A Mixed-Methods Study of Risk Factors and Experiences of Health Care Workers Tested for the Novel Coronavirus in Canada

Objective: The aims of this study were to investigate occupational arid non- work-related risk factors of coronavirus disease 2019 among health care workers (HCWs) in Vancouver Coastal Health, British Columbia, Canada, and to examine how HCWs described their experiences. Methods: This was a matched case-control study using data from online and phone questionnaires with optional open-ended questions completed by HCWs who sought severe acute respiratory syndrome coronavirus 2 testing between March 2020 and March 2021. Conditional logistic regression and thematic analysis were utilized. Results: Providing direct cam to coronavirus disease 2019 patients during the intermediate cohort period (adjusted odds ratio, 1.90;95% confidence interval, 1.04 to 3.46) and community exposure to a known case in the late cohort period (adjusted odds ratio, 3.595%;confidence interval, 1.86 to 6.83) were associated with higher infection odds. Suboptimal communication, mental stress, and situations perceived as unsafe were common sources of dissatisfaction. Conclusions: Varying levels of risk between occupational groups call for wider targeting of infection prevention measures. Strategies for mitigating community exposure and supporting HCW resilience are required.

A scoping review to identify the type and effect of hand hygiene interventions on the reduction of infectious diseases (including COVID-19) in preschool children

Background. Proper handwashing can reduce the burden of diseases related to hand hygiene (HH) and so contribute reducing under-5 mortality. Preschoolers can benefit from HH interventions by the burden of disease and absenteeism being reduced. Objective. To perform a scoping review of literature to assess the types and effectiveness of HH interventions at preschools, with a view to providing a guideline for appropriate interventions for South African facilities. Methods. A literature search was conducted through the PubMed database to identify relevant studies. An iterative screening process to focus the review allowed for information on the type and effectiveness of interventions to be collated. An updated PubMed search was conducted to determine whether any interventions related to COVID-19 at preschools could be included. Results. No additional studies relating to COVID-19 were found. Of the 305 studies identified during the initial search, only 12 fitted the specific search criteria. Of these, 10 studies showed improvements in HH-related indicators following the interventions. Only two studies used health education as an intervention, whereas the others included the supply of HH products (to varying extents) as part of the intervention. Conclusion. HH interventions appear successful in reducing diseases spread by poor HH, improving general HH practices and reducing absenteeism among preschoolers. Studies using innovative, entertaining methods of educating children have shown to be successful in improving handwashing techniques and decreasing microbial growth on children’s hands. HH interventions are suggested as an effective measure to improve HH during the COVID-19 pandemic.

Occupational health information systems for health workers during the COVID-19 pandemic in South Africa

Introduction: Reliable health information systems (HIS) are crucial for sound decision-making for occupational health services (OHS). Strengthening OHS is essential for a healthy and safe healthcare workforce during the COVID-19 pandemic. This study aimed to assess the presence and utilization of OHS HIS in South African hospitals during the COVID-19 pandemic. Methods: A cross-sectional survey was utilized to assess OHS HIS use to inform the COVID-19 outbreak response to protect health workers (HWs) in four hospitals. A validated online questionnaire was administered among purposively selected hospital managers, trade unions and OHS teams. Data were then transferred to Stata for analysis. Results: Seventy-three HWs, representing a combined workforce of 14,743 HWs, participated. Fifty-five percent were female and 65% had an undergraduate qualification. OHS HIS reports were deemed poorly organized by 64%;31% indicated poor data collection;37% noted poor data storage, and ≥ 33% were unhappy or frustrated with the use of HIS for OHS planning. Over 67% felt OHS HIS needed reforms;≤ 14% reported access to IT developers, and 52% access to IT infrastructure. Only 33% knew the minimum set of OHS indicators, and 51% reported that there was demand for OHS information. None of the hospitals were utilizing electronic OHS HIS including for COVID-19. Conclusions: Overall there is poor knowledge and utilization of OHS HIS, despite the availability of an electronic system in two of the hospitals. It is essential, that all the hospitals are provided with access to OHS HIS, and training and awareness conducted to improve OHS management.

A mixed methods study of risk factors and lived experiences of health care workers tested for the novel coronavirus in Canada

Introduction: Health care workers (HCWs) worldwide have borne a disproportionate burden of infection from SARS-COV-2-19, but this varies markedly by jurisdiction: HCWs in the Vancouver Coastal Health (VCH) region of British Columbia, Canada have infection rates paralleling those of the background population. We assessed the association of risk factors among HCWs in this region, and examined how HCWs frame their experience. Methods: We conducted a matched case control study with an integrated qualitative component using questionnaire data from HCWs who sought testing at a VCH site between March 2020 and March 2021. Results: Quantitative data from 1340 HCWs were included. Free text responses for qualitative analysis were received from 316 HCWs. Community exposure to a known COVID-19 patient was associated with COVID-19 infection (adjusted odds ratio (aOR) 2.45;95% CI 1.67-3.59). Compared to medical staff, care aides and licensed practical nurses had a considerably higher infection risk (aOR 2.92;95% CI 1.49-5.70). Direct care for COVID-19 patients, however, was not associated with infection (aOR 1.05;95% CI 0.76–1.45). Framing of HCWs’ experiences broadly reflected the phase of the pandemic during which they were tested. Communication challenges and being in situations perceived as unsafe in and out of work were cited as sources of dissatisfaction. Conclusions: Community exposures were more important determinants of infection than workplace exposures in our study area. Availability of protective equipment, and clear communication are important for enhancing a sense of safety among HCWs during this unprecedented pandemic.

