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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

Published online by Cambridge University Press:  15 April 2021

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

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
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).

References

Sahu, AK, Amrithanand, VT, Mathew, R, Aggarwal, P, Nayer, J, Bhoi, S. COVID-19 in healthcare workers—a systematic review and meta-analysis. Am J Emerg Med 2020;38:17271731.CrossRefGoogle ScholarPubMed
Recensement national des cas de COVID-19 chez les professionnels en établissements de santé. Mise à jour le 30 juin 2020. Santé Publique France website. https://www.santepubliquefrance.fr/etudes-et-enquetes/recensement-national-des-cas-de-covid-19-chez-les-professionnels-en-etablissements-de-sante. Published 2020. Accessed October 30, 2020.Google Scholar
Análisis de los casos de COVID-19 en personal sanitario notificados a la Red Nacional de Vigilancia Epidemiológica hasta el 10 de mayo en España. Fecha del informe: 29-05-2020. Ministerio de Sanidad de España website. Éhttps://www.ÉPIcentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_30-giugno-2020.pdf. Published 2020. Accessed October 30, 2020.Google Scholar
Épidemia COVID-19 Aggiornamento nazionale 30 giugno 2020 – ore 11:00. Instituto Superior di Sanità website. Éhttps://www.ÉPIcentro.iss.it/coronavirus/bollettino/Bollettino-sorveglianza-integrata-COVID-19_30-giugno-2020.pdf. Published 2020. Accessed October 30, 2020.Google Scholar
Schwartz, KL, Achonu, C, Buchan, SA, et al. Epidemiology, clinical characteristics, household transmission, and lethality of severe acute respiratory syndrome coronavirus-2 infection among healthcare workers in Ontario, Canada. PLoS One 2020;15:e0244477.CrossRefGoogle ScholarPubMed
Coronavirus disease 2019 (COVID-19): epidemiology update. Government of Canada website. https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html#a3. Published 2020. Accessed February 2, 2021.Google Scholar
Harrison, D, Muradali, K, El Sahly, H, Bozkurt, B, Jneid, H. Impact of the SARS-CoV-2 pandemic on healthcare workers. Hosp Pract 2020;48:161164.CrossRefGoogle Scholar
Chen, M, Wei, X, Wang, Z. Protecting healthcare workers from SARS-CoV-2 and other infections. Epidemiol Infect 2020;148:e217.CrossRefGoogle ScholarPubMed
Lentz, RJ, Colt, H, Chen, H, et al. Assessing coronavirus disease 2019 (COVID-19) transmission to healthcare personnel: the global ACT-HCP case-control study. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.455.CrossRefGoogle Scholar
Eyre, DW, Lumley, SF, O’Donnell, D, et al. Differential occupational risks to healthcare workers from SARS-CoV-2 observed during a prospective observational study. eLife 2020;9:e60675.CrossRefGoogle ScholarPubMed
Zheng, C, Hafezi, N, Cooper, V, et al. Characteristics and transmission dynamics of COVID-19 in healthcare workers at a London Teaching Hospital. J Hosp Infect 2020;106:325329.CrossRefGoogle Scholar
Wilkins, J, Gray, EL, Wallia, A, et al. Seroprevalence and correlates of SARS-CoV-2 antibodies in healthcare workers in Chicago. medRxiv 2020. doi: 10.1101/2020.09.11.20192385.CrossRefGoogle Scholar
Gómez-Ochoa, SA, Franco, OH, Rojas, LZ, et al. COVID-19 in healthcare workers: a living systematic review and meta-analysis of prevalence, risk factors, clinical characteristics, and outcomes. Am J Epidemiol 2020. doi: 10.1093/aje/kwaa191.CrossRefGoogle Scholar
Hughes, MM, Groenewold, MR, Lessem, SE, et al. Update: characteristics of healthcare personnel with COVID-19 — United States, February 12–July 16, 2020. Morb Mortal Wkly Rep 2020;69:13641368.CrossRefGoogle Scholar
Data tables 2016 Census. Québec. Statistics Canada website. https://www12.statcan.gc.ca/census-recensement/2016/dp-pd/index-eng.cfm. Published 2016. Accessed October 30, 2020.Google Scholar
Statistiques. Médecins actifs seulement. Collège des Médecins du Québec website. http://www.cmq.org/statistiques/generalites.aspx. Published 2020. Accessed October 30, 2020.Google Scholar
Rapport statistique sur l’effectif infirmier, 2018-2019. Le Québec et ses régions. Ordre des infirmières et infirmiers du Québec website. https://www.oiiq.org/documents/20147/3410233/Rapport_statistique_2018-2019.pdf. Published 2019. Accessed October 30, 2020.Google Scholar
Rapport annuel, 2018-2019. Ordre des infirmières et infirmiers auxiliaires du Québec website. https://www.oiiaq.org/publications/rapports-annuels. Published 2019. Accessed October 30, 2020.Google Scholar
