% CI 1.14 to 2.55) and negative perception of work activity environment (OR 1.9, 95% CI 1.3 to 2.8). CONCLUSION: We have shown that all HCWs suffered from some health impact shortly after the first peak of the COVID-19 outbreak. We underline some stressors with high impact, including work demand, work abilities and organisational context, and emphasise the need for risk management.


Subject(s)
COVID-19 , Cross-Sectional Studies , Disease Outbreaks , Health Personnel , Hospitals , Humans , Male , Personnel, Hospital , SARS-CoV-2
2.
Med Lav ; 112(6): 453-464, 2021 Dec 23.
Article in English | MEDLINE | ID: covidwho-1595946

ABSTRACT

BACKGROUND: Healthcare Workers (HCWs) are a key element in managing the COVID-19 pandemic, but they are also at high risk of infection. OBJECTIVE: The aim of this study was to describe, in a large university hospital which provided healthcare services to patients with SARS-CoV-2 infection, the course of the epidemic among HCWs and effectiveness of COVID-19 vaccination in reducing SARS-CoV-2 infection and disease. METHODS: Our case series included all "Fatebenefratelli Sacco" University Hospital workers. Data were collected until the 15th of May 2021 and analysed as part of the health surveillance program carried out by the Occupational Health Unit. RESULTS: From March 2020 until May 2021, 14.4% of workers contracted COVID-19, with the highest incidence peak recorded during the second wave of the pandemic. The prevalence of infection was slightly higher in males than in females, and a greater number of cases was found in job categories characterized by direct patient care activities. We reported a higher prevalence of "serious/critical illness" in elder workers. A clear reduction of COVID-19 incidence was found in our population during the third pandemic wave, that coincided with the start of vaccination campaign. DISCUSSION: HCWs have been at high risk of COVID-19 infection. Male sex and advanced age appear to be predisposing factor and negative prognostic factor respectively. An out-of-hospital setting appears to be the main source of COVID-19 confirming that the correct use of protective devices during work counters the risk of infection. Vaccination seems to reduce both documented cases of infection and severe illness.


Subject(s)
COVID-19 , Aged , COVID-19 Vaccines , Female , Health Personnel , Hospitals , Humans , Italy/epidemiology , Male , Pandemics , Personnel, Hospital , SARS-CoV-2
3.
Antimicrob Resist Infect Control ; 10(1): 170, 2021 12 20.
Article in English | MEDLINE | ID: covidwho-1582005

ABSTRACT

A survey of hospitals on three continents was performed to assess their infection control preparedness and measures, and their infection rate in hospital health care workers during the COVID-19 pandemic. All surveyed hospitals used similar PPE but differences in preparedness, PPE shortages, and infection rates were reported.


Subject(s)
COVID-19/epidemiology , Infection Control/methods , Personnel, Hospital/statistics & numerical data , Hospitals , Humans , Internationality , Pandemics , Personal Protective Equipment , Surveys and Questionnaires
4.
PLoS One ; 16(12): e0258348, 2021.
Article in English | MEDLINE | ID: covidwho-1581818

ABSTRACT

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a 'great-extent-of-confidence' in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors. INTERPRETATION: There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type.


Subject(s)
COVID-19/epidemiology , Health Knowledge, Attitudes, Practice , Personnel, Hospital , Adult , COVID-19/prevention & control , Cross-Sectional Studies , Education, Medical, Continuing/statistics & numerical data , Female , Humans , Male , Personnel, Hospital/statistics & numerical data , Socioeconomic Factors , Surveys and Questionnaires
5.
PLoS One ; 16(12): e0261024, 2021.
Article in English | MEDLINE | ID: covidwho-1581763

