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1.
Lancet Child Adolesc Health ; 6(4): 240-248, 2022 04.
Article in English | MEDLINE | ID: covidwho-1671373

ABSTRACT

BACKGROUND: Many adolescents have been affected by the COVID-19 pandemic either directly by being infected with the virus or indirectly by lockdowns and restrictions influencing normal living. We aimed to investigate health, including symptoms of long COVID, in adolescents (aged 15-18 years) who tested positive for SARS-CoV-2 compared with a control group. METHODS: LongCOVIDKidsDK was a national, cross-sectional study carried out in Denmark, which included SARS-CoV-2-positive adolescents and matched controls. All Danish adolescents aged 15-18 years with a positive SARS-CoV-2 test during the period Jan 1, 2020, to July 12, 2021, and a control group matched (1:4) by age and sex were sent a survey from July 20, 2021. Participants had until Sept 15, 2021, to respond. Symptoms associated with COVID-19, school attendance, and health-related quality of life were investigated using ancillary questions and validated questionnaires (Paediatric Quality of Life Inventory [PedsQL] and Children's Somatic Symptoms Inventory-24 [CSSI-24]). Statistical analyses included descriptive statistics and logistic regression. This study is registered at ClinicalTrials.gov, NCT04786353. FINDINGS: 24 315 adolescents with a positive SARS-CoV-2 test (case group) and 97 257 matched controls were invited to participate. 3013 matched controls were excluded because of suspected SARS-CoV-2 infection. 6630 (27·3%) responded in the case group and 21 640 (22·3%) responded and were eligible to participate in the control group. Across both groups, median age was 17·6 years (IQR 16·4-18·5), 16 277 (57·6%) of 28 270 responders were female, and 11 993 (42·4%) were male. Participants in the case group had greater odds of having at least one long COVID symptom lasting at least 2 months compared with the control group (3159 [61·9%] vs 12 340 [57·0%], odds ratio 1·22 [95% CI 1·15-1·30]; p<0·0001). Participants in the case group reported significantly lower symptom scores (ie, less somatic distress) on the CSSI-24 than in the control group: mean 10·7 (SD 11·4, median 7·0 [IQR 2·0-15·0]) versus 11·9 (10·6, 9·0 [4·0-17·0]; p<0·0001). Participants in the case group had better quality of life scores on the PedsQL than in the control group: physical functioning mean score 88·7 (SD 13·9, median 93·8 [IQR 84·4-100·0]) versus 86·5 (14·3, 90·6 [81·3-96·9]; p<0·0001); emotional functioning 77·1 (20·3, 80·0 [65·0-95·0]) versus 71·7 (21·4, 75·0 [60·0-90·0]; p<0·0001); social functioning 93·1 (12·5, 100·0 [90·0-100·0]) versus 88·4 (16·2, 95·0 [80·0-100·0]; p<0·0001); and school functioning 66·9 (22·5, 65·0 [60·0-85·0]) versus 62·9 (22·1, 65·0 [50·0-80·0]; p<0·0001). More participants in the case group than in the control group reported 16 or more sick days (1205 [18·2%] vs 2518 [11·6%]; p<0·0001) and 16 or more days of school absence (695 [10·5%] vs 1777 [8·2%]; p<0·0001). INTERPRETATION: Participants with SARS-CoV-2-positive tests had more long-lasting symptoms and sick leave, whereas participants in the control group had more short-lasting symptoms and worse quality of life. Knowledge of long COVID in adolescents is important to guide clinical recognition and management of this condition. FUNDING: AP Møller and Chastine McKinney Møller Foundation.