Nguyen, LH, Drew, DA, Graham, MS, et al. Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study. Lancet 2020;5:e475e483.Google Scholar
Abo-Leyah, H, Gallant, S, Cassidy, D, et al. Seroprevalence of SARS-COV-2 antibodies in Scottish healthcare workers. medRxiv 2020. doi: 10.1101/2020.10.02.20205641.CrossRefGoogle Scholar
Wei, J-T, Liu, Z-D, Fan, Z-W, Zhao, L, Cao, W-C. Epidemiology of and risk factors for COVID-19 infection among healthcare workers: a multicentre comparative study. Int J Environ Res Public Health 2020;17:7149.CrossRefGoogle Scholar
Galan, I, Velasco, M, Casas, ML, et al. SARS-CoV-2 seroprevalence among all workers in a teaching hospital in Spain: unmasking the risk. medRxiv 2020. doi: 10.1101/2020.05.29.20116731.CrossRefGoogle Scholar
Jespersen, S, Mikkelsen, S, Greve, T, et al. Severe acute respiratory syndrome coronavirus 2 seroprevalence survey among 17,971 healthcare and administrative personnel at hospitals, prehospital services, and specialist practitioners in the central Denmark region. Clin Infect Dis 2020. doi: 10.1093/cid/ciaa1471.CrossRefGoogle Scholar
Akinbami, LJ, Vuong, N, Petersen, LR, et al. SARS-CoV-2 Seroprevalence among healthcare, first response, and public safety personnel, Detroit metropolitan area, Michigan, USA, May–June 2020. Emerg Infect Dis 2020; 26:28632871.CrossRefGoogle Scholar
Blairon, L, Mokrane, S, Wilmet, A, et al. Large-scale, molecular and serological SARS-CoV-2 screening of healthcare workers in a 4-site public hospital in Belgium after COVID-19 outbreak. J Infect 2020. doi: 10.1016/j.jinf.2020.07.033.CrossRefGoogle Scholar
Rudberg, A-S, Havervall, S, Månberg, A, et al. SARS-CoV-2 exposure, symptoms and seroprevalence in healthcare workers in Sweden. Nat Commun 2020;11:5064.CrossRefGoogle ScholarPubMed
Erber, J, Kappler, V, Haller, B, et al. Strategies for infection control and prevalence of anti–SARS-CoV-2 IgG in 4,554 employees of a university hospital in Munich, Germany. medRxiv 2020. doi: 10.1101/2020.10.04.20206136.CrossRefGoogle Scholar
Dimcheff, DE, Schildhouse, RJ, Hausman, MS, et al. Seroprevalence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection among Veterans’ Affairs healthcare system employees suggests higher risk of infection when exposed to SARS-CoV-2 outside the work environment. Infect Control Hosp Epidemiol 2020. doi: 10.1017/ice.2020.1220.CrossRefGoogle Scholar
Zhou, F, Li, J, Lu, M, et al. Tracing asymptomatic SARS-CoV-2 carriers among 3,674 hospital staff:a cross-sectional survey. EClinicalMedicine 2020;26:100510.CrossRefGoogle Scholar
Houghton, C, Meskell, P, Delaney, H, et al. Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database Syst Rev 2020;4:CD013582.CrossRefGoogle Scholar
Savoia, E, Argentini, G, Gori, D, Neri, E, Piltch-Loeb, R, Fantini, MP. Factors associated with access and use of PPE during COVID-19: a cross-sectional study of Italian physicians. PLoS One 2020;15:e0239024.CrossRefGoogle ScholarPubMed
Rinfret, M. Rapport annuel 2019–2020. Protecteur du citoyen website. https://rapportannuel.protecteurducitoyen.qc.ca/. Published 2020. Accessed October 30, 2020.Google Scholar
Sharma, M, Creutzfeldt, CJ, Lewis, A, et al. Healthcare professionals’ perceptions of critical care resource availability and factors associated with mental well-being during COVID-19: results from a US survey. Clin Infect Dis 2020. doi: 10.1093/cid/ciaa13111.CrossRefGoogle Scholar
Directives cliniques aux professionnels et au réseau pour la COVID-19. Ministère de la Santé et des Services Sociaux Québec website. https://www.msss.gouv.qc.ca/professionnels/covid-19/directives-cliniques-aux-professionnels-et-au-reseau/prevention-et-controle-des-infections/. Published 2020. Accessed October 30, 2020.Google Scholar
Self, WH, Tenforde, MW, Stubblefield, WB, et al. Seroprevalence of SARS-CoV-2 among frontline healthcare personnel in a multistate hospital network—13 academic medical centers, April–June 2020. Morb Mortal Wkly Rep 2020;69:12211226.CrossRefGoogle Scholar
Daga, S, Jafferbhoy, S, Menon, G, et al. Does gender or religion contribute to the risk of COVID-19 in hospital doctors? medRxiv 2020. doi: 10.1101/2020.06.15.20125450.CrossRefGoogle Scholar
Ran, L, Chen, X, Wang, Y, Wu, W, Zhang, L, Tan, X. Risk factors of healthcare workers with coronavirus disease 2019: a retrospective cohort study in a designated hospital of Wuhan in China. Clin Infect Dis 2020;71:22182221.CrossRefGoogle Scholar
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