The workplace is a “major driver” of COVID-19 infections among long-term care and other healthcare workers, according to the results of a new study published in the American Journal of Infection Control. The findings, according to the authors, suggest that U.S. healthcare workers in whom COVID-19 is diagnosed are most likely exposed to SARS-CoV-2 in their workplaces rather than in their homes or the greater community.
For purposes of this study, long-term care was defined as nursing homes, assisted living communities and rehabilitation facilities.
“Previous reports hypothesized that COVID-19 incidence among healthcare personnel was primarily a result of non-occupational exposures, because healthcare personnel who lived in communities with higher COVID-19 incidence were more likely to become infected with SARS-CoV-2,” said Rachael M. Billock, Ph.D., a member of the Centers for Disease Control and Prevention COVID-19 Response Team and the first author on the study. “Our findings suggest that, particularly during periods of high community incidence of COVID-19, healthcare personnel exposures occur both at the workplace and outside of it, with the workplace being a major driver of infections.”
During the study period, exposure settings were reported for 83,775 healthcare worker cases of COVID-19. Healthcare settings were the most often reported (52%) exposure sources, followed by households (30.8%) and the greater community (25.6%). Most healthcare personnel cases for which work settings were reported involved long-term care facility employees (61%).
The authors suggested that this finding may be the result of recommended facility-wide testing practices in long-term care facilities leading to greater case detection and knowledge of workplace exposures. Healthcare providers in nursing homes who had COVID also were more likely to report healthcare-associated exposures and were less likely to report using adequate personal protective equipment.
“This study provides important insights to guide infection prevention and control practices in healthcare settings so that we can better protect healthcare professionals and their patients,” said Linda Dickey, RN, MPH, 2022 president of the Association for Professionals in Infection Control and Epidemiology. “Additionally, it reiterates the importance of collecting data on healthcare personnel work-related variables, such as industry, occupation and workplace exposures, in infectious disease surveillance.”
The study also noted that after healthcare workers started being vaccinated against COVID-19 in mid-December 2020, the researchers observed a sharp decline in COVID-19 diagnoses among healthcare personnel. From December 2020 through March 2021, healthcare-associated exposures changed from being the most commonly reported exposure type among healthcare personnel to the least. This finding, according to the authors, suggests that healthcare personnel, regardless of their personal vaccination status, may have experienced reduced workplace exposure due to early vaccination among coworkers and some patients or residents.
The study, “Reported exposure trends among healthcare personnel COVID-19 cases, USA, March 2020-March 2021,” can be found here.