COVID 19: Health care workers, risks, protection and transmission

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) pandemic has been a major challenge for healthcare systems throughout the world. Health care workers (HCW) have been considered at high risk of contracting the virus and may also pose a significant risk of transmitting the virus to patients, colleagues and social contacts [1]. The resilience of any healthcare system relies upon staff to maintain their health and to be protected from the risks associated with their work. In addition, it is important that HCW are not a source of infection impacting upon vulnerable community members and their colleagues. The focus of many healthcare systems in the peak stages of the pandemic has been to ensure facilities were not overwhelmed and services maintained ability to respond to the acute demands. This ultimately led to service re-design and stepping down of nonacute services and development of remote consultations where feasible [2]. Rigorous infection control processes have been adopted in all healthcare systems which include enhanced hand hygiene and deep cleaning protocols, use of personal protective equipment (PPE), patient cohorting, isolation protocols and various testing protocols [3]. Whilst it is appropriate to adopt all methods, it is important to identify the measures associated with the most impact and to ensure any assumptions are challenged and where possible confirmed with robust evidence. Piccoli et al. [4] describe their local situation in Southern Switzerland (Canton of Ticino) in early 2020. The region borders Lombardy (Italy) which was the first European area to be affected by an outbreak of SARS-CoV-2 [5]. Steps were put in place to mitigate against overwhelming of the health care service. Piccoli et al. [4] sought to assess the impact of healthcare reorganisation on seroprevalence in specific SARS-CoV-2 risk exposure groups of HCW. It is worth noting that seropositivity in this study is used as an indication of past or current infection. There are significant