Health Care Worker SARS-CoV-2 Infection Is Flying Under the Radar | Health Care Workforce | JAMA | JAMA Network
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October 27, 2020

Health Care Worker SARS-CoV-2 Infection Is Flying Under the Radar

JAMA. 2020;324(16):1600. doi:10.1001/jama.2020.19554

A high percentage of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among health care workers appear to go undetected, often because they have mild or no symptoms and workplace testing isn’t sufficient, investigators from a multistate hospital network reported.

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The study was conducted by the Influenza Vaccine Effectiveness in the Critically Ill (IVY) Network, a collaboration of US medical centers that studies influenza and coronavirus disease 2019 (COVID-19). The network enrolled 3248 clinicians who regularly cared for patients with the disease between April and June at 13 of the network’s medical centers located in 12 states.

Overall, 194, or 6%, of the participants tested positive for antibodies to SARS-CoV-2. Among them, 69% reported that they had never been diagnosed with COVID-19, 29% didn’t recall having any symptoms during the previous few months, and 44% didn’t suspect they’d had the disease.

About 90% of the participants reported always wearing a surgical mask, N95 respirator, or powered air purifying respirator while caring for patients. The clinicians who did so were less likely to test positive for SARS-CoV-2 than clinicians who didn’t use face coverings during all patient encounters. Personal protective equipment (PPE) shortages were reported by 12% of participants. The clinicians who were short of PPE were more likely to test positive than those with sufficient supplies.

“Consistent with persons in the general population with SARS-CoV-2 infection, many frontline [health care personnel] with SARS-CoV-2 infection might be asymptomatic or minimally symptomatic during infection, and infection might be unrecognized,” wrote lead author Wesley Self, MD, associate professor of emergency medicine at Vanderbilt University, and his colleagues. “Enhanced screening, including frequent testing of frontline [health care personnel], and universal use of face coverings in hospitals are two strategies that could reduce SARS-CoV-2 transmission.”

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