Subject(s)
COVID-19/complications , Adolescent , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/psychology , COVID-19 Testing , Case-Control Studies , Cross-Sectional Studies , Denmark/epidemiology , Female , Humans , Male , Quality of Life , SARS-CoV-2 , Schools , Sick Leave/statistics & numerical data , Surveys and Questionnaires
2.
PLoS One ; 16(12): e0260453, 2021.
Article in English | MEDLINE | ID: covidwho-1623646

ABSTRACT

A majority of SARS-CoV-2 infections are transmitted from a minority of infected subjects, some of which may be symptomatic or pre-symptomatic. We aimed to quantify potential infectiousness among asymptomatic healthcare workers (HCWs) in relation to prior or later symptomatic disease. We previously (at the onset of the SARS-CoV-2 epidemic) performed a cohort study of SARS-CoV-2 infections among 27,000 healthcare workers (HCWs) at work in the capital region of Sweden. We performed both SARS-CoV-2 RT-PCR and serology. Furthermore, the cohort was comprehensively followed for sick leave, both before and after sampling. In the present report, we used the cohort database to quantify potential infectiousness among HCWs at work. Those who had sick leave either before or after sampling were classified as post-symptomatic or pre-symptomatic, whereas the virus-positive subjects with no sick leave were considered asymptomatic. About 0.2% (19/9449) of HCW at work were potentially infectious and pre-symptomatic (later had disease) and 0.17% (16/9449) were potentially infectious and asymptomatic (never had sick leave either before nor after sampling). Thus, 33% and 28% of all the 57 potentially infectious subjects were pre-symptomatic or asymptomatic, respectively. When a questionnaire was administered to HCWs with past infection, only 10,5% of HCWs had had no indication at all of having had SARS-CoV-2 infection ("truly asymptomatic"). Our findings provide a unique quantification of the different groups of asymptomatic, potentially infectious HCWs.


Subject(s)
Asymptomatic Infections/epidemiology , COVID-19/epidemiology , Health Personnel/statistics & numerical data , Sick Leave/statistics & numerical data , Adult , Cohort Studies , Female , Humans , Male , Middle Aged , Sweden/epidemiology
3.
PLoS One ; 16(12): e0260652, 2021.
Article in English | MEDLINE | ID: covidwho-1560976

ABSTRACT

Healthcare and residential care workers represent two occupational groups that have, in particular, been at risk of Covid-19, its long-term consequences, and related sick leave. In this study, we investigated the predictors of prolonged sick leave among healthcare and residential workers due to non-hospitalized Covid-19 in the early period of the pandemic. This study is based on a patient register (n = 3209) and included non-hospitalized healthcare or residential care service workers with a positive RT- PCR for SARS-CoV-2 (n = 433) between March and August 2020. Data such as socio-demographics, clinical characteristics, and the length of sick leave because of Covid-19 and prior to the pandemic were extracted from the patient's electronic health records. Prolonged sick leave was defined as sick leave ≥ 3 weeks, based on the Swedish pandemic policy. A generalized linear model was used with a binary distribution, adjusted for age, gender, and comorbidity in order to predict prolonged sick leave. Of 433 (77% women) healthcare and residential care workers included in this study, 14.8% needed longer sick leave (> 3 weeks) due to Covid-19. Only 1.4% of the subjects were on sick leave because of long Covid. The risk of sick leave was increased two-fold among residential care workers (adjusted RR 2.14 [95% CI 1.31-3.51]). Depression/anxiety (adjusted RR 2.09 [95% CI 1.31-3.34]), obesity (adjusted RR 1.96 [95% CI 1.01-3.81]) and dyspnea at symptom onset (adjusted RR 2.47 [95% CI 1.55-3.92]), sick leave prior to the pandemic (3-12 weeks) (adjusted RR 2.23 [95% CI 1.21-4.10]) were associated with longer sick leave. From a public health perspective, considering occupational category, comorbidity, symptoms at onset, and sick leave prior to the pandemic as potential predictors of sick leave in healthcare may help prevent staff shortage.


Subject(s)
COVID-19/epidemiology , Health Personnel/psychology , Sick Leave/statistics & numerical data , Adult , COVID-19/virology , Comorbidity , Depression/diagnosis , Dyspnea/diagnosis , Female , Humans , Male , Middle Aged , Pandemics , Risk , SARS-CoV-2/isolation & purification , Sweden/epidemiology
4.
Occup Environ Med ; 79(3): 176-183, 2022 03.
Article in English | MEDLINE | ID: covidwho-1379626

