• Adherence to personal protective equipment guidelines during the COVID-19 pandemic among healthcare personnel: A louisiana case study

      Aggarwal, Ayushi; Darwish, Oliver A.; Karvar, Mehran; Ma, Chenhao; Wu, Mengfan; Haug, Valentin; Orgill, Dennis P.; Panayi, Adriana C. (Cambridge University Press, 2021-06-08)
      Objective: To determine the extent that appropriate personal protective equipment (PPE), per CDC guidance, was used during the COVID-19 pandemic by health care personnel (HCP) in Louisiana in five clinical settings. Methods: An online questionnaire was distributed to the LA Nursery registry. Appropriate use of PPE in each of the five clinical scenarios was defined by the authors based on CDC guidelines. The scenarios ranged from communal hospital space to carrying out Aerosol Generating Procedures (AGP). 1760 HCP participated between June-July 2020. Results: The average adherence in LA was lowest for carrying out AGPs scenario at 39.5% compliance and highest for patient contact when COVID-19 not suspected scenario at 82.8% compliance. Adherence among parishes varied widely. Commentary to suggest a shortage of PPE supply and the practice of re-using PPE was strong. Conclusions: Use of appropriate PPE varied by setting. It was higher in scenarios where only face masks (or respirators) were the standard (i.e., community hospital or when COVID-19 not suspected) and lower in scenarios where additional PPE (e.g., gloves, eye protection, and isolation gown) were required. Policy implications: As HCP are at the forefront of efforts to contain the coronavirus, the factors underlying variable adherence to CDC protocols in LA need to be further analyzed and addressed. © 2021 Society for Disaster Medicine and Public Health, Inc.
    • Coronavirus disease 2019 (COVID-19) symptoms, patient contacts, polymerase chain reaction (PCR) positivity and seropositivity among healthcare personnel in a Maryland healthcare system

      O'Hara, Lyndsay M; Schrank, Gregory M; Frisch, Melissa; Hogan, Regina; Deal, Kellie E; Harris, Anthony D; Leekha, Surbhi (Cambridge University Press, 2021-08-20)
      In a large system-wide healthcare personnel (HCP) testing experience using SARS-CoV-2 PCR and serologic testing early in the COVID-19 pandemic, we did not find increased infection risk related to COVID-19 patient contact. Our findings support workplace policies for HCP protection and underscore the role of community exposure and asymptomatic infection. © 2021 by The Society for Healthcare Epidemiology of America.
    • Risk Factors Associated With SARS-CoV-2 Seropositivity Among US Health Care Personnel

      Jacob, Jesse T; Baker, Julia M; Fridkin, Scott K; Lopman, Benjamin A; Steinberg, James P; Christenson, Robert H; King, Brent; Leekha, Surbhi; O'Hara, Lyndsay M; Rock, Peter; et al. (American Medical Association, 2021-03-10)
      Importance: Risks for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care personnel (HCP) are unclear. Objective: To evaluate the risk factors associated with SARS-CoV-2 seropositivity among HCP with the a priori hypothesis that community exposure but not health care exposure was associated with seropositivity. Design, Setting, and Participants: This cross-sectional study was conducted among volunteer HCP at 4 large health care systems in 3 US states. Sites shared deidentified data sets, including previously collected serology results, questionnaire results on community and workplace exposures at the time of serology, and 3-digit residential zip code prefix of HCP. Site-specific responses were mapped to a common metadata set. Residential weekly coronavirus disease 2019 (COVID-19) cumulative incidence was calculated from state-based COVID-19 case and census data. Exposures: Model variables included demographic (age, race, sex, ethnicity), community (known COVID-19 contact, COVID-19 cumulative incidence by 3-digit zip code prefix), and health care (workplace, job role, COVID-19 patient contact) factors. Main Outcome and Measures: The main outcome was SARS-CoV-2 seropositivity. Risk factors for seropositivity were estimated using a mixed-effects logistic regression model with a random intercept to account for clustering by site. Results: Among 24 749 HCP, most were younger than 50 years (17 233 [69.6%]), were women (19 361 [78.2%]), were White individuals (15 157 [61.2%]), and reported workplace contact with patients with COVID-19 (12 413 [50.2%]). Many HCP worked in the inpatient setting (8893 [35.9%]) and were nurses (7830 [31.6%]). Cumulative incidence of COVID-19 per 10 000 in the community up to 1 week prior to serology testing ranged from 8.2 to 275.6; 20 072 HCP (81.1%) reported no COVID-19 contact in the community. Seropositivity was 4.4% (95% CI, 4.1%-4.6%; 1080 HCP) overall. In multivariable analysis, community COVID-19 contact and community COVID-19 cumulative incidence were associated with seropositivity (community contact: adjusted odds ratio [aOR], 3.5; 95% CI, 2.9-4.1; community cumulative incidence: aOR, 1.8; 95% CI, 1.3-2.6). No assessed workplace factors were associated with seropositivity, including nurse job role (aOR, 1.1; 95% CI, 0.9-1.3), working in the emergency department (aOR, 1.0; 95% CI, 0.8-1.3), or workplace contact with patients with COVID-19 (aOR, 1.1; 95% CI, 0.9-1.3). Conclusions and Relevance: In this cross-sectional study of US HCP in 3 states, community exposures were associated with seropositivity to SARS-CoV-2, but workplace factors, including workplace role, environment, or contact with patients with known COVID-19, were not. These findings provide reassurance that current infection prevention practices in diverse health care settings are effective in preventing transmission of SARS-CoV-2 from patients to HCP.