scholarly journals Epidemiology, clinical characteristics, household transmission, and lethality of severe acute respiratory syndrome coronavirus-2 infection among healthcare workers in Ontario, Canada

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244477
Author(s):  
Kevin L. Schwartz ◽  
Camille Achonu ◽  
Sarah A. Buchan ◽  
Kevin A. Brown ◽  
Brenda Lee ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Language Processing ◽  
Healthcare Workers ◽  
Clinical Characteristics ◽  
Care Home ◽  
Multivariable Logistic Regression Model ◽  
Cross Sectional ◽  
Term Care ◽  
Personal Support ◽  
Risk Of Death

Introduction Protecting healthcare workers (HCWs) from Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a priority to maintain a safe and functioning healthcare system. Our objective was to describe and compare the epidemiology, clinical characteristics, and lethality of SARS-CoV-2 infections among HCWs compared to non-HCWs. Methods Using reportable disease data at Public Health Ontario, we conducted a population-based cross-sectional study comparing demographic, exposure, and clinical variables between HCWs and non-HCWs with SARS-CoV-2 infections as of 30 September 2020. We calculated rates of infections over time and determined the frequency of within household transmissions using natural language processing based on residential address. We evaluated the risk of death using a multivariable logistic regression model adjusting for age, sex, comorbidities, symptoms, and long-term care home exposure. Results There were 7,050 (12.5%) HCW SARS-CoV-2 infections in Ontario, Canada, of whom 24.9% were nurses, 2.3% were physicians, and the remaining 72.8% other specialties, including personal support workers. Overall HCWs had an infection rate of 1,276 per 100,000 compared to non-HCWs of 346 per 100,000 (3.7 times higher). This difference decreased from a 7 times higher rate in April to no difference in September 2020. Twenty-six percent of HCWs had a household member with SARS-CoV-2 infection; 6.8% were probable acquisitions, 12.3% secondary transmissions, and 6.9% unknown direction of transmission. Death among HCWs was 0.2% compared to 6.1% of non-HCWs. The risk of death in HCWs remained significantly lower than non-HCWs after adjustment (adjusted odds ratio 0.09; 95%CI 0.05–0.17). Conclusion HCWs represent a disproportionate number of diagnosed SARS-CoV-2 infections in Ontario, however this discrepancy is at least partially explained by limitations in testing earlier in the pandemic for non-HCWs. We observed a low risk of death in HCWs which could not be completely explained by other factors.

scholarly journals A New Features of SARS-CoV-2 Infection in Wenzhou, China

2020 ◽  
Author(s):  
Zhao Hongjun ◽  
Xiaoxiao Lu ◽  
Tiegang Li ◽  
Boqi Rao ◽  
Dedong Wang ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Wuhan City ◽  
Intimate Contact ◽  
Cross Sectional ◽  
Epidemic Area ◽  
History Of ◽  
Epidemiological Characteristics

Abstract BACKGROUND: An outbreak of pneumonia associated with the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) was initially emerged in Wuhan city, and subsequently spread throughout China. Then the epidemic is rapidly circulating in a few other countries at present. So it is very urgent to delineate the clinical characteristics of these affected patients. METHODS: To investigate the epidemiological characteristics of this new Coronavirus Disease 2019 (COVID-19), a cross-sectional study was executed with 459 patients with confirmed COVID-19 in Wenzhou, China, from January 27 to February 12, 2020. RESULTS: The median age of all patients was 48.0 years, and 46.8% were females. 37.5% of patients had a history of residence in Wuhan. Fever (72.1%) and cough (43.6%) were the most frequent symptoms. We also found that there were three kinds of unconventional patients including 4.4% of total confirmed patients who were asymptomatic, 7.8% patients who had no link to Wuhan city but contact with individuals from Wuhan without any symptoms at the time of contact, and 10.7% who had no link to Wuhan city nor a history of intimate contact with patients or individuals from Wuhan without any symptoms, respectively. CONCLUSIONS: Our findings presented the possibility of asymptomatic carriers affected with SARS-CoV-2, and this phenomenon suggested that chances of uncontrollable transmission in the larger population might be higher than formerly estimated, and transmission by these three kinds of unconventional patients in Wenzhou may be one of the characteristics of infection in other Chinese cities outside the Wuhan epidemic area.

