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Epidemiology, clinical characteristics, household transmission, and lethality of severe acute respiratory syndrome coronavirus-2 infection among healthcare workers in Ontario, Canada.
Schwartz, Kevin L; Achonu, Camille; Buchan, Sarah A; Brown, Kevin A; Lee, Brenda; Whelan, Michael; Wu, Julie Hc; Garber, Gary.
  • Schwartz KL; Public Health Ontario, Toronto, Ontario, Canada.
  • Achonu C; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
  • Buchan SA; Unity Health Toronto, Toronto, Ontario, Canada.
  • Brown KA; Public Health Ontario, Toronto, Ontario, Canada.
  • Lee B; Public Health Ontario, Toronto, Ontario, Canada.
  • Whelan M; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
  • Wu JH; Public Health Ontario, Toronto, Ontario, Canada.
  • Garber G; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
PLoS One ; 15(12): e0244477, 2020.
Article in English | MEDLINE | ID: covidwho-999843
ABSTRACT

INTRODUCTION:

Protecting healthcare workers (HCWs) from Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a priority to maintain a safe and functioning healthcare system. Our objective was to describe and compare the epidemiology, clinical characteristics, and lethality of SARS-CoV-2 infections among HCWs compared to non-HCWs.

METHODS:

Using reportable disease data at Public Health Ontario, we conducted a population-based cross-sectional study comparing demographic, exposure, and clinical variables between HCWs and non-HCWs with SARS-CoV-2 infections as of 30 September 2020. We calculated rates of infections over time and determined the frequency of within household transmissions using natural language processing based on residential address. We evaluated the risk of death using a multivariable logistic regression model adjusting for age, sex, comorbidities, symptoms, and long-term care home exposure.

RESULTS:

There were 7,050 (12.5%) HCW SARS-CoV-2 infections in Ontario, Canada, of whom 24.9% were nurses, 2.3% were physicians, and the remaining 72.8% other specialties, including personal support workers. Overall HCWs had an infection rate of 1,276 per 100,000 compared to non-HCWs of 346 per 100,000 (3.7 times higher). This difference decreased from a 7 times higher rate in April to no difference in September 2020. Twenty-six percent of HCWs had a household member with SARS-CoV-2 infection; 6.8% were probable acquisitions, 12.3% secondary transmissions, and 6.9% unknown direction of transmission. Death among HCWs was 0.2% compared to 6.1% of non-HCWs. The risk of death in HCWs remained significantly lower than non-HCWs after adjustment (adjusted odds ratio 0.09; 95%CI 0.05-0.17).

CONCLUSION:

HCWs represent a disproportionate number of diagnosed SARS-CoV-2 infections in Ontario, however this discrepancy is at least partially explained by limitations in testing earlier in the pandemic for non-HCWs. We observed a low risk of death in HCWs which could not be completely explained by other factors.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0244477

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pandemics / SARS-CoV-2 / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2020 Document Type: Article Affiliation country: Journal.pone.0244477