418. Low Frequency of Healthcare Worker Infections Following Occupational Exposures to COVID-19. (4th December 2021)

• Record Type: Journal Article
• Authors: Seidelman, Jessica; Akinboyo, Ibukunoluwa; Rinehart, Maya; Stiegel, Matthew; Moehring, Rebekah W; Anderson, Deverick J; Said, Kristen; Epling, Carol A; Lewis, Sarah S; Smith, Becky
• Is Part Of: Open forum infectious diseases. Volume 8(2021)Supplement 1
• Page Start: S309
• Page End: S310
• Publication Date: 2021-12-04
• Subjects: Communicable diseases -- Periodicals; Medical microbiology -- Periodicals; Infection -- Periodicals; 616.9
• DOI: 10.1093/ofid/ofab466.618
• Languages: English
• ISSNs: 2328-8957

Abstract

Abstract: Background: Data on occupational acquisition of COVID-19 in healthcare settings are limited. Contact tracing efforts are high resource investments. Methods: Duke Health developed robust COVID-19 contact tracing methods as part of a comprehensive prevention program. We prospectively collected data on HCW exposures and monitored for development of symptomatic (SYX) and asymptomatic (ASYX) COVID-19 infection after documented high-, medium, and low-risk exposures. HCWs were required to self-report exposures or were identified through contact tracing as potentially exposed to COVID-19 positive HCWs, patients or visitors. Contact tracers interviewed exposed HCWs and assessed the risk of exposure as high-, medium-, or low-risk based on CDC guidance (Table 1). Testing was recommended at 6 days after high- or medium-risk exposures and was provided upon HCW request following low-risk exposures. Our vaccination campaign began in 12/2020. Results: 12, 916 HCWs registered in the contact tracing database. From March 2020-May 2021, we identified 6, 606 occupational exposures (0.51 exposures/HCW). The highest incidence of workplace exposures per number of HCWs in each job category was among respiratory therapists (RT) (0.95 exposures/RT), nursing assistants (NA) (0.79 exposures/NA), and physicians (0.64 exposures/physician). The most common exposure risk level was medium (51.4%), followed by low (35.5%), and then high (13.1%). A total of 260 (2%) HCW had positive tests/conversions; 28 (10.8%) were ASYX at the time of testing. High-risk exposures had a significantly greater number of post-exposure infections compared to medium- and low-risk exposures (12.5% vs. 4.2%, vs. 0.4%; p < 0.001). The rate of SYX infection following exposure to a fellow HCW (179/3, 198; 5.6%) was higher than that following exposure to a patient (81/3, 408; 2.4%; p< 0.001). Conclusion: Conversion following exposure to COVID-19 in the healthcare setting with appropriate protective equipment was low. Incomplete testing of all exposed individuals was a limitation and our data may under-estimate the true conversion rate. Our findings support our local practice of not quarantining HCWs following non-household exposures. Limiting contact tracing to only high or medium risk exposures may best utilize limited personnel resources. Disclosures: Rebekah W. Moehring, MD, MPH, UpToDate, Inc. (Other Financial or Material Support, Author Royalties)