444 - Coronavirus Disease 2019 (COVID-19) Among Healthcare Workers in Southeast Michigan

Background: Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has significantly impacted Michigan, with over 60,000 cases and 5,700 deaths to date.  During the surge, Metropolitan Detroit was the epicenter of the outbreak, accounting for 80% of cases and 86% of deaths statewide.  Healthcare workers (HCW) are particularly at risk; however, rates of infection based on job category has not been described previously in the United States.  We describe the impact of the outbreak on our workforce.Background Michigan COVID
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Methods: This was a retrospective review of employees with COVID-19 at Henry Ford Health System (HFHS), a comprehensive, integrated, health care organization in Southeast Michigan includes 5 hospitals and 9 emergency departments from 3/10/2020-6/10/2020. Employees exhibiting symptoms and/or signs consistent with COVID-19 infection were referred to employee health and tested for SARS-CoV-2.  All employees with positive polymerase chain reaction (PCR) of upper respiratory tract were included.  Data were obtained from a dedicated analytics dashboard that tracked all testing and results for employees.  Rate (number positives/total tested) of infection for each job category was determined.

Results: A total 5352 (16%) of 33538 employees were tested, of whom 1036 (19%) tested positive. The number of infected workers represents approximately 3.1 % of the workforce. The sharp increase of COVID-19 admissions correlated with the rise in HCW COVID-19 positivity (Figure 1). The number of HCW tested largely correlated with the disease burden at each hospital (Figure2). Table 1 shows total population of symptomatic HCW tested and demonstrates volume of testing and positivity were higher among HCW with close patient contact. The positivity rates in specific clinical support staff are shown in Table 2. Notably, there were high rates of positivity among non-clinical business and management employees tested suggesting community-transmission.Table 1
Table 2
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Conclusion: COVID-19 risk is highest among HCW in high volume settings with close patient contact. Community exposure may be an important factor that contributes to this risk. Strategies to minimize transmission in healthcare settings should be combined with HCW education emphasizing measures to avoid exposure within the community.