ABSTRACT

BACKGROUND: Tracheostomy has been proposed as an option to help organize the healthcare system to face the unprecedented number of patients hospitalized for a COVID-19-related acute respiratory distress syndrome (ARDS) in intensive care units (ICU). It is, however, considered a particularly high-risk procedure for contamination. This paper aims to provide our experience in performing tracheostomies on COVID-19 critically ill patients during the pandemic and its long-term local complications. METHODS: We performed a retrospective analysis of prospectively collected data of patients tracheostomized for a COVID-19-related ARDS in two university hospitals in the Paris region between January 27th (date of first COVID-19 admission) and May 18th, 2020 (date of last tracheostomy performed). We focused on tracheostomy technique (percutaneous versus surgical), timing (early versus late) and late complications. RESULTS: Forty-eight tracheostomies were performed with an equal division between surgical and percutaneous techniques. There was no difference in patients' characteristics between surgical and percutaneous groups. Tracheostomy was performed after a median of 17 [12-22] days of mechanical ventilation (MV), with 10 patients in the "early" group (≤ day 10) and 38 patients in the "late" group (> day 10). Survivors required MV for a median of 32 [22-41] days and were ultimately decannulated with a median of 21 [15-34] days spent on cannula. Patients in the early group had shorter ICU and hospital stays (respectively 15 [12-19] versus 35 [25-47] days; p = 0.002, and 21 [16-28] versus 54 [35-72] days; p = 0.002) and spent less time on MV (respectively 17 [14-20] and 35 [27-43] days; p<0.001). Interestingly, patients in the percutaneous group had shorter hospital and rehabilitation center stays (respectively 44 [34-81] versus 92 [61-118] days; p = 0.012, and 24 [11-38] versus 45 [22-71] days; p = 0.045). Of the 30 (67%) patients examined by a head and neck surgeon, 17 (57%) had complications with unilateral laryngeal palsy (n = 5) being the most prevalent. CONCLUSIONS: Tracheostomy seems to be a safe procedure that could help ICU organization by delegating work to a separate team and favoring patient turnover by allowing faster transfer to step-down units. Following guidelines alone was found sufficient to prevent the risk of aerosolization and contamination of healthcare professionals.


Subject(s)
COVID-19/surgery , Tracheostomy/methods , Aged , COVID-19/mortality , COVID-19/therapy , Critical Care/methods , Female , Follow-Up Studies , Hospitals, University , Humans , Intensive Care Units , Length of Stay , Male , Middle Aged , Paris , Personnel, Hospital , Respiration, Artificial , Retrospective Studies , Tracheostomy/adverse effects , Treatment Outcome
6.
Clin Med Res ; 19(4): 169-178, 2021 12.
Article in English | MEDLINE | ID: covidwho-1581438

ABSTRACT

Objective: Both Middle East Respiratory Syndrome (MERS) and Coronavirus Disease 2019 (COVID-19) have an emotional toll on healthcare workers (HCWs), but the difference of the impact between the two diseases remains unknown.Design: A cross sectional descriptive survey.Setting: A tertiary care hospital.Participants: 125 HCWs who worked during the 2014 MERS as well as the 2020 COVID-19 outbreaks in high-risk areas of the hospital including critical care, emergency room and COVID-19 clinics.Methods: The comprehensive survey comprised 5 sections and 68 questions and was administered to HCWs before availability of the COVID-19 vaccine. The survey evaluated hospital staff emotions, perceived stressors, external factors that reduced stress, personal coping strategies, and motivators for future outbreaks. The participants rated each question for MERS and COVID-19 simultaneously on a scale from 0-3. The responses were reported as mean and standard deviation, while Wilcoxon signed-rank test was used to calculate the difference in responses.Results: There were 102 (82%) participants who returned the questionnaire. The ritual of obsessive hand washing, emotional and physical fatigue, ongoing changes in infection control guidelines, fear of community transmission, and limitations on socialization and travel were the major stressors that were significantly worse during COVID-19 compared to MERS (P<0.05) and led to HCWs adoption of additional 'personal' coping strategies during COVID-19. There was no difference between COVID-19 and MERS, however, among preferences for 'external' factors made available to HCWs that could reduce stress or in their preferences for motivators to work in future outbreaks (P>.05).Conclusion: Both the MERS and COVID-19 outbreaks were emotionally draining for HCWs. However, COVID-19 was a relatively more stressful experience than MERS for HCWs and led to greater personal, behavioral, and protective adaptations by the hospital staff.


