Session : COVID-19 Epidemiology + Prevention

68 - Active Monitoring of a Healthcare Worker Cohort During the COVID-19 Epidemic

Oral Abstract

Location: On Demand

Background: Initial CDC recommendations for passive monitoring of COVID-19 related symptoms among staff may not be sufficient in preventing the introduction and transmission of SARS-CoV-2 in healthcare settings. We therefore implemented active monitoring for SARS-CoV-2 infection in healthcare workers (HCWs) at an academic medical center during the COVID-19 epidemic in northeast US.

Methods: We recruited a cohort of HCWs at Yale New Haven Hospital who worked in COVID-19 units and did not have COVID-19 related symptoms between March 28 and June 1, 2020. During follow-up, participants provided daily information on symptoms by responding to a web-based questionnaire, self-administered nasopharyngeal (NP) and saliva specimens every 3 days, and blood specimens every 14 days. We performed SARS-CoV-2 RT-PCR and an anti-spike protein IgM and IgG ELISA to identify virological and serological-confirmed infection, respectively.

Results: We enrolled 525 (13%) amongst 4,136 HCW of whom daily information on symptoms and NP, saliva, and blood specimens were obtained for 66% (of 13208), 42% (or 1977), 44% (of 2071) and 65% (of 1099), respectively, of the follow-up measurement points. We identified 16 (3.0% of 525) HCWs with PCR-confirmed SARS-CoV-2 infection and an additional 12 (2.3% of 525) who were not tested by PCR or had negative PCR results but had serological evidence of infection. The overall cumulative incidence of SARS-CoV-2 infection was 5.3% (28 of 525) amongst HCWs. Cases were not identified by hospital protocols for passive staff self-monitoring for symptoms. Amongst 16 PCR-confirmed cases, 9 (56%) of the 16 PCR-confirmed HCW had symptoms during or after the date of initial detection. We did not identify an epidemiological link between the 28 confirmed cases.

Conclusion: We found that a significant proportion (5.3%) of HCWs were infected with SARS-CoV-2 during the COVID-19 epidemic. In the setting of universal PPE use, infections were possibly acquired in the community rather than stemming from patient-HCW or HCW-HCW transmission. Passive monitoring of symptoms is inadequate in preventing introductions of SARS-CoV-2 into the healthcare setting due to asymptomatic and oligosymptomatic presentations.

Presenting Author(s)

Rupak Datta, MD, PhD

Instructor
Yale School of Medicine - Yale New Haven Hospital
West Haven, CT

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Slides Slides and Audio

Co-Author(s)

Melissa Campbell, MD

Clinical Fellow
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AW

Anne Wyllie, PhD

Associate Research Scientist
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AC

Arnau Casanovas-Massana, MSc, PhD

Associate Research Scientist
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RH

Ryan Handoko, MD

Hospital Resident
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LS

Lorenzo Sewanan, B.S.

Medical Student
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NN

Nida Naushad, B.S.

Medical Student
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
MS

Michael Simonov, M.D.

Clinical Fellow
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
EW

Elizabeth White, B.S.

Medical Student
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
JV

Jordan Valdez, B.S.

Medical Student
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
FL

Feimei Liu, B.S.

Ph.D. Candidate
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Saad Omer, MBBS, MPH, PHD

Director
Yale Institute for Global Health

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
CD

Charles Dela Cruz, MD, PhD

Associate Professor
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
SF

Shelli F. Farhadian, MD, PhD

Assistant Professor
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AR

Aaron Ring, MD, PhD

Assistant Professor
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AI

Akiko Iwasaki, PhD

Professor
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
NG

Nathan Grubaugh, Ph.D.

Assistant Professor
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
RM

Richard A. Martinello, MD

Associate Professor
Yale School of Medicine
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AK

Albert I. Ko, MD

Professor
Yale School of Public Health
New Haven, Connecticut

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.