ABSTRACT

OBJECTIVE: To quantify occupational risks of COVID-19 among healthcare staff during the first wave (9 March 2020-31 July 2020) of the pandemic in England. METHODS: We used pseudonymised data on 902 813 individuals employed by 191 National Health Service trusts to explore demographic and occupational risk factors for sickness absence ascribed to COVID-19 (n=92 880). We estimated ORs by multivariable logistic regression. RESULTS: With adjustment for employing trust, demographic characteristics and previous frequency of sickness absence, risk relative to administrative/clerical occupations was highest in 'additional clinical services' (care assistants and other occupations directly supporting those in clinical roles) (OR 2.31 (2.25 to 2.37)), registered nursing and midwifery professionals (OR 2.28 (2.23 to 2.34)) and allied health professionals (OR 1.94 (1.88 to 2.01)) and intermediate in doctors and dentists (OR 1.55 (1.50 to 1.61)). Differences in risk were higher after the employing trust had started to care for documented patients with COVID-19, and were reduced, but not eliminated, following additional adjustment for exposure to infected patients or materials, assessed by a job-exposure matrix. For prolonged COVID-19 sickness absence (episodes lasting >14 days), the variation in risk by staff group was somewhat greater. CONCLUSIONS: After allowance for possible bias and confounding by non-occupational exposures, we estimated that relative risks for COVID-19 among most patient-facing occupations were between 1.5 and 2.5. The highest risks were in those working in additional clinical services, nursing and midwifery and in allied health professions. Better protective measures for these staff groups should be a priority. COVID-19 may meet criteria for compensation as an occupational disease in some healthcare occupations. TRIAL REGISTRATION NUMBER: ISRCTN36352994.


Subject(s)
COVID-19/epidemiology , Health Occupations/statistics & numerical data , Health Personnel , Occupational Exposure/statistics & numerical data , Sick Leave/statistics & numerical data , Adult , England/epidemiology , Female , Humans , Male , Middle Aged , Risk Factors , SARS-CoV-2 , State Medicine
5.
Proc Natl Acad Sci U S A ; 118(29)2021 07 20.
Article in English | MEDLINE | ID: covidwho-1306503

ABSTRACT

We study US sick leave use and unaddressed sick leave needs in the midst of the global severe acute respiratory syndrome coronavirus type 2 (SARS COV 2) pandemic based on a representative survey. More than half of all US employees are unaware of the new emergency sick leave options provided by the federal Families First Coronavirus Response Act (FFCRA). Awareness and take-up rates are significantly higher among Asian Americans and lower among the foreign-born. About 8 million employees used emergency sick leave in the first 6 to 8 mo. Nevertheless, the share of employees who needed but could not take paid sick leave tripled in the pandemic; unaddressed sick leave needs total 15 million employees per month and are 69% higher among women. Our findings show that access to paid sick leave significantly reduces unaddressed sick leave needs. We conclude that given the fragmented US sick leave landscape, to address the strong increase in unaddressed sick leave needs during the pandemic, federal FFCRA response was not adequate.


Subject(s)
COVID-19/psychology , Needs Assessment , Presenteeism/statistics & numerical data , Sick Leave/statistics & numerical data , Awareness , COVID-19/epidemiology , Emergency Medical Services/statistics & numerical data , Facilities and Services Utilization/statistics & numerical data , Humans , United States
6.
J Infect Dis ; 224(1): 14-20, 2021 07 02.
Article in English | MEDLINE | ID: covidwho-1294728

ABSTRACT

BACKGROUND: Whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity among asymptomatic subjects reflects past or future disease may be difficult to ascertain. METHODS: We tested 9449 employees at Karolinska University Hospital, Stockholm, Sweden for SARS-CoV-2 RNA and antibodies, linked the results to sick leave records, and determined associations with past or future sick leave using multinomial logistic regression. RESULTS: Subjects with high amounts of SARS-CoV-2 virus, indicated by polymerase chain reaction (PCR) cycle threshold (Ct) value, had the highest risk for sick leave in the 2 weeks after testing (odds ratio [OR], 11.97; 95% confidence interval [CI], 6.29-22.80) whereas subjects with low amounts of virus had the highest risk for sick leave in the 3 weeks before testing (OR, 6.31; 95% CI, 4.38-9.08). Only 2.5% of employees were SARS-CoV-2 positive while 10.5% were positive by serology and 1.2% were positive in both tests. Serology-positive subjects were not at excess risk for future sick leave (OR, 1.06; 95% CI, .71-1.57). CONCLUSIONS: High amounts of SARS-CoV-2 virus, as determined using PCR Ct values, was associated with development of sickness in the next few weeks. Results support the concept that PCR Ct may be informative when testing for SARS-CoV-2. Clinical Trials Registration. NCT04411576.