Health Behavior Associated With Influenza Vaccination Among Healthcare Workers in Long-Term-Care Facilities

2002 ◽  
Vol 23 (10) ◽  
pp. 609-614 ◽  
Author(s):  
D. G. Manuel ◽  
B. Henry ◽  
J. Hockin ◽  
M. Naus
Keyword(s):  
Health Behavior ◽  
Focus Groups ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Long Term Care ◽  
Cross Sectional ◽  
Term Care ◽  
Staff Members ◽  
Care Facilities

Objective:To investigate the health behavior associated with influenza vaccination among healthcare workers (HCWs) in long-term–care facilities.Design:A cross-sectional, self-administered survey of HCWs, augmented with focus groups to further examine attitudes toward influenza vaccination.Setting:Two long-term–care facilities participated in the survey. The focus groups were held at one of the two facilities.Participants:All HCWs were invited to participate in the survey and all nonmanagerial staff members were invited to participate in the focus groups. The response rate for the survey was 58% (231 of 401).Results:Vaccinated HCWs had a more positive attitude toward influenza vaccination and a greater belief that the vaccine is effective. This was not accompanied by differences in vaccine knowledge or values of potential preventive outcomes. Nonvaccinated respondents were more likely to believe that other preventive measures, such as washing hands, taking vitamins and supplements, eating a nutritious diet, exercising, and taking homeopathic or naturopathic medications, were more effective than vaccination. Additional findings from the focus groups suggest that HCWs believe that the main purpose of influenza vaccination programs is to protect residents' health at the expense, potential harm, and burden of responsibility of the staff.Conclusions:This study identifies challenges to and opportunities for improving vaccination rates among HCWs. A message that emphasizes the health benefits of vaccination to staff members, such as including vaccination as part of a staff “wellness” program, may improve the credibility of influenza immunization programs and coverage rates.(Infect Control Hosp Epidemiol 2002;23:609-614).

scholarly journals Communication in Home Care: The Experiences of Formal Caregivers in Communicating with Persons Living with Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 899-899
Author(s):  
Pabiththa Kamalraj ◽  
Marie Savundranayagam ◽  
J B Orange ◽  
Marita Kloseck
Keyword(s):  
Home Care ◽  
Care Home ◽  
Personal Space ◽  
Phenomenological Approach ◽  
Structured Interviews ◽  
Term Care ◽  
Caregiver Support ◽  
Formal Caregivers ◽  
Personal Support ◽  
Hermeneutic Phenomenological

Abstract There is limited literature on formal caregivers’ communication with persons living with dementia (PLWD) in home settings. Most research comes from studies of long-term care home settings or informal home care contexts. Yet, there are expected needs and rising demands for formal caregiver support within home care. The aim of this study was to understand better the lived experiences of personal support workers (PSWs) regarding their communication with PLWD in home settings. A hermeneutic phenomenological approach guided this research. Semi-structured interviews were conducted with 15 PSW participants. Three major themes were identified through thematic analysis: (1) challenged by dementia-related impairments; (2) valuing communication in care; and (3) home is a personal space. PSWs experienced difficulties in their communication with PLWD despite recognizing the importance of communication in providing optimal home care. This suggests that while PSWs possess good intentions, they do not possess the skills necessary to ensure effective interactions. Dementia-specific education and training are recommended to improve PSWs’ communication skills and to enhance quality of care. Findings highlight further the uniqueness of the personal home space itself on PSWs experiences with communication. Aspects of the home care environment can enable, but also complicate, successful communication between PSWs and PLWD. Consequently, findings also have implications for family members of PLWD and home care employers regarding optimizing practice and improving care.

scholarly journals An Outbreak of COVID-19 among mRNA-Vaccinated Nursing Home Residents

Vaccines ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 859
Author(s):  
Fabrizio Faggiano ◽  
Maicol Andrea Rossi ◽  
Tiziana Cena ◽  
Fulvia Milano ◽  
Antonella Barale ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Long Term Care ◽  
Nursing Home Residents ◽  
Care Facility ◽  
Risk Of Infection ◽  
Term Care ◽  
Long Term Care Facility ◽  
Risk Of Death ◽  
The North

An outbreak was described among the guests of a Long-Term Care Facility in the North of Italy. Among 23 guests, 20 of whom were fully vaccinated with BNT162b2 vaccine, the outbreak led to a final count of 11 positive guests, 9 of whom were vaccinated, and 4 positive healthcare workers, of whom only 1 was vaccinated. Eight of the positive guests (six vaccinated and two unvaccinated) had symptoms that in five cases (three vaccinated and two unvaccinated) led to death. The risk of infection and the risk of death appeared not to be correlated with the health status neither with the serological titer, but only with age.

scholarly journals Household Clusters of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Suzhou, China