Subject(s)
COVID-19 , Middle East Respiratory Syndrome Coronavirus , COVID-19 Vaccines , Cross-Sectional Studies , Emotions , Health Personnel , Humans , Pandemics , Personnel, Hospital , SARS-CoV-2 , Tertiary Care Centers
7.
Asia Pac J Public Health ; 33(8): 847-853, 2021 11.
Article in English | MEDLINE | ID: covidwho-1574345

ABSTRACT

The objective of this study was to investigate the association between adherence to healthy lifestyles (as measured by the healthy lifestyle index [HLI]) and depressive symptoms among staff members at a large national medical institution in Tokyo, Japan, during the coronavirus disease 2019 (COVID-19) pandemic. The study sample consisted of 1228 staff members aged between 21 and 73 years who participated in a cross-sectional survey conducted in July 2020. We constructed the HLI by assigning one point to each healthy lifestyle factor: normal body mass index, sufficient physical activity, non-smoking status, non-to-moderate alcohol consumption, and sufficient sleep duration. The multivariate adjusted odds ratios for depressive symptoms were 1.00 (reference), 0.71, 0.66, and 0.56 for participants with HLI scores of 0 to 2, 3, 4, and 5, respectively. The present study suggests the role of healthy lifestyles in mental health among hospital staff working during the pandemic.


Subject(s)
COVID-19 , Pandemics , Adult , Aged , Cross-Sectional Studies , Depression/epidemiology , Healthy Lifestyle , Hospitals , Humans , Japan/epidemiology , Middle Aged , Personnel, Hospital , SARS-CoV-2 , Young Adult
8.
Gac Med Mex ; 157(3): 313-317, 2021.
Article in English | MEDLINE | ID: covidwho-1535087

ABSTRACT

INTRODUCTION: During the COVID-19 pandemic, adherence to hygiene measures is an objective aimed at reducing morbidity and mortality. OBJECTIVE: To evaluate adherence to hand hygiene and protection measures during the COVID-19 pandemic in a tertiary care hospital. METHODS: Cross-sectional study on health personnel handwashing at the five moments recommended by the World Health Organization, as well as on the use of specific personal protective equipment. RESULTS: One hundred and seventeen hand hygiene opportunities were observed in health personnel. Hand washing was observed in 40 (34 %) and omission in 76 (65 %). Adherence to the use of face shield was observed in five (4 %), and lack of adherence in 112 (96%). Adherence to the use of face mask was observed in 65 nursing professionals (87 %), with appropriate use of the mask in 56 of them (60 %) and use of face shield in one (1 %). CONCLUSION: Health personnel showed low proportions of adherence to hand hygiene and use of equipment for specific protection during the COVID-19 pandemic.


Subject(s)
COVID-19/prevention & control , Guideline Adherence/statistics & numerical data , Hand Hygiene/statistics & numerical data , Personal Protective Equipment/statistics & numerical data , Personnel, Hospital/statistics & numerical data , Cross-Sectional Studies , Female , Hand Hygiene/standards , Humans , Male , Personnel, Hospital/standards , Prospective Studies , Tertiary Care Centers , Time Factors
9.
S Afr Med J ; 111(11): 1092-1097, 2021 11 05.
Article in English | MEDLINE | ID: covidwho-1534501

ABSTRACT

BACKGROUND: The availability of well and functional healthcare workers (HCWs) and support staff is pivotal to a country's ability to manage the COVID-19 pandemic effectively. While HCWs have been identified as being at increased risk for acquisition of SARS-CoV-2 infection, there is a paucity of data pertaining to South African (SA) HCW-related infection rates. Global and provincial disparities in these numbers necessitate local data in order to mitigate risks. OBJECTIVES: To ascertain the overall SARS-CoV-2 infection rates and outcomes among all hospital staff at three hospitals in the Tshwane district of Gauteng Province, SA, and further determine associations with the development of severe COVID-19 disease. METHODS: This retrospective audit was conducted across three academic hospitals in the Tshwane district for the period 1 June - 31 August 2020. Deidentified data from occupational health and safety departments at each hospital were used to calculate infection rates. A more detailed analysis at one of the three hospitals included evaluation of demographics, work description, possible source of SARS-CoV-2 exposure (community or hospital), comorbidities and outcomes. RESULTS: The period prevalence of SARS-CoV-2 infections ranged from 6.1% to 15.4% between the three hospitals, with the average period prevalence being 11.1%. The highest incidence of SARS-CoV-2 infections was observed among administrative staff (2.8 cases per 1 000 staff days), followed by nursing staff (2.7 cases per 1 000 staff days). Medical doctors had the lowest incidence of 1.1 cases per 1 000 staff days. SARS-CoV-2 infections were categorised as either possibly community or possibly healthcare facility acquired for 26.6% and 73.4% of the infections, respectively. The administrative group had the highest proportion of possible community-acquired infections (41.8%), while doctors had the lowest (6.1%). The mean age of individuals with mild and severe disease was 41 years and 46.1 years, respectively (p=0.004). The presence of comorbidities was significantly associated with severity of disease (p=0.002). CONCLUSIONS: This study highlights that hospital staff, including administrative staff, are clearly at high risk for acquisition of SARS-CoV-2 infection during a surge.


