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Characterization and evolution of infection control practices among severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–infected healthcare workers in acute-care hospitals and long-term care facilities in Québec, Canada, Spring 2020

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  15 April 2021

Sara Carazo Open the ORCID record for Sara Carazo [Opens in a new window] ,
Denis Laliberté ,
Jasmin Villeneuve ,
Richard Martin ,
Pierre Deshaies ,
Geoffroy Denis ,
Georges Adib ,
France Tissot ,
Marc Dionne  and
Gaston De Serres Open the ORCID record for Gaston De Serres [Opens in a new window]
Sara Carazo
Affiliation:
CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
Denis Laliberté
Affiliation:
Department of Social and Preventive Medicine, Laval University, Québec, Québec, Canada CIUSSS de la Capitale-Nationale, Québec, Québec, Canada
Jasmin Villeneuve
Affiliation:
Institut National de Santé Publique du Québec, Québec, Québec, Canada
Richard Martin
Affiliation:
Institut National de Santé Publique du Québec, Québec, Québec, Canada
Pierre Deshaies
Affiliation:
CIUSSS de Chaudière-Appalaches, Lévis, Québec, Canada
Geoffroy Denis
Affiliation:
CIUSSS Centre Sud de Montréal, Montreal, Québec, Canada McGill University, Montreal, Québec, Canada
Georges Adib
Affiliation:
Institut National de Santé Publique du Québec, Québec, Québec, Canada
France Tissot
Affiliation:
Institut National de Santé Publique du Québec, Québec, Québec, Canada
Marc Dionne
Affiliation:
CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
Gaston De Serres*
Affiliation:
CHU de Québec-Université Laval Research Center, Québec, Québec, Canada Department of Social and Preventive Medicine, Laval University, Québec, Québec, Canada Institut National de Santé Publique du Québec, Québec, Québec, Canada
*
Author for correspondence: Gaston De Serres, E-mail: gaston.deserres@inspq.qc.ca
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Abstract

Objectives:

In this study, we aimed to (1) estimate the severe acute respiratory coronavirus 2 (SARS-CoV-2) infection rate and the secondary attack rate among healthcare workers (HCWs) in Québec, the most affected province of Canada during the first wave; (2) describe the evolution of work-related exposures and infection prevention and control (IPC) practices in infected HCWs; and (3) compare the exposures and practices between acute-care hospitals (ACHs) and long-term care facilities (LTCFs).

Design:

Survey of cases.

Participants:

The study included Québec HCWs from private and public institutions with laboratory-confirmed coronavirus disease 2019 (COVID-19) diagnosed between March 1 and June 14, 2020. HCWs aged ≥18 years who worked during the exposure period and survived their illness were eligible for the survey.

Methods:

After obtaining consent, 4,542 HCWs completed a standardized questionnaire. COVID-19 rates and proportions of exposures and practices were estimated and compared between ACHs and LTCFs.

Results:

HCWs represented 13,726 (25%) of 54,005 reported COVID-19 cases in Québec and had an 11-times greater rate of COVID-19 than non-HCWs. Their secondary household attack rate was 30%. Most affected occupations were healthcare support workers, nurses and nurse assistants working in LTCFs (45%) and ACHs (30%). Compared to ACHs, HCWs in LTCFs had less training, higher staff mobility between working sites, similar PPE use, and better self-reported compliance with at-work physical distancing. Suboptimal IPC practices declined over time but were still present at the end of the first wave.

Conclusion:

Québec HCWs and their families were severely affected during the first wave of COVID-19. Insufficient pandemic preparedness and suboptimal IPC practices likely contributed to high transmission in both LTCFs and ACHs.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 4 , April 2022 , pp. 481 - 489
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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Footnotes

PREVIOUS PRESENTATION: Part of these data were presented in an official report of the Institut Nationale de Santé Publique du Québec (https://www.inspq.qc.ca/publications/3061-enquete-epidemiologique-travailleurs-sante-covid).

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