SARS-CoV-2 infection prevalence in healthcare workers, administrative and support staff: the first wave experience at three academic hospitals in the Tshwane District of Gauteng

ABSTRACT

Background: Healthcare workers (HCWs) have been identified as being at an increased risk for acquisition of SARS-CoV-2 infections, but there is a paucity of data pertaining to South African HCW related infection rates. Global and provincial disparities in these numbers necessitate local data in order to mitigate risks. We sought to ascertain the SARS-CoV-2 infection rates and outcomes among all hospital staff and further determined associations for the development of severe COVID-19 disease. Methods: This retrospective audit was conducted across three academic hospitals in the Tshwane District for the period from 1 June 2020 to 31 August 2020. De-identified data from Occupational Health and Safety Department (OHSD) was used to calculate infection rates. A more detailed analysis of 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), with medical doctors displaying the lowest incidence of 1.1 cases per 1 000 staff days. SARS-CoV-2 infections were either 'probable' community or healthcare facility acquired for 26.6% and 73.4% of the infections, respectively. Community acquisition was highest for the administrative group (41.8%) and lowest for doctors (6.1%). The mean age for mild and severe disease was 41 and 46.1 years, respectively (p = 0.004). The presence of comorbidities was significantly associated with the severity of the disease (p = 0.002). Conclusion: The period prevalence of 11.1% was comparable to similar international studies. This study highlights that hospitals staff, including the administrative staff, are clearly at a high risk of acquiring SARS-CoV-2 infections during a surge.