Subject(s)
Academic Medical Centers , COVID-19/epidemiology , Personnel, Hospital/statistics & numerical data , Adult , Age Distribution , COVID-19/physiopathology , Female , Humans , Incidence , Male , Middle Aged , Patient Acuity , Prevalence , Retrospective Studies , Risk Factors , South Africa/epidemiology
10.
Am J Infect Control ; 49(12): 1554-1557, 2021 12.
Article in English | MEDLINE | ID: covidwho-1520638

ABSTRACT

To protect both patients and staff, healthcare personnel (HCP) were among the first groups in the United States recommended to receive the COVID-19 vaccine. We analyzed data reported to the U.S. Department of Health and Human Services (HHS) Unified Hospital Data Surveillance System on COVID-19 vaccination coverage among hospital-based HCP. After vaccine introduction in December 2020, COVID-19 vaccine coverage rose steadily through April 2021, but the rate of uptake has since slowed; as of September 15, 2021, among 3,357,348 HCP in 2,086 hospitals included in this analysis, 70.0% were fully vaccinated. Additional efforts are needed to improve COVID-19 vaccine coverage among HCP.


Subject(s)
COVID-19 Vaccines , COVID-19 , Delivery of Health Care , Hospitals , Humans , Personnel, Hospital , SARS-CoV-2 , United States , United States Dept. of Health and Human Services , Vaccination Coverage
11.
Int J Environ Res Public Health ; 18(21)2021 11 08.
Article in English | MEDLINE | ID: covidwho-1512322

ABSTRACT

This study aimed to identify the factors that influence the components of burnout-emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA)-among hospital health workers, including doctors and nurses, during the COVID-19 pandemic. We analyzed 200 healthcare workers' responses to the Employee Health Promotion Survey conducted at a general hospital in Seoul with over 200 hospital beds. The questionnaire included items about COVID-19-related burnout and its influencing factors. We performed three different multiple regression analyses using EE, DP, and PA as the dependent variables. The results show that sex, marital status, workload of treating suspected COVID-19 patients, fear of COVID-19 infection, anxiety, and depression predicted EE. The predictors of DP were job category, consecutive months of work in the current department, satisfaction with work environment, anxiety, and depression. The predictors of PA were the workload of directly interacting with patients, socioeconomic status, and job stress. For EE and DP, burnout was found to be worse in doctors and nurses than in other health workers; moreover, burnout was worse among nurses than among doctors across all three aspects of burnout. The findings can be used to establish tailored policies to address each burnout component.


Subject(s)
Burnout, Professional , COVID-19 , Burnout, Professional/epidemiology , Disease Outbreaks , Hospitals , Humans , Pandemics , Personnel, Hospital , Republic of Korea/epidemiology , SARS-CoV-2 , Surveys and Questionnaires
12.
Pan Afr Med J ; 40: 39, 2021.
Article in English | MEDLINE | ID: covidwho-1502776

ABSTRACT

Introduction: as the coronavirus disease 2019 (COVID-19) spreads, sleep problems are expected to increase among healthcare workers. Therefore, we aimed to assess the knowledge of COVID-19, sleep problem and identify sociodemographic factors associated with sleep problems among healthcare workers in a Nigerian neuropsychiatric hospital. Methods: a cross-sectional study was conducted among 200 healthcare workers in a neuropsychiatric hospital using self-administered questionnaires to assess knowledge of COVID-19, sleep problem, social support, and sociodemographic factors that affect sleep. Chi-square test and Spearman's correlation were applied to assess the association between sociodemographic factors and sleep problems. Results: about 23.9% of the healthcare workers reported having a sleep problem. However, there was no association of sleep problems with any sociodemographic factors except age (r=0.26) and social support (r=-0.18). Conclusion: the study offered insight into the occurrence of sleep problems among healthcare workers and suggested a guide for planning interventions targeted at improving the psychological well-being of healthcare workers in the face of current global pandemics.