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Lin Yao ◽  
Peijun Tang ◽  
Hui Jiang ◽  
Binbin Gu ◽  
Ping Xu ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Clinical Characteristics ◽  
Secondary Infection ◽  
High Rate ◽  
Cross Sectional ◽  
Emerging Virus ◽  
Transmission Capability ◽  
Index Cases ◽  
Substantial Morbidity ◽  
Close Contacts

Objectives. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging virus causing substantial morbidity and mortality worldwide. We performed a cross-sectional investigation of SARS-CoV-2 clusters in Suzhou to determine the transmissibility of the virus among close contacts and to assess the demographic and clinical characteristics between index and secondary cases. Methods. We review the clustered patients with SARS-CoV-2 infections in Suzhou between 22 January and 29 February 2020. The demographic and clinical characteristics were compared between index and secondary cases. We calculated the basic reproduction number ( R 0 ) among close contacts with SLI model. Results. By 22 February, 87 patients with SARS-CoV-2 infection were reported, including 50 sporadic and 37 clustered cases, who were generated from 13 clusters. On admission, 5 (20.8%) out of 24 secondary cases were asymptomatic. The male ratio of index cases was significantly higher than that of secondary cases. Additionally, the index cases were more likely to have fever and increased CRP levels than the secondary cases. The R 0 values of clusters displayed a significantly declining trend over time for all clusters. The relative risk of infection in blood-related contacts of cases versus unrelated contacts was 1.60 for SARS-CoV-2 (95% CI: 0.42-2.95). Conclusions. In conclusion, SARS-CoV-2 has great person-to-person transmission capability among close contacts. The secondary cases are more prone to have mild symptoms than index cases. There is no increased RR of secondary infection in blood relatives versus unrelated contacts. The high rate of asymptomatic SARS-CoV-2 infections highlights the urgent need to enhance active case finding strategy for early detection of infectious patients.

scholarly journals Mild manifestations of COVID-19 in healthcare workers

2020 ◽  
Vol 14 (12) ◽  
pp. e0008950
Author(s):  
Jingwen Li ◽  
Xi Long ◽  
Qing Zhang ◽  
Xi Fang ◽  
Na Li ◽  
...  
Keyword(s):  
High Risk ◽  
Severe Acute Respiratory Syndrome ◽  
Working Conditions ◽  
Health Professionals ◽  
Medical Staff ◽  
Healthcare Workers ◽  
Clinical Characteristics

Medical staff treating Coronavirus Disease 2019 (COVID-19) patients are at high risk for exposure to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and many have been infected, which may cause panic among medical workers, their relatives, health professionals, and government leaders. We report the epidemiologic and clinical characteristics of healthcare workers and that the majority of infected medical staff had milder symptoms/conditions with a better prognosis than admitted patients. Timely improvement to medical staff’s working conditions such as allowing adequate rest and providing sufficient medical protection is extremely important.

scholarly journals YOU DON’T KNOW WHAT YOU DON’T KNOW: A SURVEY OF CAREER MENTORING NEEDS IN CLINICAL GEROPSYCHOLOGY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S852-S852
Author(s):  
Rachael Spalding ◽  
Brenna N Renn ◽  
Rebecca S Allen ◽  
Jennifer Birdsall ◽  
Barry Edelstein
Keyword(s):  
Job Search ◽  
Online Survey ◽  
Hospice Care ◽  
Cross Sectional ◽  
Term Care ◽  
Personal Support ◽  
Geriatric Mental Health ◽  
Observational Cohort ◽  
First Job ◽  
Career Preferences

Abstract Mentorship carries the potential to improve the placement, persistence, and success of those working in geriatric mental health. We sought to explore the career preferences and perceived barriers to obtaining desired jobs in the field of clinical geropsychology using an online survey of trainees and etablished professional geropsychologists. This cross-sectional observational cohort study recruited 96 respondents .Both trainees (n = 42) and professional geropsychologists (n = 54) completed an online survey. Trainees endorsed a variety of characteristics to describe their ideal jobs in geropsychology; particularly interdisciplinary teamwork and jobs in medical settings, palliative/hospice care facilities, long-term care, and geriatric outpatient care. The most commonly endorsed perceived barrier to trainees’ ideal jobs was the location of the position. Responses from professional geropsychologists elucidated factors that influenced their first job and resources that were helpful, or would have been helpful, during their job search process. The majority of respondents described the role of mentoring in career development, specifically with skill development, decision-making assistance, and personal support. Mentorship is instrumental throughout one’s training and career and offers instrumental and emotional support in job-searching and defining one’s career. Results should be considered with respect to training and retention of clinical geropsychologists given the workforce shortage, particularly in academia.

scholarly journals Epidemiological and clinical characteristics of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers in Hubei Province, China