Subject(s)
Asymptomatic Diseases , COVID-19/epidemiology , COVID-19/virology , Health Personnel , SARS-CoV-2 , Adult , Aged , Antibodies, Viral , COVID-19/diagnosis , Disease Progression , Female , Hospitals, University , Humans , Male , Mass Screening , Middle Aged , Polymerase Chain Reaction , RNA, Viral , SARS-CoV-2/genetics , Serologic Tests , Sick Leave/statistics & numerical data , Sweden/epidemiology , Young Adult
7.
Public Health ; 195: 142-144, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1263359

ABSTRACT

OBJECTIVES: This study examined the prevalence and factors associated with paid sick leave benefits among direct service providers who work with people experiencing homelessness. STUDY DESIGN: Cross-sectional study using an online survey disseminated during the second wave of the COVID-19 pandemic in Canada. METHODS: Survey data from 572 direct service providers working in the homeless, supportive housing, and harm reduction service sectors were analyzed for this study. Univariate and multivariate logistic regression models were used to examine predictors of paid sick leave benefits. RESULTS: One hundred one (17.7%) participants did not have any paid sick leave benefits. In the univariate models, paid sick leave was associated with older age, greater family income, full-time work, specific employment settings (supportive housing and not emergency shelters or harm reduction programs), having a regular medical doctor, and fewer occupational impacts of the COVID-19 pandemic. Older age, full-time work, and non-receipt of emergency financial benefits remained statistically significant predictors in the multivariate model. CONCLUSIONS: Although the majority of service providers working with people experiencing homelessness have some amount of paid sick leave benefits, there is a precariously employed subset of individuals who are younger and working part-time in the sector. Temporary expansion of paid sick leave and removal of waiting periods for new employees to qualify for benefits are recommended.


Subject(s)
COVID-19 , Emergency Service, Hospital/statistics & numerical data , Employment/statistics & numerical data , Homeless Persons , Pandemics , Sick Leave/statistics & numerical data , Adult , Age Factors , Aged , COVID-19/epidemiology , Canada , Cross-Sectional Studies , Female , Harm Reduction , Humans , Male , Middle Aged , Prevalence , SARS-CoV-2 , Salaries and Fringe Benefits , Sick Leave/economics
8.
Respiration ; 100(8): 786-793, 2021.
Article in English | MEDLINE | ID: covidwho-1238620

ABSTRACT

BACKGROUND: The COVID-19 pandemic has led to shortage of intensive care unit (ICU) capacity. We developed a triage strategy including noninvasive respiratory support and admission to the intermediate care unit (IMCU). ICU admission was restricted to patients requiring invasive ventilation. OBJECTIVES: The aim of this study is to describe the characteristics and outcomes of patients admitted to the IMCU. METHOD: Retrospective cohort including consecutive patients admitted between March 28 and April 27, 2020. The primary outcome was the proportion of patients with severe hypoxemic respiratory failure avoiding ICU admission. Secondary outcomes included the rate of emergency intubation, 28-day mortality, and predictors of ICU admission. RESULTS: One hundred fifty-seven patients with COVID-19-associated pneumonia were admitted to the IMCU. Among the 85 patients admitted for worsening respiratory failure, 52/85 (61%) avoided ICU admission. In multivariate analysis, PaO2/FiO2 (OR 0.98; 95% CI: 0.96-0.99) and BMI (OR 0.88; 95% CI: 0.78-0.98) were significantly associated with ICU admission. No death or emergency intubation occurred in the IMCU. CONCLUSIONS: IMCU admission including standardized triage criteria, self-proning, and noninvasive respiratory support prevents ICU admission for a large proportion of patients with COVID-19 hypoxemic respiratory failure. In the context of the COVID-19 pandemic, IMCUs may play an important role in preserving ICU capacity by avoiding ICU admission for patients with worsening respiratory failure and allowing early discharge of ICU patients.