Subject(s)
COVID-19 , Health Knowledge, Attitudes, Practice , Personnel, Hospital/statistics & numerical data , Sleep Wake Disorders/epidemiology , Adult , Age Factors , Cross-Sectional Studies , Female , Hospitals, Psychiatric , Humans , Male , Nigeria , Personnel, Hospital/psychology , Social Support , Surveys and Questionnaires
13.
BMJ Open ; 11(10): e046676, 2021 10 29.
Article in English | MEDLINE | ID: covidwho-1495458

ABSTRACT

OBJECTIVES: We aimed to explore the seroprevalence of hospital staff comparing to preprocedural patients in Thai community hospitals to shed light on the situation of COVID-19 infection of frontline healthcare workers in low infection rate countries where mass screening was not readily available. DESIGN: Cross-sectional study. SETTING: 52 community hospitals in 35 provinces covered all regions of Thailand. PARTICIPANTS: 857 participants consisted of 675 hospital staff and 182 preprocedural patients. OUTCOME MEASURE: COVID-19 seroprevalence using a locally developed rapid IgM/IgG test kit RESULTS: Overall, 5.5% of the participants (47 of 857) had positive IgM, 0.2% (2 of 857) had positive IgG which both of them also had positive IgM. Hospitals located in the central part of Thailand had the highest IgM seroprevalence (11.9%). Preprocedural patients had a higher rate of positive IgM than the hospital staff (12.1% vs 3.7%). Participants with present upper respiratory tract symptoms had a higher rate of positive IgM than those without (9.6% vs 4.5%). Three quarters (80.5%, 690 of 857) of the participants were asymptomatic, of which, 31 had positive IgM (4.5%) which consisted of 20 of 566 healthcare workers (3.5%) and 11 of 124 preprocedural patients (8.9%). CONCLUSIONS: COVID-19 antibody test could detect a substantial number of potential silent spreaders in Thai community hospitals where the nasopharyngeal PCR was not readily available, and the antigen test was prohibited. Antibody testing should be encouraged for mass screening in a limited resource setting, especially in asymptomatic individuals. TRIAL REGISTRATION: TCTR20200426002.


Subject(s)
COVID-19 , Antibodies, Viral , Cross-Sectional Studies , Health Personnel , Hospitals, Community , Humans , Immunoglobulin G , Immunoglobulin M , Personnel, Hospital , SARS-CoV-2 , Seroepidemiologic Studies , Thailand/epidemiology
14.
J Affect Disord ; 297: 156-168, 2022 01 15.
Article in English | MEDLINE | ID: covidwho-1492205

ABSTRACT

BACKGROUND: Hospital workers have been under intense psychological pressure since the COVID-19 outbreak. We analyzed the psychological status of hospital staff in the late period of the COVID-19 to provide a basis for the construction of global health care after the COVID-19 outbreak. METHODS: We used online surveys to assess participants' self-reported symptoms at the late stage of the outbreak. This study collected data on sociodemographic characteristics, epidemic-related factors, psychological status (PHQ-9, GAD-7, and PHQ-15), psychological assistance needs, perceived stress and support, PTSD symptoms (PCL-C) and suicidal and self-injurious ideation (SSI). Participants were hospital workers in all positions from 46 hospitals. Chi-square tests to compare the scales and logistic regression analysis were used to identify risk factors for PTSD and SSI. RESULTS: Among the 33,706 participants, the prevalences of depression, anxiety, somatic symptoms, PTSD symptoms, and SSI were 35.8%, 24.4%, 49.7%, 5.0%, and 1.3%, respectively. Logistic regression analysis showed that work in a general ward, attention to the epidemic, high education, work in non-first-line departments, insufficient social support, and anxiety and somatization symptoms were influencing factors of PTSD (P<0.05). The independent risk factors for SSI were female gender; psychological assistance needs; contact with severe COVID-19 patients; high stress at work; single or divorced marital status; insufficient social support; and depression, anxiety or PTSD symptoms (P<0.05). LIMITATIONS: This cross-sectional study could not reveal causality, and voluntary participation may have led to selection bias. The longer longitudinal studies are needed to determine the long-term psychological impact. CONCLUSION: This COVID-19 pandemic had a sustained, strong psychological impact on hospital workers, and hospital workers with PTSD symptoms were a high-risk group for SSI in the later period of the epidemic. Continuous attention and positive psychological intervention are of great significance for specific populations.