2020 ◽  
pp. 1-7
Author(s):  
Mingyang Wu ◽  
Cong Xie ◽  
Ran Wu ◽  
Yanling Shu ◽  
Lulin Wang ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Clinical Characteristics ◽  
Disease Onset ◽  
Case Fatality ◽  
Patient Characteristics ◽  
Hubei Province ◽  
Occupational Groups ◽  
Risk Of Death ◽  
Control And Prevention ◽  
Respiratory Coronavirus

Abstract Objective: To evaluate the epidemiological and clinical characteristics of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection among healthcare workers (HCWs) in Hubei Province, China. Design: Retrospective cohort study. Setting: Hubei Provincial Center for Disease Control and Prevention. Participants: The participants in this study are cases identified by epidemiological investigation in Hubei Province, as of February 27, 2020, and were followed until March 7, 2020. In total, 1,989 HCWs and 41,137 other occupational cases were included for analysis. Methods: We used descriptive statistics to summarize patient characteristics. Results: Of 1,989 laboratory-confirmed HCWs, 297 (14.93%) had severe or critical cases, 73 (3.67%) had asymptomatic infections, and 18 died of coronavirus disease 2019 (COVID-19). The case fatality rate was 0.9%. The proportion of severe or critical cases decreased from the beginning to the end of the outbreak (from 21.29% to 3.52%), and the proportion of asymptomatic cases increased from 0.0% to 47.18%. Nearly half of HCWs with confirmed COVID-19 reported no known contact with COVID-19 patients (969, 48.72%). Fever and cough were the most common symptoms at disease onset in both HCWs and other occupational cases; however, HCWs had higher rates of fatigue (30.90% vs 25.02%; P < .001) and myalgia (19.15% vs 13.43%; P < .001). Additionally, compared with other occupational groups, HCWs were associated with a lower risk of death after adjustment for potential confounders (odd ratio [OR], 0.50; 95% confidence interval [CI], 0.30–0.79). Conclusions: Compared with COVID-19 cases in other occupational groups, HCWs with COVID-19 have half the risk of death, although they have been shown to have higher rates of fatigue and myalgia.

scholarly journals COVID-19 in French Nursing Homes during the Second Pandemic Wave: A Mixed-Methods Cross-Sectional Study

2021 ◽  
Author(s):  
Morgane Dujmovic ◽  
Thomas Roederer ◽  
Severine Frison ◽  
Carla Melki ◽  
Thomas Lauvin ◽  
...  
Keyword(s):  
Mixed Methods ◽  
Nursing Homes ◽  
Care Home ◽  
Case Fatality ◽  
Well Being ◽  
Crisis Response ◽  
Full Time ◽  
Cross Sectional ◽  
Risk Of Death ◽  
Pandemic Wave

Introduction French nursing homes were deeply affected by the first wave of the COVID-19 pandemic, with 38% of all residents infected and 5% dying. Yet, little was done to prepare these facilities for the second pandemic wave, and subsequent outbreak response strategies largely duplicated what had been done in the spring of 2020, regardless of the unique needs of the care home environment. Methods A cross-sectional, mixed-methods study using retrospective, quantitative data from residents of 14 nursing homes between November 2020 and mid-January 2021. Four facilities were purposively selected as qualitative study sites for additional in-person, in-depth interviews in January and February 2021. Results The average attack rate in the 14 participating nursing facilities was 39% among staff and 61% among residents. One-fifth (20) of infected residents ultimately died from COVID-19 and its complications. Failure-to-Thrive-Syndrome (FTTS) was diagnosed in 23% of COVID-positive residents. Those at highest risk of death were men (HR=1.78; IC95: 1.18 - 2.70; p=0.006) with FTTS (HR=4.04; IC95: 1.93 - 8.48; p<0.001) in facilities with delayed implementation of universal FFP2 masking policies (HR=1.05; IC95: 1.02 - 1.07; p<0.001). The lowest mortality was found in residents of facilities with a partial (HR=0.30; IC95: 0.18 - 0.51; p<0.001) or full-time physician on staff (HR=0.20; IC95: 0.08 - 0.53; p=0.001). Significant themes emerging from qualitative analysis centered on (i) the structural, chronic neglect of nursing homes, (ii) the negative effects of the top-down, bureaucratic nature of COVID-19 crisis response, and (iii) the counterproductive effects of lockdowns on both residents and staff. Conclusion Despite high resident mortality during the first pandemic wave, French nursing homes were ill-prepared for the second, with risk factors (especially staffing, lack of medical support, isolation/quarantine policy etc) that affected case fatality and residents' and caregivers' overall well-being and mental health.

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