RESUMEN
Background At the beginning of the current COVID-19 pandemic, it became critical to isolate all infected patients, regardless of their age. Isolating children has a negative effect on both, them and their parents/caregivers. Nevertheless isolation was mandatory because of the potential risk that visitation might have on COVID-19 dissemination mostly among health personnel. Methods From the starting of the COVID-19 pandemic in our pediatric hospital visits were forbidden. This 2 months period (April–May) was called P1. In June parents were allowed to visit (P2), under a visiting protocol previously published. Hospital workers were monitored for the presence of COVID-19 symptoms and tested for the infection when clinically justified. The positivity proportion and the relative risk (RR) of COVID-19 among the health personnel between periods were calculated. The caregivers were also followed up by phone calls. Results Since April 2020 to November 2020, 2,884 health personnel were studied for 234 days, (318,146 workers days). Although the COVID-19/1,000 health personnel days rate decreased from one period to another (1.43 vs 1.23), no statistically significant differences were found. During P1, 16 patients with COVID-19 were treated. During the follow up none of the family members were infected/symptomatic in P1, while in P2, 6/129 (4.65%) were symptomatic or had a positive test. All of them initiated between 2 and 4 days after the patient's admission. As they also had some other infected family members it was not possible to ensure the source of infection. There were no statistically significant differences in the RR of COVID-19 in health personnel, (RR 1, 95% CI 0.69–1.06, p = 0.162). Conclusions When safely implemented, allowing parents/caregivers to spend time with their hospitalized COVID-19 children does not increase the contagion risk for hospital workers or among themselves.
RESUMEN
Health personnel (HP) have been universally recognized as especially susceptible to COVID-19. In Mexico, our home country, HP has one of the highest death rates from the disease. From the beginning of the SARS-CoV-2 pandemic, an office for initial attention for HP and a call center were established at a COVID-19 national reference pediatric hospital, aimed at early detection of COVID-19 cases and stopping local transmission. The detection and call center implementation and operation, and tracing methodology are described here. A total of 1,042 HP were evaluated, with 221 positive cases identified (7.7% of all HP currently working and 26% of the HP tested). Community contagion was most prevalent (46%), followed by other HP (27%), household (14%), and hospitalized patients (13%). Clusters and contact network analysis are discussed. This is one of the first reports that address the details of the implementation process of contact tracing in a pediatric hospital from the perspective of a hybrid hospital with COVID-19 and non-COVID-19 areas.
RESUMEN
Background At the beginning of the current COVID-19 pandemic, it became critical to isolate all infected patients, regardless of their age. In the case of hospitalized children, isolation imposes a significant, negative impact on the well-being of isolated infants and their parents, in addition to the deleterious effect that the clinical condition and hospitalization by itself inflicts on patients and their families;this negative effect must be weighed against the potential risk that visitation might have on COVID-19 dissemination, mostly among hospital workers. Method Parents were gradually allowed during supervised, restricted visit time, progressively increasing the visitation time, and carefully monitoring for the presence of COVID-19 symptoms among healthcare workers (HCW) in the COVID-19 area, who were also tested for the infection when clinically justified. Family members were interrogated about symptoms and signs suggestive of COVID-19 infection, or positive PCR testing within 14 days of hospital stay. Results We found that, when safely implemented, allowing parents to spend time with their hospitalized COVID-19 children does not increase the contagion risk for hospital workers. The percentage of COVID-19 cases among HCW decreased after parents were allowed to visit their children in the COVID-19 areas. The percentage dropped from 27.78% to 12.77% (p=0.022). The rate of workers with COVID-19 for every 1000 shifts per worker was reduced after the parents were allowed to visit, although no statistically significant differences were found. Only 6 out of 129 parents (4.65%), that visited their children, were infected and there is no guarantee that they got infected within the hospital. Conclusion With proper training, parents do not increase the risk of infection among healthcare workers or among themselves. To develop and implement policies to permit the children to be accompanied during their suffering should be a standard in the context of an epidemic and out of it.