A comparative empirical analysis of low-cost decontamination methods for filtering facepiece respirators to address stock shortages during the COVID-19 Pandemic

Introduction: Filtering facepiece respirators (FFRs) reuse practices to address shortages during the COVID-19 pandemic received attention;however, evidence of SARS-CoV-2 inactivation on respirators is limited. Quality FFRs for use during outbreaks remains a priority to protect frontline and essential workers. This study aimed to compare the effectiveness of three relatively inexpensive methods to inactivate SARS-CoV-2 and ensuring respirator performance. Methods: Seven FFRs inoculated with SARS-CoV-2 were decontaminated with moist heat incubation (MHI), vapourised hydrogen peroxide (VHP), and ultraviolet germicidal irradiation (UVGI). G.stearothermophilus bioindicator was used as a control. FFR integrity, efficiency and user fit were assessed on 27 participants for 30 decontamination cycles. Ethical clearance was acquired from the University of the Witwatersrand (M200684). Results: Most participants failed fit testing for KN95 irrespective of method used except for two individuals. Participants completed more cycles after UVGI compared to VHP decontamination. Only KN95 failed filtration post-MHI, VHP and UVGI treatment. A ≥ 3 log reduction of SARS-CoV-2 was achieved using UVGI for worn FFRs (Greenline 5200 FFP2 and Makrite 9500 N95 using MHI;3M 8810SSA FFP2 using VHP;Greenline 5200 FFP2). UVGI and VHP methods achieved a 6 log reduction of G.stearothermophilus. Conclusion: Some FFRs could withstand 30 cycles of UVGI and VHP processing without diminishing filtration efficiency or fit. SARS-CoV-2 log reduction varied across the methods and FFRs models emphasing the importance of validation before reuse during a crisis.

A research program to provide a comparative contextualized analysis of occupational COVID-19 among health workers: Preliminary insights from a South African-Canadian collaboration

A research program to provide a comparative contextualized analysis of occupational COVID-19 among health workers: Preliminary insights from a South African-Canadian Collaboration. Objective The COVID-19 pandemic has demonstrated that healthcare workers (HCWs) in many settings are at high risk of occupational exposure to infectious diseases, especially where attention to occupational protection was lacking. In July 2020 our World Health Organization (WHO) collaborating centres in Canada and South Africa launched a joint Rapid Response Research program in partnership with local government health service delivery agencies in both countries to better understand how local contexts affect policies and practice;scrutinize their respective scientific and contextual rationales as well as outcome;grasp why and how these change over time;and understand organizational factors that enhance implementing resilient policies. Methods The collaboration includes cohort studies, in the Vancouver Coastal Health (VCH) region in Canada, and Gauteng province in South Africa respectively, to assess risk factors for SARS-CoV-2 infection among HCWs as well as evaluate the effectiveness of SARS-CoV-2 infection prevention and control measures. It also includes a cross-sectional study in Gauteng to explore mental health of HCWs during the pandemic and identify areas for intervention;a quasi-experimental study of the role of information systems in strengthening occupational health services for healthcare workers;and global policy analyses including an analysis of a global survey of HCWs from 161 countries. Results The global survey revealed considerable variations in the degree to which prevention and control measures were deemed adequate;the South African baseline audit of 42 hospitals also revealed considerable variations in implementing occupational health protection. We demonstrated the utility of information systems to assess risk by occupation and setting in VCH;preliminary results of the VCH case-control study demonstrated the feasibility of this design;and, importantly, we identified challenges in leveraging operational research to inform policy, practice and world-knowledge in both VCH and South Africa. Conclusion Our research activities showed the impact of vaccine roll-out and new variants on rates of COVID-19 among HCWs within different healthcare settings and occupational groups and how policies to protect HCWs have evolved (e.g., masking policies and vaccine protocols for HCWs). We conclude that lessons regarding procedural barriers to data acquisition and sharing must be addressed with an ethical framework in mind.

Dimensionality Reduction of Social Media Application Attributes for Ubiquitous Learning Using Principal Component Analysis

Ubiquitous learning is anywhere and anytime learning using e-learning and m-learning platforms. Learning takes place regularly on mobile devices. School-based instructors and learners have capitalised on ubiquitous learning platforms in unprecedented times such as COVID-19. There has been a proliferation of social media applications for ubiquitous learning. There are a vast number of attributes of the social media applications that must be considered for it to be deemed suitable for education. Further to this, mobile and desktop accessibility criteria must be considered. The aim of this research study was to determine the high impacting and most pertinent criteria to evaluate social media applications for school-based ubiquitous learning. Data was collected from 30 experts in the field of teaching and learning who were asked to evaluate 60 criteria. Principal Component Analysis (PCA) was the method employed for the dimensionality reduction. PCA was implemented using singular value decomposition (SVD) on R-Studio. The results showed loading values from principal component one for the top 40 educational requirements and technology criteria of the 60 criteria used in the study. The implications of this research study will guide researchers in the field of Educational Data Mining (EDM) and practitioners on the most important dimensions to consider when evaluating social media applications for ubiquitous learning. © 2021 Caitlin Sam et al.