Subject(s)
COVID-19/therapy , Noninvasive Ventilation , Respiratory Care Units/statistics & numerical data , Respiratory Insufficiency/therapy , Aged , COVID-19/complications , COVID-19/mortality , Female , Health Personnel/statistics & numerical data , Humans , Male , Middle Aged , Respiratory Insufficiency/virology , Retrospective Studies , Sick Leave/statistics & numerical data , Switzerland/epidemiology
9.
J Med Virol ; 93(7): 4420-4429, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1209630

ABSTRACT

There are concerns regarding the side effects of the new coronavirus disease 2019 (COVID-19) mRNA-1273 vaccine among healthcare workers (HCWs) in the United States. The objective of the study was to investigate the side effects of the mRNA-1273 vaccine with detailed review of organ systems. A randomized, cross-sectional study using an independent online survey questionnaire was conducted to collect responses from HCWs. Of all participants, 87.8% (1116/1271) provided complete responses. Of them, 38.7% (432/1116) received the mRNA-1273 vaccine, among which, 89.35% were females; 425 of these 432 mRNA-1273 vaccine recipients (98.34%) reported at least one or more symptoms. The results were classified based on the frequency of symptoms reported postvaccination. Of these, 254/432 (58.8%) were able to continue their daily routine activities. 108/432 (25%) temporarily had trouble to perform daily activities, 120/432 (27.78%) required transient time off from work, 17/432 (3.94%) required help from an outpatient provider, 1/432 (0.23%) required help from emergency department, and none of them were hospitalized. Despite the wide array of self-reported symptoms, 97.02% of the HCWs did not intend to skip the second dose of vaccine. Among all the symptoms reported, localized pain, generalized weakness, headache, myalgia, chills, fever, nausea, joint pains, sweating, localized swelling at the injection site, dizziness, itching, rash, decreased appetite, muscle spasm, decreased sleep quality, and brain fogging were the most commonly reported symptoms (in descending order of occurrence). Most of the symptoms reported were nonlife threatening. Despite the wide array of self-reported symptoms, there appears to be a higher acceptance for this vaccine.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Health Personnel/psychology , Injection Site Reaction/pathology , Activities of Daily Living , Adult , Aged , Anaphylaxis/pathology , COVID-19/immunology , COVID-19 Vaccines/immunology , Cross-Sectional Studies , Female , Fever , Humans , Male , Middle Aged , SARS-CoV-2/immunology , Self Report , Sick Leave/statistics & numerical data , Surveys and Questionnaires , Young Adult
10.
BJS Open ; 5(2)2021 03 05.
Article in English | MEDLINE | ID: covidwho-1127312

ABSTRACT

BACKGROUND: During the initial COVID-19 outbreak up to 28.4 million elective operations were cancelled worldwide, in part owing to concerns that it would be unsustainable to maintain elective surgery capacity because of COVID-19-related surgeon absence. Although many hospitals are now recovering, surgical teams need strategies to prepare for future outbreaks. This study aimed to develop a framework to predict elective surgery capacity during future COVID-19 outbreaks. METHODS: An international cross-sectional study determined real-world COVID-19-related absence rates among surgeons. COVID-19-related absences included sickness, self-isolation, shielding, and caring for family. To estimate elective surgical capacity during future outbreaks, an expert elicitation study was undertaken with senior surgeons to determine the minimum surgical staff required to provide surgical services while maintaining a range of elective surgery volumes (0, 25, 50 or 75 per cent). RESULTS: Based on data from 364 hospitals across 65 countries, the COVID-19-related absence rate during the initial 6 weeks of the outbreak ranged from 20.5 to 24.7 per cent (mean average fortnightly). In weeks 7-12, this decreased to 9.2-13.8 per cent. At all times during the COVID-19 outbreak there was predicted to be sufficient surgical staff available to maintain at least 75 per cent of regular elective surgical volume. Overall, there was predicted capacity for surgeon redeployment to support the wider hospital response to COVID-19. CONCLUSION: This framework will inform elective surgical service planning during future COVID-19 outbreaks. In most settings, surgeon absence is unlikely to be the factor limiting elective surgery capacity.


