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Coronavirus 2019 (COVID-19) Infections Among Healthcare Workers, Los Angeles County, February – May 2020

Our take —

Healthcare workers, both those with direct patient contact and non-clinical staff, represented close to 10% of all confirmed COVID-19 cases in Los Angeles County. Half of these confirmed cases were from long-term care facilities, and nurses were the occupational group most affected. Overall, healthcare workers make up a substantial proportion of cases, but reported lower rates of both hospitalization and death compared to all cases. These findings provide evidence about how to direct funding related to personal protective equipment and other resources to reduce transmission.

Study design

Case Series

Study population and setting

From the start of the pandemic to May 31, 2020, Los Angeles County was notified of all confirmed COVID-19 cases and attempted to conduct standardized interviews with positive cases to determine occupational setting, occupational role, date of symptom onset, date last worked, known exposure, and whether or not the patient was hospitalized. Interviews were completed for 60% of all reported cases. Healthcare workers were defined as those working or volunteering in healthcare settings and included those that had both direct patient interaction and non-clinical staff.

Summary of Main Findings

During this period, a total of 57,118 confirmed cases were reported in Los Angeles County of which 5458 (9.6%) were confirmed among healthcare workers; 5118 of these (93.8%) had complete information. Half of all confirmed healthcare worker cases (46.6%) were from long-term care facilities; 27.7% were from hospitals; 6.9% worked at medical offices. Nurses represented about half of all cases (49.4%). Close to half had an unknown exposure to SARS-CoV-2 (45.1%); healthcare related exposures within their facility accounted about 44% of all exposures. Close to 70% reported working during their estimated infectious period. About 5% reported requiring hospitalization due to COVID-19, and 40 deaths (0.7%) were reported.

Study Strengths

This study represents all identified healthcare worker cases of COVID-19 since the start of the pandemic in a large urban setting in the United States.

Limitations

While the study presented the percentage of healthcare workers broken down by occupational setting and role, there is no discussion on the total number or proportion of these disaggregated groups, e.g. burden among hospital workers versus workers from long-term care facilities, or the total number or proportion of doctors versus the total number of nurses.

Value added

This study presents the relative burden of COVID-19 among different groups of healthcare workers in Los Angeles County, and could aid in resource allocation planning.

This review was posted on: 11 September 2020