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Effect of a national policy of universal masking and uniform criteria for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) exposure on hospital staff infection and quarantine

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  03 May 2021

Elizabeth Temkin ,
Mitchell J. Schwaber ,
Azza Vaturi ,
Eyal Nadir ,
Rama Zilber ,
Osnat Barel ,
Lidia Pavlov  and
Yehuda Carmeli
Elizabeth Temkin*
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel
Mitchell J. Schwaber
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Azza Vaturi
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel
Eyal Nadir
Affiliation:
Division of Epidemiology, Israel Ministry of Health, Jerusalem, Israel
Rama Zilber
Affiliation:
Nursing Administration, Israel Ministry of Health, Jerusalem, Israel
Osnat Barel
Affiliation:
Nursing Administration, Israel Ministry of Health, Jerusalem, Israel
Lidia Pavlov
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel
Yehuda Carmeli
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
*
Author for correspondence: Elizabeth Temkin, E-mail: [email protected]
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Abstract

Objective:

To determine the effect of 2 regulations issued by the Israel Ministry of Health on coronavirus disease 2019 (COVID-19) infections and quarantine among healthcare workers (HCWs) in general hospitals.

Design:

Before-and-after intervention study without a control group (interrupted time-series analysis).

Setting:

All 29 Israeli general hospitals.

Participants:

All HCWs.

Interventions:

Two national regulations were issued on March 25, 2020: one required universal masking of HCWs, patients, and visitors in general hospitals and the second defined what constitutes HCW exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and when quarantine is required.

Results:

Overall, 283 HCWs were infected at work or from an unknown source. Before the intervention, the number of HCWs infected at work increased by 0.5 per day (95% confidence interval [CI], 0.2–0.7; P < .001), peaking at 16. After the intervention, new infections declined by 0.2 per day (95% CI, −0.3 to −0.1; P < .001). Before the intervention, the number of HCWs in quarantine or isolation increased by 97 per day (95% CI, 90–104; P < .001), peaking at 2,444. After the intervention, prevalence decreased by 59 per day (95% CI, −72 to −46; P < .001). Epidemiological investigations determined that the most common source of HCW infection (58%) was a coworker.

Conclusions:

Universal masking in general hospitals reduced the risk of hospital-acquired COVID-19 among HCWs. Universal masking combined with uniform definitions of HCW exposure and criteria for quarantine limited the absence of HCWs from the workforce.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 6 , June 2022 , pp. 757 - 763
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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References

COVID-19: protecting healthcare workers. Lancet 2020;395:922.Google Scholar
Coronavirus disease 2019 (COVID-19). Cases and deaths among healthcare personnel. US Centers for Disease Control and Prevention website. https://covid.cdc.gov/covid-data-tracker/?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fcases-updates%2Fcases-in-us.html#health-care-personnel. Accessed April 16, 2021.Google Scholar
Mask use in the context of COVID-19. World Health Organization website. https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak. Published 2020. Accessed April 16, 2021.Google Scholar
Wang, X, Ferro, EG, Zhou, G, Hashimoto, D, Bhatt, DL. Association between universal masking in a healthcare system and SARS-CoV-2 positivity among healthcare workers. JAMA 2020;324:703–704.CrossRefGoogle Scholar
Seidelman, JL, Lewis, SS, Advani, SD, et al. Universal masking is an effective strategy to flatten the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) healthcare worker epidemiologic curve. Infect Control Hosp Epidemiol 2020;41:1466–1467.Google ScholarPubMed
Stone, SP, Cooper, BS, Kibbler, CC, et al. The ORION statement: guidelines for transparent reporting of outbreak reports and intervention studies of nosocomial infection. Lancet Infect Dis 2007;7:282–288.CrossRefGoogle ScholarPubMed
Linden, A. Conducting interrupted time-series analysis for single- and multiple-group comparisons. Stata J 2015;15:480–500.CrossRefGoogle Scholar
Backer, JA, Klinkenberg, D, Wallinga, J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20–28 January 2020. Euro Surveill 2020;25(5):2000062.Google ScholarPubMed
Contejean, A, Leporrier, J, Canouï, E, et al. Comparing dynamics and determinants of SARS-CoV-2 transmissions among healthcare workers of adult and pediatric settings in central Paris. Clin Infect Dis 2021;72:257–264.CrossRefGoogle ScholarPubMed
Klompas, M, Morris, CA, Sinclair, J, Pearson, M, Shenoy, ES. Universal masking in hospitals in the COVID-19 era. N Engl J Med 2020;382(21):e63.CrossRefGoogle ScholarPubMed
Infection prevention and control during healthcare when novel coronavirus (nCoV) infection is suspected. World Health Organization website. https://www.who.int/publications/i/item/10665-331495. Accessed April. 16, 2021.Google Scholar
Advice on the use of masks in the context of COVID-19: interim guidance, 6 April 2020. World Health Organization website. https://apps.who.int/iris/handle/10665/331693. Published 2020. Accessed April 16, 2021.Google Scholar
Zhao, Y, Liang, W, Luo, Y, et al. Personal protective equipment protecting healthcare workers in the Chinese epicenter of COVID-19. Clin Microbiol Infect 2020;26:1716–1718.CrossRefGoogle Scholar
Nguyen, LH, Drew, DA, Graham, MS, et al. Risk of COVID-19 among frontline healthcare workers and the general community: a prospective cohort study. Lancet Public Heal 2020;5:e475–e483.CrossRefGoogle Scholar
Çelebi, G, Pişkin, N, Bekleviç, AÇ, et al. Specific risk factors for SARS-CoV-2 transmission among healthcare workers in a university hospital. Am J Infect Control 2020;48:1225–1230.CrossRefGoogle ScholarPubMed
Suárez-García, I, Martínez de Aramayona López, MJ, Vicente, AS, Abascal, PL. SARS-CoV-2 infection among healthcare workers in a hospital in Madrid, Spain. J Hosp Infect 2020;106:357–363.CrossRefGoogle Scholar
Gagneux-Brunon, A, Pelissier, C, Gagnaire, J, et al. SARS-CoV-2 infection: advocacy for training and social distancing in healthcare settings. J Hosp Infect. 2020;106:610–612.CrossRefGoogle ScholarPubMed
Morice, AH. Editorial comment on: global burden of COVID-19 pandemic on healthcare workers. ERJ Open Res 2020;6:50195–52020.CrossRefGoogle ScholarPubMed
Houghton, C, Meskell, P, Delaney, H, et al. Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database Syst Rev 2020;4:CD013582.Google Scholar
Katz, E. VA Instructs coronavirus-exposed staff to continue working, places those who don’t in AWOL status. Goverment Executive 2020 website. https://www.govexec.com/workforce/2020/04/va-instructs-coronavirus-exposed-staff-continue-working-places-those-who-dont-awol-status/164693/. Published April 17, 2020. Accessed May 3, 2021.Google Scholar
Rickman, HM, Rampling, T, Shaw, K, et al. Nosocomial transmission of COVID-19: a retrospective study of 66 hospital-acquired cases in a London teaching hospital. Clin Infect Dis 2021;72:690–693.CrossRefGoogle Scholar
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