Rates and Risk Factors Associated with COVID-19 Infection Among Myanmar Ethnic Minority Doctors in UK NHS (preprint)

ABSTRACT

Background: There is dearth of information on personal and work-related risk factors associated with COVID-19 infection among ethnic healthcare workers in UK NHS.Methods: A questionnaire survey was conducted among Myanmar Ethnic Minority Doctors immediately after the peak of pandemic in UK during June 2020. We aimed to explore real world personal work experience of doctors working in the NHS during the rising phase of the first wave of the pandemic and to provide better understanding and deeper insight into the impact of COVID-19 with regard to susceptibility and risk of poor outcome among doctors.Findings: Of 670 potentially eligible participants from Myanmar ethnic background, a total of 512 responses were received. Majority are training grade doctors and majority of respondents work in acute hospital setting; 42.3% and 46.2% in COVID-ward areas and non-COVID ward areas, respectively. Probable infection rate was extremely high among respondents (N=221 (43.2%)) and 66 (12.9%) had a positive test. The majority, ~70%, who were symptomatic believed they got infection from working in a hospital environment. In multivariate models, controlling for age, sex, body mass index, smoking, hypertension, diabetes mellitus, usage of ACE inhibitors/Angiotensin Receptor Blockers, and vitamin C & D containing supplements, only ‘working in COVID-19 ward area in acute setting’ was significantly less likely to be associated with our primary outcome of being tested positive for COVID-19 (adjusted OR (95% confidence interval) 0.49 (0.28, 0.86; p= 0.014). For ‘probable COVID-19 infection’, being older (aOR 0.97 (0.95, 0.99); p=0.002), using vitamin D containing vitamins (aOR 0.59 (0.36, 0.98); p=0.043) and working in COVID-ward area in acute setting (aOR 0.47 (0.31, 0.70); p<0.001) were less likely to be associated with COVID-symptoms while current smoking (aOR 8.63 (2.52,29.60); p=0.001) and use of ACEI/ARB (aOR 9.54 (1.63, 55.93); p=0.012) were associated with COVID-19 symptoms. Among those with symptoms, the majority were stressed or very stressed with COVID symptoms, but a substantial proportion of those without COVID symptoms also reported being stressed or very stressed.Interpretation: Given that COVID-19 testing is not instituted routinely to healthcare staff over the period of survey covering December 2019 to June 2020, the results are likely to be underestimation of the real impact. The high infection rates are most likely related to initial lack of adequate PPEs in so called non-COVID clinical areas and lack of policy on widespread testing of all hospital admissions (especially in older people) for COVID-19. We highlight the need for support to NHS workforce for potential consequences of physical and mental health due to COVID-19.Funding Self-funded.Funding Statement This project is self-funded.Declaration of Interests None to declareEthics Approval Statement The study gained ethical approval from College Ethics Review Board, University of Aberdeen (CERB/2020/5/1955).