Subject(s)
COVID-19 , Elective Surgical Procedures/statistics & numerical data , Family Leave/statistics & numerical data , Health Workforce , Quarantine/statistics & numerical data , Sick Leave/statistics & numerical data , Surgeons/supply & distribution , Surgery Department, Hospital , Cross-Sectional Studies , Humans , Internationality , SARS-CoV-2
11.
Sci Rep ; 11(1): 5160, 2021 03 04.
Article in English | MEDLINE | ID: covidwho-1117661

ABSTRACT

The extent that antibodies to SARS-CoV-2 may protect against future virus-associated disease is unknown. We invited all employees (n = 15,300) at work at the Karolinska University Hospital, Stockholm, Sweden to participate in a study examining SARS-Cov-2 antibodies in relation to registered sick leave. For consenting 12,928 healthy hospital employees antibodies to SARS-CoV-2 could be determined and compared to participant sick leave records. Subjects with viral serum antibodies were not at excess risk for future sick leave (adjusted odds ratio (OR) controlling for age and sex: 0.85 [95% confidence interval (CI) (0.85 (0.43-1.68)]. By contrast, subjects with antibodies had an excess risk for sick leave in the weeks prior to testing [adjusted OR in multivariate analysis: 3.34 (2.98-3.74)]. Thus, presence of viral antibodies marks past disease and protection against excess risk of future disease. Knowledge of whether exposed subjects have had disease in the past or are at risk for future disease is essential for planning of control measures.Trial registration: First registered on 02/06/20, ClinicalTrials.gov NCT04411576.


Subject(s)
Antibodies, Viral/blood , COVID-19/immunology , SARS-CoV-2/immunology , Sick Leave/statistics & numerical data , Adult , Antibodies, Viral/immunology , COVID-19/epidemiology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Sweden/epidemiology
12.
J Infect Dis ; 224(1): 14-20, 2021 07 02.
Article in English | MEDLINE | ID: covidwho-1081341

ABSTRACT

BACKGROUND: Whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity among asymptomatic subjects reflects past or future disease may be difficult to ascertain. METHODS: We tested 9449 employees at Karolinska University Hospital, Stockholm, Sweden for SARS-CoV-2 RNA and antibodies, linked the results to sick leave records, and determined associations with past or future sick leave using multinomial logistic regression. RESULTS: Subjects with high amounts of SARS-CoV-2 virus, indicated by polymerase chain reaction (PCR) cycle threshold (Ct) value, had the highest risk for sick leave in the 2 weeks after testing (odds ratio [OR], 11.97; 95% confidence interval [CI], 6.29-22.80) whereas subjects with low amounts of virus had the highest risk for sick leave in the 3 weeks before testing (OR, 6.31; 95% CI, 4.38-9.08). Only 2.5% of employees were SARS-CoV-2 positive while 10.5% were positive by serology and 1.2% were positive in both tests. Serology-positive subjects were not at excess risk for future sick leave (OR, 1.06; 95% CI, .71-1.57). CONCLUSIONS: High amounts of SARS-CoV-2 virus, as determined using PCR Ct values, was associated with development of sickness in the next few weeks. Results support the concept that PCR Ct may be informative when testing for SARS-CoV-2. Clinical Trials Registration. NCT04411576.


Subject(s)
Asymptomatic Diseases , COVID-19/epidemiology , COVID-19/virology , Health Personnel , SARS-CoV-2 , Adult , Aged , Antibodies, Viral , COVID-19/diagnosis , Disease Progression , Female , Hospitals, University , Humans , Male , Mass Screening , Middle Aged , Polymerase Chain Reaction , RNA, Viral , SARS-CoV-2/genetics , Serologic Tests , Sick Leave/statistics & numerical data , Sweden/epidemiology , Young Adult
13.
Infect Dis Health ; 26(1): 3-10, 2021 02.
Article in English | MEDLINE | ID: covidwho-1065108

