CHU de Québec-Université Laval Research Center, Québec, Québec, Canada.
Department of Social and Preventive Medicine, Laval University, Québec, Québec, Canada.
Infect Control Hosp Epidemiol. 2022 Apr;43(4):481-489. doi: 10.1017/ice.2021.160. Epub 2021 Apr 15.
In this study, we aimed to (1) estimate the severe acute respiratory coronavirus 2 (SARS-CoV-2) infection rate and the secondary attack rate among healthcare workers (HCWs) in Québec, the most affected province of Canada during the first wave; (2) describe the evolution of work-related exposures and infection prevention and control (IPC) practices in infected HCWs; and (3) compare the exposures and practices between acute-care hospitals (ACHs) and long-term care facilities (LTCFs).
Survey of cases.
The study included Québec HCWs from private and public institutions with laboratory-confirmed coronavirus disease 2019 (COVID-19) diagnosed between March 1 and June 14, 2020. HCWs aged ≥18 years who worked during the exposure period and survived their illness were eligible for the survey.
After obtaining consent, 4,542 HCWs completed a standardized questionnaire. COVID-19 rates and proportions of exposures and practices were estimated and compared between ACHs and LTCFs.
HCWs represented 13,726 (25%) of 54,005 reported COVID-19 cases in Québec and had an 11-times greater rate of COVID-19 than non-HCWs. Their secondary household attack rate was 30%. Most affected occupations were healthcare support workers, nurses and nurse assistants working in LTCFs (45%) and ACHs (30%). Compared to ACHs, HCWs in LTCFs had less training, higher staff mobility between working sites, similar PPE use, and better self-reported compliance with at-work physical distancing. Suboptimal IPC practices declined over time but were still present at the end of the first wave.
Québec HCWs and their families were severely affected during the first wave of COVID-19. Insufficient pandemic preparedness and suboptimal IPC practices likely contributed to high transmission in both LTCFs and ACHs.
本研究旨在：(1) 估计加拿大受影响最严重省份魁北克省医护人员（HCWs）中严重急性呼吸冠状病毒 2 型（SARS-CoV-2）感染率和二次攻击率；(2) 描述感染 HCWs 中与工作相关的暴露和感染预防与控制（IPC）措施的演变；(3) 比较急性护理医院（ACHs）和长期护理设施（LTCFs）之间的暴露和措施。
病例调查。
本研究包括魁北克省私营和公共机构的 HCWs，这些 HCWs 实验室确诊为 2020 年 3 月 1 日至 6 月 14 日期间的新型冠状病毒病 2019（COVID-19）。在暴露期间工作并幸存的年龄≥18 岁的 HCWs 有资格参加调查。
在获得同意后，4542 名 HCWs 完成了一份标准化问卷。估计了 ACHs 和 LTCFs 之间的 COVID-19 发病率以及暴露和措施的比例，并进行了比较。
HCWs 占魁北克省报告的 54005 例 COVID-19 病例的 13.726（25%），其 COVID-19 发病率是未感染 HCWs 的 11 倍。他们的家庭二次攻击率为 30%。受影响最大的职业是在 LTCFs（45%）和 ACHs（30%）工作的医疗支持人员、护士和护士助理。与 ACHs 相比，LTCFs 的 HCWs 培训较少，工作地点之间的员工流动性更高，个人防护设备（PPE）使用相似，但自我报告的工作中保持身体距离的合规性更好。随着时间的推移，IPC 措施不理想的情况有所减少，但在第一波疫情结束时仍然存在。
魁北克省的 HCWs 及其家属在 COVID-19 第一波疫情中受到了严重影响。大流行准备不足和 IPC 措施不理想可能导致 LTCFs 和 ACHs 中的高传播率。