Subject(s)
COVID-19 , Anxiety , China , Cross-Sectional Studies , Depression , Disease Outbreaks , Female , Health Personnel , Hospitals , Humans , Pandemics , Personnel, Hospital , SARS-CoV-2 , Surveys and Questionnaires
15.
J Aging Stud ; 59: 100982, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1487801

ABSTRACT

Background There is no doubt that people with dementia can greatly benefit from the COVID-19 vaccine, especially as they are at an increased risk of developing severe complications, including long hospitalizations and high mortality rates, as a result of being infected by the virus. However, they might need the encouragement of health professionals to become vaccinated. Professionals' preferences regarding vaccination for this group are, therefore, extremely important to increase the use of this preventive measure. Aims 1. To examine hospital staff members' preferences for COVID-19 vaccination to people with or without Alzheimer's disease (AD) while differentiating between a young and an old person with the disease. 2. To examine the factors associated with these preferences. Methods A cross-sectional survey using a structured and anonymous self-report questionnaire was conducted among a sample of 278 Israeli medical staff (nurses, physicians, and paraprofessionals) working at a general hospital. The data were collected in August 2021. Results Overall, the majority (68.4%) of participants chose the 80-year-old patient with a diagnosis of AD to be the last to receive the vaccine. The percentage of participants who preferred to give the vaccine first to the 55-year-old patient with AD was almost equal to the percentage of those who preferred giving the vaccine first to the 80-year-old patient who was cognitively intact. Religion and beliefs about susceptibility to contracting COVID-19 were significantly associated with participants' preferences. Conclusion Our results suggest that hospital staff members find it difficult to decide whether age or cognitive status should be the main factor in deciding which patient should receive the vaccine first. Therefore, there is a need to implement several policy and practical steps in hospitals to assist the medical staff in such decision-making processes.


Subject(s)
Alzheimer Disease , COVID-19 , Vaccines , Aged, 80 and over , COVID-19 Vaccines , Cross-Sectional Studies , Humans , Personnel, Hospital , SARS-CoV-2
16.
PLoS Pathog ; 17(10): e1009928, 2021 10.
Article in English | MEDLINE | ID: covidwho-1484868

ABSTRACT

Non-specific protective effects of certain vaccines have been reported, and long-term boosting of innate immunity, termed trained immunity, has been proposed as one of the mechanisms mediating these effects. Several epidemiological studies suggested cross-protection between influenza vaccination and COVID-19. In a large academic Dutch hospital, we found that SARS-CoV-2 infection was less common among employees who had received a previous influenza vaccination: relative risk reductions of 37% and 49% were observed following influenza vaccination during the first and second COVID-19 waves, respectively. The quadrivalent inactivated influenza vaccine induced a trained immunity program that boosted innate immune responses against various viral stimuli and fine-tuned the anti-SARS-CoV-2 response, which may result in better protection against COVID-19. Influenza vaccination led to transcriptional reprogramming of monocytes and reduced systemic inflammation. These epidemiological and immunological data argue for potential benefits of influenza vaccination against COVID-19, and future randomized trials are warranted to test this possibility.


Subject(s)
COVID-19/immunology , Cross Protection/physiology , Immunity, Innate/physiology , Influenza Vaccines/administration & dosage , COVID-19/epidemiology , COVID-19/prevention & control , Cytokines/immunology , Cytokines/metabolism , Down-Regulation , Imidazoles/immunology , Incidence , Influenza Vaccines/immunology , Netherlands/epidemiology , Personnel, Hospital , Poly I-C/immunology , Proteomics , Risk Factors , Sequence Analysis, RNA
17.
Int J Environ Res Public Health ; 18(20)2021 10 19.
Article in English | MEDLINE | ID: covidwho-1477942