ABSTRACT

BACKGROUND: Doctors commonly continue to work when they are unwell. This norm is increasingly problematic during the COVID-19 (SARS-CoV-2) pandemic when effective infection control measures are of paramount importance. This study investigates the barriers existing before COVID-19 that prevent junior doctors with an acute respiratory illness working in Canberra, Australia, from taking sick leave, and offers suggestions about how to make sick leave more accessible for junior doctors. METHODS: Anonymous online survey study. RESULTS: 192 junior doctors were invited to participate in the study. Fifty-four responded, and only those who had worked whilst unwell with an acute respiratory illness were included, providing a total number of fifty responses. Of these, 72% believed they were infectious at the time they worked whilst unwell. 86% of respondents did not feel supported by the workplace to take sick leave when they were unwell, and 96% identified concerns about burdening colleagues with extra workload and lack of available cover as the main deterrents to accessing sick leave. CONCLUSION: Junior doctors at our health service, pre-COVID-19, do not widely feel empowered to take sick leave when they have an acute respiratory illness. Junior doctors are primarily concerned about burdening their colleagues with extra workloads in an environment where they perceive there to be a lack of available cover. Having more available cover, leadership from seniors, and clearer guidelines around the impact of sick leave on registration may contribute to a culture where junior doctors feel supported to access sick leave.


Subject(s)
Attitude of Health Personnel , Medical Staff, Hospital/statistics & numerical data , Physicians/statistics & numerical data , Sick Leave/statistics & numerical data , Workload/psychology , Australia , COVID-19 , Humans , Infection Control , Respiratory Tract Infections/physiopathology , Surveys and Questionnaires , Workload/standards , Workload/statistics & numerical data
14.
J Grad Med Educ ; 12(6): 682-685, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-1005985

ABSTRACT

BACKGROUND: Montefiore Medical Center (MMC) is a large tertiary care center in the Bronx, New York City, with 245 internal medicine residents. Beginning on February 29, 2020, residents became ill with COVID-19-like illness (CLI), which required absence from work. There was initially a shortage of personal protective equipment and delays in SARS-CoV-2 testing, which gradually improved during March and April 2020. OBJECTIVE: We evaluated the relationship between CLI-related work absence rates of internal medicine residents and MMC's COVID-19 hospital census over time. METHODS: Data on resident work absence between February 29 and May 22 were reviewed along with MMC's COVID-19 hospital census data. To determine the effect of patient exposure on resident CLI incidence, we compared the mean incidence of CLI per patient exposure days (PED = daily hospital census × days pre- or post-peak) before and after peak COVID-19 hospital census. RESULTS: Forty-two percent (103 of 245) of internal medicine residents were absent from work, resulting in 875 missed workdays. At the peak of resident work absence, 16% (38 of 245) were out sick. Residents were absent for a median of 7 days (IQR 6-9.5 days). Mean resident CLI incidence per PED (CLI/PED) was 13.9-fold lower post-peak compared to pre-peak (P = .003). CONCLUSIONS: At the beginning of the COVID-19 pandemic in New York City, a large portion of internal medicine residents at this single center became ill. However, the incidence of CLI decreased over time, despite ongoing exposure to patients with COVID-19.


Subject(s)
COVID-19/epidemiology , Internship and Residency/statistics & numerical data , Sick Leave/statistics & numerical data , Academic Medical Centers , COVID-19/transmission , COVID-19 Testing , Humans , Infectious Disease Transmission, Patient-to-Professional , Internal Medicine , Internship and Residency/methods , New York City/epidemiology , Occupational Exposure , Personnel Staffing and Scheduling , Retrospective Studies , SARS-CoV-2
15.
Int Marit Health ; 71(4): 217-228, 2020.
Article in English | MEDLINE | ID: covidwho-1005802

