Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, United States.
JMIR Public Health Surveill. 2020 Dec 3;6(4):e20260. doi: 10.2196/20260.
As the number of COVID-19 cases in the US continues to increase and hospitals experience shortage of personal protective equipment (PPE), health care workers have been disproportionately affected. However, since COVID-19 testing is now easily available, there is a need to evaluate whether routine testing should be performed for asymptomatic health care workers.
This study aimed to provide a quantitative analysis of the predicted impact that regular testing of health care workers for COVID-19 may have on the prevention of the disease among emergency department patients and staff.
Using publicly available data on COVID-19 cases and emergency department visits, as well as internal hospital staffing information, we developed a mathematical model to predict the impact of periodic COVID-19 testing of asymptomatic staff members of the emergency department in COVID-19-affected regions. We calculated various transmission constants based on the Diamond Princess cruise ship data, used a logistic model to calculate new infections, and developed a Markov model based on the average incubation period for COVID-19.
Our model predicts that after 180 days, with a transmission constant of 1.219e-4 new infections/person, weekly COVID-19 testing of health care workers would reduce new health care worker and patient infections by approximately 3%-5.9%, and biweekly testing would reduce infections in both by 1%-2.1%. At a transmission constant of 3.660e-4 new infections/person, weekly testing would reduce infections by 11%-23% and biweekly testing would reduce infections by 5.5%-13%. At a lower transmission constant of 4.067e-5 new infections/person, weekly and biweekly COVID-19 testing for health care workers would result in an approximately 1% and 0.5%-0.8% reduction in infections, respectively.
Periodic COVID-19 testing for emergency department staff in regions that are heavily affected by COVID-19 or are facing resource constraints may significantly reduce COVID-19 transmission among health care workers and previously uninfected patients.
随着美国 COVID-19 病例数量持续增加,医院面临个人防护设备(PPE)短缺,医护人员受到的影响尤为严重。然而,由于 COVID-19 检测现在已经很容易进行,因此需要评估是否应对无症状医护人员进行常规检测。
本研究旨在对定期对 COVID-19 无症状医护人员进行检测对预防急诊科患者和医护人员感染 COVID-19 的影响进行定量分析。
我们使用 COVID-19 病例和急诊科就诊的公开数据以及医院内部人员配备信息,开发了一个数学模型来预测在 COVID-19 流行地区对急诊科无症状员工进行定期 COVID-19 检测的影响。我们根据“钻石公主”号邮轮数据计算了各种传播常数,使用逻辑模型计算新感染病例,并基于 COVID-19 的平均潜伏期开发了一个马尔可夫模型。
我们的模型预测,在 180 天后,如果传播常数为 1.219e-4 个新感染/人,那么对医护人员进行每周一次的 COVID-19 检测,将使新的医护人员和患者感染人数减少约 3%-5.9%,每两周检测一次则会使两者的感染人数减少 1%-2.1%。在传播常数为 3.660e-4 个新感染/人的情况下,每周检测将减少 11%-23%的感染,每两周检测将减少 5.5%-13%的感染。在传播常数较低的 4.067e-5 个新感染/人情况下,对急诊科员工进行每周和每两周一次的 COVID-19 检测,分别会使感染人数减少约 1%和 0.5%-0.8%。
在 COVID-19 严重流行或资源紧张的地区,对急诊科员工进行定期 COVID-19 检测可能会显著降低医护人员和之前未感染患者之间的 COVID-19 传播。