ABSTRACT

COVID-19, which is caused by SARS-CoV-2, is an occupational health risk, especially for healthcare employees due to their higher exposure and consequently higher risk of symptomatic and asymptomatic infections. This study was designed to determine the longitudinal seroprevalence of specific immunoglobulin-G (IgG) antibodies in employees in a hospital setting. All employees in a secondary care hospital, including healthcare and non-healthcare workers, were invited to participate in this single-center study. After an initial screening, a 6-month follow-up was carried out, which included serological examination for SARS-CoV-2 IgG antibodies and a questionnaire for self-reported symptoms, self-perception, and thoughts about local and national hygiene and pandemic plans. The seroprevalence of SARS-CoV-2 IgG antibodies was 0.74% among 406 hospital employees (0.75% in healthcare workers, 0.72% in non-healthcare workers), initially recruited in April 2020, in their follow-up blood specimens in October 2020. In this study, 30.54% of the participants reported using the official German coronavirus mobile application and the majority were content with the local and national rules in relation to coronavirus-related restrictions. At the 6-month follow-up, the 0.74% seroprevalence was below the reported seroprevalence of 1.35% in the general German population. The prevalence in healthcare workers in direct patient care compared with that in workers without direct patient contact did not differ significantly. Further follow-up to monitor the seroprevalence in the high-risk healthcare sector during the ongoing global pandemic is essential.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibodies, Viral , Health Personnel , Hospitals , Humans , Personnel, Hospital , Seroepidemiologic Studies
18.
Lancet Glob Health ; 9(11): e1517-e1527, 2021 11.
Article in English | MEDLINE | ID: covidwho-1472216

ABSTRACT

BACKGROUND: Over 1 year since the first reported case, the true COVID-19 burden in Ethiopia remains unknown due to insufficient surveillance. We aimed to investigate the seroepidemiology of SARS-CoV-2 among front-line hospital workers and communities in Ethiopia. METHODS: We did a population-based, longitudinal cohort study at two tertiary teaching hospitals involving hospital workers, rural residents, and urban communities in Jimma and Addis Ababa. Hospital workers were recruited at both hospitals, and community participants were recruited by convenience sampling including urban metropolitan settings, urban and semi-urban settings, and rural communities. Participants were eligible if they were aged 18 years or older, had provided written informed consent, and were willing to provide blood samples by venepuncture. Only one participant per household was recruited. Serology was done with Elecsys anti-SARS-CoV-2 anti-nucleocapsid assay in three consecutive rounds, with a mean interval of 6 weeks between tests, to obtain seroprevalence and incidence estimates within the cohorts. FINDINGS: Between Aug 5, 2020, and April 10, 2021, we did three survey rounds with a total of 1104 hospital workers and 1229 community residents participating. SARS-CoV-2 seroprevalence among hospital workers increased strongly during the study period: in Addis Ababa, it increased from 10·9% (95% credible interval [CrI] 8·3-13·8) in August, 2020, to 53·7% (44·8-62·5) in February, 2021, with an incidence rate of 2223 per 100 000 person-weeks (95% CI 1785-2696); in Jimma Town, it increased from 30·8% (95% CrI 26·9-34·8) in November, 2020, to 56·1% (51·1-61·1) in February, 2021, with an incidence rate of 3810 per 100 000 person-weeks (95% CI 3149-4540). Among urban communities, an almost 40% increase in seroprevalence was observed in early 2021, with incidence rates of 1622 per 100 000 person-weeks (1004-2429) in Jimma Town and 4646 per 100 000 person-weeks (2797-7255) in Addis Ababa. Seroprevalence in rural communities increased from 18·0% (95% CrI 13·5-23·2) in November, 2020, to 31·0% (22·3-40·3) in March, 2021. INTERPRETATION: SARS-CoV-2 spread in Ethiopia has been highly dynamic among hospital worker and urban communities. We can speculate that the greatest wave of SARS-CoV-2 infections is currently evolving in rural Ethiopia, and thus requires focused attention regarding health-care burden and disease prevention. FUNDING: Bavarian State Ministry of Sciences, Research, and the Arts; Germany Ministry of Education and Research; EU Horizon 2020 programme; Deutsche Forschungsgemeinschaft; and Volkswagenstiftung.


