October 4, 2021

Occupational exposures, secondary cases of COVID-19 in HCWs

By: Judy Mathias
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Editor's Note

In this study, researchers from Northwestern Memorial Hospital and Feinberg School of Medicine, Chicago, find that more healthcare workers (HCWs) were exposed to COVID-19 by coworkers than patients, and lapses in infection prevention practices increased transmission risk.

Between June and December 2020, 2,357 HCWs were involved in occupational exposures:


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  • 1,655 HCWs had Tier 1 exposures (ie, the case did not wear a face covering, and the HCW was unmasked or was masked but did not wear eye protection and was within 6 feet of the case for at least 15 minutes)
  • 311 HCWs had Tier 2 exposures (ie, the HCW was in contact with an aerosol-generating procedure and did not wear an N95 respirator, eye protection, gown, and gloves)
  • 391 HCWs were in an unknown tier of exposures (ie, when data were missing, the tier was categorized as unknown)
  • 1,128 HCWs were exposed to patients, and 1,229 HCWs were exposed to other employees
  • RNs accounted for the majority of HCWs exposed to patients (499) and employees (388)
  • the number of exposed HCWs was highest in June (440), September (374), October (533), and November (448), which coincided with community levels of virus transmission.

Close adherence to Centers for Disease Control and Prevention guidelines is crucial for safe care of COVID-19 patients and to prevent COVID-19 transmission among HCWs, the researchers note.

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