ABSTRACT
IntroductionContact tracing and subsequent quarantining of Health Care Workers (HCWs) is essential to minimize further transmission of COVID-19 infection. In this study, we have reported the yield of Contact Tracing of COVID-19 Patients and HCWs and risk stratification of exposed HCWs. MethodologyThis is a secondary analysis of routine data collected for contact tracing from 19th March to 31st August 2020 at All India Institute of Medical Sciences, Bhubaneswar, Odisha, India. HCWs exposed to COVID-19 infections were categorized as per the risk stratification guidelines and the high-risk contacts were quarantined for 14 days and tested on 7th day from last day of exposure. The low risk contacts were encouraged to closely monitor their symptoms while continuing to work. ResultsOut of 3411 HCWs exposed to COVID 19 patients (n=269) and HCWs (n=91), 890 (26.1%) were high risk contacts and 2521 (73.9%) were low risk contacts. The test positivity rate of high-risk contact was 3.82% and for low risk contact was 1.90%. Average number of high-risk contacts was significantly higher; for admitted patients (6.6) as compared to HCWs (4.0) and outpatients (0.2), p value = 0.009; for patients admitted in non-COVID areas (15.8) as compared to COVID areas (0.27), p value < 0.001; and when clustering of cases was present (14.3) as compared to isolated cases (8.2); p value < 0.001. Trend analysis (15 days block period) showed a significant decline in number of mean numbers of high-risk contacts during the study period. ConclusionContact tracing and risk stratification was effective and helped in reducing the number of HCWs going for quarantine. There was also a decline in high-risk contacts during study period suggesting role of implementation of hospital based COVID related infection control strategies. This contact tracing and risk stratification approach designed in the current study can also be implemented in other healthcare settings.
ABSTRACT
IntroductionThe COVID-19 pandemic continuing to be a significant public health concern across the whole world, including India. In the absence of any specific treatment or vaccine against COVID-19., the role of efficient testing and reporting has been uncontested so far as the number of cases is rising daily. In order to strengthen the screening activities and to prevent nosocomial infection, facility-based screening centres have been designed and operated at various level of healthcare, including tertiary care institutions. MethodsThe present study has been planned with an objective to understand the patient profile and evaluate the functioning of COVID-19 screening OPD(CS-OPD) at a tertiary care hospital. In this hospital-based retrospective study, data from individuals visiting the COVID-19 screening OPD during the period from 17th March 2020 to 31st July 2020 were collected. We documented and analysed relevant demographic, epidemiological and clinical characteristics of the patients. ResultsA total of 10,735 patients visited the COVID-19 screening OPD during the defined study period out of which 3652 individuals were tested. Majority of the patients, i.e. 65.67% (7050) were male and in 15-59 years age group (84.68%). Most common symptoms among patients visiting CS-OPD was Cough (9.86%). Out of the total, 17.17% (1843) of patient reported to the CS-OPD with contact history of COVID-19 positive patient. On the other hand, 13.49% (1448) of patients were with either domestic or international travel history. The overall testing rate and positivity rate for CS-OPD during this period were found to be 34.02% and 7.94% respectively. ConclusionThe clinical, demographic and epidemiological characteristics of patients visiting CS-OPD varied across the study period depending upon the containment and testing strategy. The CS-OPD played a crucial role in preventing nosocomial infection and maintaining non-COVID care at the tertiary care hospital.
