A study of healthcare workers has shown their likelihood of being infected with COVID during the pandemic was three times higher compared to the general population, with about one in five of those infected workers being asymptomatic and unaware they had COVID.
The study also shows that it was not only frontline staff who faced the higher risk, suggesting that there was transmission between staff and within the wider community. The results are published in ERJ Open Research.
However, health care workers who had been infected were very unlikely to contract COVID a second time in the following six months.
The research was led by Professor James Chalmers, a consultant respiratory physician from the University of Dundee.
“We have always believed that front line health workers face a high risk of contracting COVID and that’s why we’ve tried to ensure they have the PPE needed to protect themselves,” said Prof Chalmers. “But many questions remain about the level of this risk and what other measures we can take to protect staff and reduce transmission of the disease.”
The study recruited 2063 staff working in a wide variety of healthcare roles in the East of Scotland. Between May and September 2020, the participants had blood tests for COVID antibodies, a very accurate indication of prior COVID infection. The researchers also recorded whether any participants developed an infection in subsequent months.
The health care workers results were compared with a randomly selected control group of blood samples taken by local GPs during the same time period.
These blood tests showed that 300 (14.5%) of the healthcare workers had been infected, a rate more than triple the proportion of people infected in the local population. The highest rates of infections among the workers were found in dentistry (26%), health care assistants (23.3%) and hospital porters (22.2%). The rate among admin staff was the same as that of doctors (21.1%).
Rates among people working in areas of the hospital where COVID patients were being treated were somewhat higher than those working in non-COVID areas (17.4% vs 13.5%). However, the majority of infections were in staff who were not working directly with COVID patients, suggesting there was transmission between staff or infections acquired in the community.
Out of the 300 healthcare workers testing positive, 56 (18.7%) did not think that they had ever caught COVID and were totally asymptomatic. This is an important finding, according to the researchers, since people without symptoms are likely to go to work, potentially infecting others.
In the months following their blood tests, 39 workers developed a symptomatic COVID infection, but only one of these was a worker who had previously tested positive. This equates to an 85% risk reduction, similar to the level of protection provided by COVID vaccines.
Prof Chalmers said: “A lot of attention during the pandemic has been around PPE for doctors and nurses but we found that dentists, healthcare assistants and porters were the staff most likely to test positive.
“We continued to monitor staff for up to seven months and found that having a positive antibody test gave 85% protection against a future infection. This is really good news for people who have already had COVID-19, as it means the chances of a second infection are very low.”
The team hopes to continue the research to see how long immunity persists and how vaccination affects infections among healthcare workers.
Professor Anita Simonds, President of the European Respiratory Society and Consultant in Respiratory and Sleep Medicine at Royal Brompton Hospital, UK, was not involved in the research, offered comments.
She said: “This research shows the high levels of COVID infection among all healthcare workers, with the highest evidence of infection in dentists, healthcare assistants and porters. Staff working in critical care, who are likely to have been protected by using personal protective equipment at all times, were not disproportionately affected.
“It should be noted that among administrative staff, 21.1% were found to have been infected with COVID, indicating that all those working directly with patients, and those working in other hospital roles are at risk, and vaccination and risk assessment for appropriate levels of PPE in all these frontline groups are crucial.”
Source: European Respiratory Society
