Many SARS-CoV-2 infections in frontline health care personnel may go undetected
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Among more than 3,200 frontline U.S. health care personnel, around 6% had evidence of a prior SARS-CoV-2 infection — but a high proportion of infections went previously undetected, researchers reported in MMWR.
Additionally, the study found that SARS-CoV-2 seroprevalence was lower among health care personnel (HCP) who reported always wearing a face mask compared with those who did not.
“Universal use of face coverings and lowering clinical thresholds for testing could be important strategies for reducing hospital transmission.” Wesley H. Self, MD, MPH, associate professor of emergency medicine at Vanderbilt University Medical Center, and colleagues wrote.
Self and colleagues collected serum specimens from frontline HCP who had contact with COVID-19 patients at 13 U.S. academic medical centers in California, Colorado, Maryland, Massachusetts, Minnesota, New York, North Carolina, Ohio, Oregon, Tennessee, Utah and Washington. They asked participants to report potential COVID-19 symptoms experienced since Feb. 1, 2020, prior testing for SARS-CoV-2, and their use of PPE over the previous week.
There were 3,248 respondents. Of the HCP included in the study, 5.6% had antibody evidence of a prior SARS-CoV-2 infection, and 29% with SARS-CoV-2 antibodies were asymptomatic in previous months. Additionally, 69% of the respondents did not have a previous diagnosis of COVID-19. The prevalence of SARS-CoV-2 was lower in respondents who reported always wearing a face mask during patient care (6%) when compared with HCPs who did not (9%).
“Understanding the prevalence of and factors associated with SARS-CoV-2 infection among frontline HCPs who care for COVID-19 patients are important for protecting both HCPs and their patients,” the authors wrote.
Perspective
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Carlos del Rio, MD
This is an important study showing that, in general, SARS-CoV-2 infection among HCPs is less than 10%, and only the site in New York City had a seroprevalence of 30%. Also, among many of the sites, the seroprevalence among HCPs was lower than that in the community. The study identified two factors associated with SARS-CoV-2 infection among HCPs — PPE shortages and interacting with a patient without wearing a face mask. These findings thus have important policy implications: We need to ensure that there are no shortages of PPE for HCPs, and mandate the use of face masks in each and every patient-facing encounter — an important strategy to protect HCPs from infection.
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