Delayed healthcare seeking and prolonged illness in healthcare workers during the COVID-19 pandemic: a single-centre observational study. Issue 11 (26th November 2020)

• Record Type: Journal Article
• Authors: de Wilton, Angus; Kilich, Eliz; Chaudhry, Zain; Bell, Lucy CK; Gahir, Joshua; Cadman, Jane; Lever, Robert A; Logan, Sarah A
• Is Part Of: BMJ open. Volume 10:Issue 11(2020)
• Publication Date: 2020-11-26
• Subjects: epidemiology -- health policy -- human resource management -- public health -- infectious diseases; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-040216
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: To describe a cohort of self-isolating healthcare workers (HCWs) with presumed COVID-19. Design: A cross-sectional, single-centre study. Setting: A large, teaching hospital based in Central London with tertiary infection services. Participants: 236 HCWs completed a survey distributed by internal staff email bulletin. 167 were women and 65 men. Measures: Information on symptomatology, exposures and health-seeking behaviour were collected from participants by self-report. Results: The 236 respondents reported illness compatible with COVID-19 and there was an increase in illness reporting during March 2020 Diagnostic swabs were not routinely performed. Cough (n=179, 75.8%), fever (n=138, 58.5%), breathlessness (n=84, 35.6%) were reported. Anosmia was reported in 42.2%. Fever generally settled within 1 week (n=110/138, 88%). Several respondents remained at home and did not seek formal medical attention despite reporting severe breathlessness and measuring hypoxia (n=5/9, 55.6%). 2 patients required hospital admission but recovered following oxygen therapy. 84 respondents (41.2%) required greater than the obligated 7 days off work and 9 required greater than 3 weeks off. Conclusion: There was a significant increase in staff reporting illness compatible with possible COVID-19 during March 2020. Subsequent serology studies at the same hospital study site have confirmed sero-positivity for COVID-19 up to 45% by the end of April 2020 in frontline HCWs. The study revealed a concerning lack of healthcare seeking in respondents with significant red flag symptoms (severe breathlessness, hypoxia). This study also highlighted anosmia as a key symptom of COVID-19 early in the pandemic, prior to this symptom being more widely recognised as a feature of COVID-19.