COVID 19 infection in health care workers is rising and many hospitals are being forced down to shut operations due to infection among their staff. Mumbai’s Wockhardt hospital and Sai Hospital were closed as many dozen of their doctors ,nurses and other staff tested positive for COVID 19. At many health centers across the world the entire staff have been kept under quarantine.
Healthcare workers (HCWs) play an essential role at the front lines,providing care for patients. In the context of COVID-19 and during routine health services, they provide critical care to patients and ensure that infection prevention and control (IPC) measures are implemented and adhered to in healthcare facilities in order to limit healthcare-associated infections.
As of 8 April 2020, 22073 cases of COVID-19 among HCWs from 52 countries had been reported to WHO.
However, at the present time, there is no systematic reporting of HCW COVID-19 infections to WHO and therefore this number probably under-represents the true number of COVID-19 HCW infections globally.
To date, there are a limited number of publications and national situation reports that provide information on the number of HCW infections. For example, a publication from China CDC on 44672 confirmed cases as of 17 February 2020 indicated 1688 (3.8%) infections were among HCWs, including five deaths.
In Italy, a situation report from 10 April 2020 reported15314 infections among HCW, representing 11% of all infections at that time.
Further publications have described the epidemiological and clinical characteristics of infections among HCWs.
While many infections are indicated as mild, severe outcomes, including deaths, among HCW shave also been reported. Understanding infection in HCWs is critical to informing the specific IPC measures needed to protect HCWs from infection.
A limited number of publications have identified risk factors for infection among HCWs. Preliminary results suggest HCWs are being infected both in the workplace and in the community, most often through infected family members.
What are factors causing COVID 19 infection in health care workers ?
In healthcare settings, factors associated with HCW infection have included:
- Late recognition or suspicion of COVID-19 in patients,
- Working in a higher-risk department,
- Longer duty hours,
- Sub-optimal adherence to IPC measures such as hand hygiene practices, and
- Lack of or improper use of personal protective equipment (PPE).
- Inadequate or insufficient IPC training for respiratory pathogens, including the COVID-19 virus
How to prevent COVID 19 infection in HCWs ?
To prevent infection in healthcare settings, WHO recommends the use of contact and droplet precautions by HCWs caring for patients with COVID-19.
WHO also recommends that airborne precautions be applied in settings in which procedures and support treatments that generate aerosols are performed.
In this context, the correct use of PPE is critical, in particular wearing appropriate PPE for the clinical setting, paying special attention to procedures to put on and remove PPE correctly, and adhering to hand hygiene and other IPC measures.
When these precautions are applied correctly and consistently, alongside standard precautions and administrative, engineering and environmental controls, the risk for HCW infections is substantially reduced or avoided altogether.
Therefore, WHO recommends that IPC measures be complemented by occupational safety and health measures, psycho-social support,adequate staffing levels, and clinical rotation,to reduce the risk of burn-out, for safe and healthy working environments and to respect the rights of health workers to decent working conditions.
Finally, as HCWs caring for patients with COVID-19 are subject to long working hours, fatigue, occupational burn-out, stigma, physical and psychological violence, and back injury from patient handling, it is important that efforts be made to maintain the physical and mental health of HCWs and the quality of care.
WHO has also developed a risk assessment tool for exposed HCWs in a healthcare facility and a sero-epidemiological protocol to determine risk factors for infection among HCW, and is finalizing an in-depth epidemiological surveillance tool for HCW infections.
A number of countries are currently using these tools and protocols, and this information will be essential to understand the extent of infection among HCWs, the extent of transmission within healthcare facilities and the best approaches to protect HCWs against infection.
COVID 19 infection in health care workers is rising and many hospitals are being forced down to shut operations due to infection among their staff. Mumbai’s Wockhardt hospital and Sai Hospital were closed as many dozen of their doctors ,nurses and other staff tested positive for COVID 19. At many health centers across the world the entire staff have been kept under quarantine.
Healthcare workers (HCWs) play an essential role at the front lines,providing care for patients. In the context of COVID-19 and during routine health services, they provide critical care to patients and ensure that infection prevention and control (IPC) measures are implemented and adhered to in healthcare facilities in order to limit healthcare-associated infections.
As of 8 April 2020, 22073 cases of COVID-19 among HCWs from 52 countries had been reported to WHO.
However, at the present time, there is no systematic reporting of HCW COVID-19 infections to WHO and therefore this number probably under-represents the true number of COVID-19 HCW infections globally.
To date, there are a limited number of publications and national situation reports that provide information on the number of HCW infections. For example, a publication from China CDC on 44672 confirmed cases as of 17 February 2020 indicated 1688 (3.8%) infections were among HCWs, including five deaths.
In Italy, a situation report from 10 April 2020 reported15314 infections among HCW, representing 11% of all infections at that time.
Further publications have described the epidemiological and clinical characteristics of infections among HCWs.
While many infections are indicated as mild, severe outcomes, including deaths, among HCW shave also been reported. Understanding infection in HCWs is critical to informing the specific IPC measures needed to protect HCWs from infection.
A limited number of publications have identified risk factors for infection among HCWs. Preliminary results suggest HCWs are being infected both in the workplace and in the community, most often through infected family members.
What are factors causing COVID 19 infection in health care workers ?
In healthcare settings, factors associated with HCW infection have included:
- Late recognition or suspicion of COVID-19 in patients,
- Working in a higher-risk department,
- Longer duty hours,
- Sub-optimal adherence to IPC measures such as hand hygiene practices, and
- Lack of or improper use of personal protective equipment (PPE).
- Inadequate or insufficient IPC training for respiratory pathogens, including the COVID-19 virus
How to prevent COVID 19 infection in HCWs ?
To prevent infection in healthcare settings, WHO recommends the use of contact and droplet precautions by HCWs caring for patients with COVID-19.
WHO also recommends that airborne precautions be applied in settings in which procedures and support treatments that generate aerosols are performed.
In this context, the correct use of PPE is critical, in particular wearing appropriate PPE for the clinical setting, paying special attention to procedures to put on and remove PPE correctly, and adhering to hand hygiene and other IPC measures.
When these precautions are applied correctly and consistently, alongside standard precautions and administrative, engineering and environmental controls, the risk for HCW infections is substantially reduced or avoided altogether.
Therefore, WHO recommends that IPC measures be complemented by occupational safety and health measures, psycho-social support,adequate staffing levels, and clinical rotation,to reduce the risk of burn-out, for safe and healthy working environments and to respect the rights of health workers to decent working conditions.
Finally, as HCWs caring for patients with COVID-19 are subject to long working hours, fatigue, occupational burn-out, stigma, physical and psychological violence, and back injury from patient handling, it is important that efforts be made to maintain the physical and mental health of HCWs and the quality of care.
WHO has also developed a risk assessment tool for exposed HCWs in a healthcare facility and a sero-epidemiological protocol to determine risk factors for infection among HCW, and is finalizing an in-depth epidemiological surveillance tool for HCW infections.
A number of countries are currently using these tools and protocols, and this information will be essential to understand the extent of infection among HCWs, the extent of transmission within healthcare facilities and the best approaches to protect HCWs against infection.