ABSTRACT

BACKGROUND: The well-being of the world's 1.65 million seafarers is expected to be secured by the rights established under the Maritime Labour Convention (MLC), 2006 with active monitoring of its implementation by the flag administrations through the International Maritime Organisation (IMO) and International Labour Organisation (ILO). However, the substantial gains achieved since entry into force of MLC in August 2013 appear to have been severely dented by the COVID-19 global pandemic. The aim of the study was to examine, on a pilot basis, the disruptions and challenges to the observance of seafarers' rights to shore leave, repatriation and medical assistance as an immediate consequence of COVID-19. MATERIALS AND METHODS: The impact of COVID-19 on seafarers' rights was examined in three dimensions - shore leave, repatriation and medical assistance. Questionnaires were administered online from June to August 2020 to 450 seafarers, top 10 ship-management companies, 35 shipping companies and maritime administrations of top 5 seafarer supplying countries. The paper discusses the results of the survey. RESULTS: The research revealed a previously unknown majority preference for shore leave, that diminished sharply during COVID-19. Impact on work-performance and well-being of seafarers was revealed with only a fifth of the seafarers having willingly agreed to an extension of contract. This study revealed incidence rates at 6 months into the pandemic of several parameters - delayed repatriations (21.44%) that includes crew with contract extensions (12.48%), crew with completed contract awaiting repatriation (8.96%) and crew that had exceeded 12-month continuous service (0.82%). Compensation, if provided, is meagre and was affecting ratings the most. Deprivation of medical assistance was also revealed. CONCLUSIONS: The well being of seafarers would likely remain vulnerable to breaches, unless measures are put in place to safeguard the rights assured under MLC in the face of uncertainties caused by a pandemic such as COVID-19.


Subject(s)
COVID-19/epidemiology , Health Services Accessibility/statistics & numerical data , Occupational Health/statistics & numerical data , Ships , Sick Leave/statistics & numerical data , Workload/statistics & numerical data , Humans , Pilot Projects , Workplace/organization & administration
16.
Am J Ind Med ; 64(2): 73-77, 2021 02.
Article in English | MEDLINE | ID: covidwho-985921

ABSTRACT

Globally, migrant and immigrant workers have borne the brunt of the COVID-19 pandemic as essential workers. They might be a Bulgarian worker at a meat processing plant in Germany, a Central American farmworker in the fields of California, or a Filipino worker at an aged-care facility in Australia. What they have in common is they are all essential workers who have worked throughout the coronavirus pandemic and have been infected with coronavirus at work. COVID-19 has highlighted the inequitable working conditions of these workers. In many instances, they are employed precariously, and so are ineligible for sick leave or social security, or COVID-19 special payments. If these are essential workers, they should get at least the same health and safety benefits of all nonessential workers. Improving the working and living conditions of migrant workers can and should be a positive outcome of the coronavirus pandemic.


Subject(s)
COVID-19/epidemiology , Occupational Diseases/epidemiology , Transients and Migrants/statistics & numerical data , COVID-19/transmission , Cross-Sectional Studies , Global Health/statistics & numerical data , Health Workforce/statistics & numerical data , Humans , Insurance Benefits/statistics & numerical data , Occupational Health/statistics & numerical data , Occupational Health Services/supply & distribution , Risk Factors , Sick Leave/statistics & numerical data , Social Security/statistics & numerical data , Social Values , Socioeconomic Factors
18.
Health Aff (Millwood) ; 39(12): 2197-2204, 2020 12.
Article in English | MEDLINE | ID: covidwho-874210

ABSTRACT

This analysis examines whether the coronavirus disease 2019 (COVID-19) emergency sick leave provision of the bipartisan Families First Coronavirus Response Act (FFCRA) reduced the spread of the virus. Using a difference-in-differences strategy, we compared changes in newly reported COVID-19 cases in states where workers gained the right to take paid sick leave (treatment group) versus in states where workers already had access to paid sick leave (control group) before the FFCRA. We adjusted for differences in testing, day-of-the-week reporting, structural state differences, general virus dynamics, and policies such as stay-at-home orders. Compared with the control group and relative to the pre-FFCRA period, states that gained access to paid sick leave through the FFCRA saw around 400 fewer confirmed cases per state per day. This estimate translates into roughly one prevented case per day per 1,300 workers who had newly gained the option to take up to two weeks of paid sick leave.


Subject(s)
COVID-19/prevention & control , Emergencies , Sick Leave/statistics & numerical data , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19 Testing/methods , COVID-19 Testing/statistics & numerical data , Emergencies/epidemiology , Humans , Least-Squares Analysis , Propensity Score , Sick Leave/legislation & jurisprudence , State Government , United States/epidemiology
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