Hospital-acquired COVID-19 affects patients, workers, study says
While the absolute risk of acquiring COVID-19 in the hospital was low—up to 0.75% risk per day of exposure pre-Delta (B1617.2) variant—patients or healthcare workers (HCWs) with COVID-19 nonetheless can be factors in the spread of COVID-19, a study published yesterday in PLOS One says.
The researchers looked at four UK teaching hospitals, where 66,184 patients were hospitalized and 5,569 HCWs were on the job from Jan 12 to Oct 2, 2020. Of the patients, 1.4% had a positive test within the same period, and 10.5% of those (97) had their first positive test post-hospitalization at least 7 days after admission, wherein they were considered a nosocomial case. Patients who likely acquired COVID-19 infections while in the hospital were older, had longer lengths of stay, and had more readmission, the researchers note.
Among the HCWs, 11.0% were positive during the study period.
For susceptible patients, 1 day in the same ward with a patient with hospital-acquired COVID-19 infection was associated with an additional 7.5 infections per 1,000 susceptible patients per day (95% credible interval [CrI], 5.5 to 9.5). Exposure to an infectious patient with community-acquired COVID-19 or to an infectious HCW, on the other hand, was associated with an additional 2.0 infections per 1,000 susceptible patients per day (95% CrI, 1.6 to 2.2).
HCW infections acquired from patients or from another HCW were both associated with an additional 0.8 infection per 1,000 susceptible HCWs per day (95% CrI, 0.3 to 1.6 and 0.6 to 1.0, respectively). Exposure to an infectious patient with community-acquired COVID-19 infection was associated with an additional 0.2 infection per 1,000 susceptible HCWs per day (95% CrI, 0.2 to 0.2).
“In this study, we observed that exposure to patients with hospital-acquired SARS-CoV-2 is associated with a substantial infection risk to both HCWs and other hospitalised patients. Infection control measures to limit nosocomial transmission must be optimised to protect both staff and patients from SARS-CoV-2 infection,” the researchers write, noting that increased mitigations from Apr 25, 2020, onward were associated with 75% reduced odds of infection in susceptible patients.
Oct 12 PLOS One study
About 3 in 20 Midwest healthcare workers COVID vaccine hesitant
In a 1,971-person survey conducted from March to May, about 3 in 20 Midwest HCWs were hesitant about the COVID-19 vaccine, according to a study published yesterday in the American Journal of Infection Control.
Respondents were from a 465-bed University of Illinois at Chicago hospital, a 664-bed Rush University Medical Center hospital, and a 26-hospital system in Wisconsin and Illinois run by Advocate Aurora. The survey, which was based off the Health Belief Model framework, showed that 15% of HCWs had not received or were not planning to receive a COVID-19 vaccine.
Overall, vaccinated HCWs were more likely than unvaccinated HCWs to be influenced by having close contacts who wanted them to be vaccinated (odds ratio [OR], 5.52 to 18.83, depending on the relation). They were also more likely to believe that the vaccination would decrease the spread of COVID-19 (OR, 51.49) and decrease the likelihood of themselves, their patients, and their family from getting infected (ORs, 28.22, 22.45, and 27.19, respectively).
Unvaccinated people, in comparison, were 93% more likely to believe that the vaccine had insufficient evidence. They were also more likely to be Black (OR, 0.34), Republican (OR, 0.54), allergic to any vaccine component (OR, 0.27), or believe it would negatively affect pregnancy or pregnancy planning (OR, 0.09), according to multivariable logistic regression that led to a 95%–accurate vaccine hesitancy model.
The researchers noted that those who were vaccinated were more likely to be persuaded toward acceptance by external stimuli (eg, media, personal healthcare provider; OR, 1.83 and 4.77, respectively) than unvaccinated HCWs.
“Rather than focusing on generalized, impersonal outreach advertisements from a hospital administration or the mainstream media,” they conclude, “hospitals should work internally to foster relationships and trust building among employees across departments and job roles, especially among nurses and physicians who remain highly trusted in their communities.”
Oct 12 Am J Infect Control study