Most COVID-infected healthcare workers were exposed at work early in pandemic
In its first evaluation of COVID-19 exposures among US healthcare professionals (HCPs) over the first year of the pandemic, the Centers for Disease Control and Prevention (CDC) reports that most HCPs were likely infected at work rather than in the community.
The study, published yesterday in the American Journal of Infection Control, used national surveillance data on 83,775 HCPs with information on where they were likely infected with COVID-19 from Mar 1, 2020, to Mar 31, 2021.
The researchers also used separate multivariable regression models to estimate adjusted prevalence ratios (aPRs) for links between community incidence and healthcare, household, and community exposures among 65,650 HCP infections occurring before the COVID-19 vaccine rollout.
Through May 2021, at least 500,000 US HCPs tested positive for COVID-19, and 1,653 died.
HCPs were most often exposed to SARS-CoV-2 at work (52.0%), followed by exposures at home (30.8%) and in the community (25.6%). An adjusted analyses showed that HCPs were more likely to have been exposed at work (aPR, 1.31) than at home or in the community (aPR, 0.73) under the highest versus the lowest community incidences.
Community COVID-19 incidence followed similar temporal patterns as healthcare exposures, peaking in April, July, and December 2020. Deaths peaked in April 2020, December 2020, and January 2021. The largest declines in workplace exposures were seen in June 2020, after improved infection prevention and control procedures were implemented.
After COVID-19 vaccines were rolled out to HCPs in December 2020, healthcare exposures fell from the most to the least common exposure type.
In an Association for Professionals in Infection Control and Epidemiology (APIC) news release, lead author Rachael Billock, PhD, noted that the findings differ from those of previous studies that concluded that HCPs were largely infected outside of work.
"These results emphasize the continued need for improved infection prevention and control measures in occupational settings, as well as the need for improved surveillance to identify and reduce occupational exposures to SARS-CoV-2 among HCPs and all workers," she said.
In particular, researchers called for adequate infection-control training, nonpunitive sick leave policies, COVID-19 screening, and availability of effective personal protective equipment.
Apr 13 Am J Infect Control study
Apr 14 APIC news release
Patients at risk for cardiovascular disease suffer more severe COVID-19
New research to be presented at the end of the month at the European Congress of Clinical Microbiology & Infectious Diseases (ECCMID) meeting suggests that people with elevated risk of developing a stroke or heart attack over the next 10 years are nearly three times as likely to be hospitalized and require intensive care unit (ICU) treatment, and six times as likely to die from COVID-19 compared with those at low cardiovascular risk.
The study was conducted by a team of researchers at the London School of Hygiene & Tropical Medicine, and used electronic medical records of 949,973 adults (aged 40 to 84) in England to determine the incidence and risk of COVID-19 infection (as confirmed by lab testing) and severe COVID-19 (based on hospital admission, ICU admission, and death).
The adults were classified as having an increased risk for future cardiovascular disease based on a range of factors, including body mass index, smoking history, blood pressure, cholesterol, age, social deprivation, and ethnicity. Based on those criteria, 113,142 (12%) had existing cardiovascular disease, 303,558 (32%) were classified as being at raised risk, and 533,273 (56%) were at low risk.
The likelihood of COVID-19 infection was similar for people with and without cardiovascular disease risk (4.9 vs 4.5 cases per 1,000, respectively), but people at increased risk for heart problems had more severe COVID-19.
"Rates of death (311 per 1,000 vs 24 per 1,000), ICU admission (97 per 1,000 vs 36 per 1,000) and hospitalization (607 per 1,000 vs 169 per 1,000) were substantially higher in those with raised cardiovascular risk," according to a press release on the research.
"It is important that people at greater risk of developing cardiovascular disease should be encouraged to take up COVID-19 vaccines and boosters," said researcher Charlotte Warren-Gash, PhD.
Apr 13 ECCMID press release
Five states report more avian flu in poultry flocks
Five states reported more highly pathogenic avian flu outbreaks, including Nebraska, where the virus struck a massive layer farm housing more than 1.7 million birds, according to the latest updates from federal and state agriculture departments.
Nebraska's outbreak occurred in Dixon County in the far northeastern corner of the state near the borders with Iowa and South Dakota. The Nebraska Department of Agriculture (NDA) said the outbreak is the state's sixth and that depopulation is under way.
Elsewhere in the Midwest, North Dakota reported its eighth outbreak, which hit a backyard flock in Sheridan County in the central part of the state, and Wisconsin confirmed an outbreak at a turkey farm in Barron County that houses 52,000 bird, according to updates from the US Department of Agriculture (USDA) Animal and Plant Health Inspection Service (APHIS).
In other parts of the nation, North Carolina reported another broiler farm in Wayne County at a facility housing nearly 90,000 birds. So far, the state has had nine outbreaks, all involving commercial poultry. And finally, Montana reported another outbreak in backyard birds, its third. The latest one struck a flock of 21 birds in Toole County on the border with Canada.
The outbreaks are part of ongoing spread of the Eurasian H5N1 strain, which has now led to the loss of more than 25.8 million birds.
Apr 13 NDA statement
USDA APHIS poultry avian flu update page
In related international developments, Hungary reported another H5N1 outbreak in poultry, this time at a farm raising foie gras geese in Bacs Kiscun County in the south, according to a notification from the World Organisation for Animal Health (OIE). The virus killed 24 of 3,510 susceptible birds.
Apr 14 OIE report on H5N1 in Hungary