Subject(s)
COVID-19/epidemiology , Personnel, Hospital/statistics & numerical data , Residence Characteristics/statistics & numerical data , Adult , Ethiopia/epidemiology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Models, Statistical , Seroepidemiologic Studies , Young Adult
19.
Int J Environ Res Public Health ; 18(20)2021 10 17.
Article in English | MEDLINE | ID: covidwho-1470872

ABSTRACT

BACKGROUND: Close patient contact is an essential component of clinical dental education, which can expose students and faculty to risk of COVID-19 and its sequelae. METHODS: The study was a cross-sectional survey conducted among faculty and clinical students at an academic dental hospital in Al Madinah western Saudi Arabia. An online questionnaire was distributed to collect data on prevalence, risk factors, clinical manifestations, and long-term health and socioeconomic complications of COVID-19 infection. RESULTS: Prevalence of COVID-19 was 19.6% among a total of 316 students and faculty. Participants cited family and friends as the primary source of infection (40.3%). Among cross-infection control practices, they cited failure to practice distancing as the primary reason for infection transmission (61.3%). The disease was symptomatic in 85.5% of infected personnel. Most frequently reported clinical manifestations were: fever, cough, malaise, and diarrhoea (74.1%, 56.5%, 40.3%, 32.3%, respectively). A proportion of 37.1% of infected personnel stated that they had long COVID-19, and 58.3% of infected students reported deteriorated academic achievement. CONCLUSIONS: One in five of clinical dental students and their faculty had COVID-19. Most cases were symptomatic, and a large proportion developed long COVID or adverse socioeconomic consequences. Regardless of the severity of symptoms encountered during the acute stage of COVID-19 infection, all infected dental healthcare personnel should be followed, especially those who report long COVID. Continuous follow-up and assistance for infected students may be warranted to mitigate the potential academic and mental drawbacks caused by the pandemic. Dental schools should adopt clear policies regarding COVID-19 transmission and prevention and should implement them in their infection-control education and training.


Subject(s)
COVID-19 , COVID-19/complications , Cross-Sectional Studies , Hospitals , Humans , Personnel, Hospital , SARS-CoV-2 , Saudi Arabia/epidemiology
20.
Int J Environ Res Public Health ; 18(20)2021 10 14.
Article in English | MEDLINE | ID: covidwho-1470837

ABSTRACT

BACKGROUND: Hospital staffing shortages are again (mid-year 2021) becoming a significant problem as the number of positive COVID-19 cases continues to increase worldwide. OBJECTIVE: To assess the costs of sending HCW into quarantine (Scenario 1) from the hospital's and the taxpayer's perspective versus the costs arising from implementing point-of-care COVID-19 antigen testing (POCT) for those staff members who, despite learning that they have been exposed to hospital patients later found to be infected with COVID-19, continue to report to work (Scenario 2). METHODS: A mathematical model was built to calculate the costs of a sample-and-stay strategy for exposed healthcare workers (HCW) in Germany by utilizing a high-quality antigen fluorescent immunoassay (FIA), compared to the costs of quarantine. Direct costs and wage costs were evaluated from the hospital as well as from the taxpayer perspective assuming a SARS-CoV-2 infection prevalence of 10%. RESULTS: Serial POCT testing of exposed HCW in Germany (Scenario 2) who do not go into quarantine but continue to work during a post-exposure period of 14 days at their working place raises costs of EUR 289 (±20%: EUR 231 to EUR 346, rounded) per HCW at the expense of the employing hospital while the extra-costs to the taxpayer per exposed HCW are limited to EUR 16 (±20%: EUR 13 to EUR 19). In contrast, sending HCW into quarantine (Scenario 1) would result in costs of EUR 111 (±20%: EUR 89 to EUR 133) per exposed HCW for the hospital but EUR 2235 (±20%: EUR 1744 to EUR 2727) per HCW at the expense of the taxpayer. CONCLUSIONS: Monitoring exposed HCW who continued working by sequential POCT may considerably reduce costs from the perspective of the taxpayer and help mitigate personnel shortages in hospitals during pandemic COVID-19 waves.


Subject(s)
COVID-19 , Health Personnel , Humans , Pandemics , Personnel, Hospital , Point-of-Care Systems , SARS-CoV-2
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