Hospital based contact tracing of COVID-19 patients and health care workers and risk stratification of exposed health care workers during the COVID-19 Pandemic in Eastern India

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.