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Investigations, actions and learning from an outbreak of SARS-CoV-2 infection among healthcare workers in the United Kingdom

Investigations, actions and learning from an outbreak of SARS-CoV-2 infection among healthcare workers in the United Kingdom
Investigations, actions and learning from an outbreak of SARS-CoV-2 infection among healthcare workers in the United Kingdom
Background: We report an outbreak of SARS coronavirus-2 (SARS-CoV-2) infection among healthcare workers (HCW) in an NHS elective healthcare facility.

Methodology: A narrative chronological account of events after declaring an outbreak of SARS-CoV-2 among HCWs. As part of the investigations, HCWs were offered testing during the outbreak. These were: (1) screening by real-time reverse transcriptase polymerase chain reaction (RT- PCR) to detect a current infection; and (2) serum samples to determine seroprevalence.

Results: Over 180 HCWs were tested by real-time RT-PCR for SARS-CoV-2 infection. The rate of infection was 15.2% (23.7% for clinical or directly patient-facing HCWs vs. 4.8% in non-clinical non-patient-facing HCWs). Of the infected HCWs, 57% were asymptomatic. Seroprevalence (SARS-CoV-2 IgG) among HCWs was 13%. It was challenging to establish an exact source for the outbreak. The importance of education, training, social distancing and infection prevention practices were emphasised. Additionally, avoidance of unnecessary transfer of patients and minimising cross-site working for staff and early escalation were highlighted. Establishing mass and regular screening for HCWs are also crucial to enabling the best care for patients while maintaining the wellbeing of staff.

Conclusion: To our knowledge, this is the first UK outbreak report among HCWs and we hope to have highlighted some key issues and learnings that can be considered by other NHS staff and HCWs globally when dealing with such a task in future.
COVID-19, novel coronavirus, pandemic, SARS-CoV-2 IgG
1757-1774
156-161
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Pelosi, Emanuela
d07026a0-0508-47d1-92de-b99c22aa29da
Mahobia, Nitin
cf61df75-633e-4622-abc7-271979c13d3f
White, Nicola
c0d3a08d-fe0d-42af-a13c-ebeca35bc96e
Labdon, Christopher
3b8f8716-7b15-49a1-95de-41dcfdc4ba33
Ahmad-Saeed, Nusreen
e71dce99-ff6a-4b66-8630-0b21f2c7ff21
Grieves, Ashley
425457b7-a576-4da8-862f-65cdec25e220
Johnstone, Penelope
f7c368b7-7ffa-4429-868b-2393fbf2ee06
Higgs, David
3062fe75-bd0e-48f0-838b-0f16e0a75e35
Jeramiah, Sarah
3691d63a-6dae-4f53-85c6-d01a42786202
Dailly, Sue
b52ec388-e301-4a3a-9852-c366486bacd3
Henderson, Thelma
01ca27b1-c43d-439f-95e0-1f3f61741337
Stringfellow, Mary
d1286c8e-91f1-40ac-9a30-724e07480524
Wilson-Davies, Eleri
d00864cd-4409-4a8e-831c-464c9cebe7ee
Grundy, Paul
0ceddba7-59f8-469f-8b50-4d08936e92a0
Saeed, Kordo
87cb67e5-71e8-4759-bf23-2ea00ebd8b39
Pelosi, Emanuela
d07026a0-0508-47d1-92de-b99c22aa29da
Mahobia, Nitin
cf61df75-633e-4622-abc7-271979c13d3f
White, Nicola
c0d3a08d-fe0d-42af-a13c-ebeca35bc96e
Labdon, Christopher
3b8f8716-7b15-49a1-95de-41dcfdc4ba33
Ahmad-Saeed, Nusreen
e71dce99-ff6a-4b66-8630-0b21f2c7ff21
Grieves, Ashley
425457b7-a576-4da8-862f-65cdec25e220
Johnstone, Penelope
f7c368b7-7ffa-4429-868b-2393fbf2ee06
Higgs, David
3062fe75-bd0e-48f0-838b-0f16e0a75e35
Jeramiah, Sarah
3691d63a-6dae-4f53-85c6-d01a42786202
Dailly, Sue
b52ec388-e301-4a3a-9852-c366486bacd3
Henderson, Thelma
01ca27b1-c43d-439f-95e0-1f3f61741337
Stringfellow, Mary
d1286c8e-91f1-40ac-9a30-724e07480524
Wilson-Davies, Eleri
d00864cd-4409-4a8e-831c-464c9cebe7ee
Grundy, Paul
0ceddba7-59f8-469f-8b50-4d08936e92a0

Saeed, Kordo, Pelosi, Emanuela, Mahobia, Nitin, White, Nicola, Labdon, Christopher, Ahmad-Saeed, Nusreen, Grieves, Ashley, Johnstone, Penelope, Higgs, David, Jeramiah, Sarah, Dailly, Sue, Henderson, Thelma, Stringfellow, Mary, Wilson-Davies, Eleri and Grundy, Paul (2021) Investigations, actions and learning from an outbreak of SARS-CoV-2 infection among healthcare workers in the United Kingdom. Journal of Infection Prevention, 22 (4), 156-161. (doi:10.1177/1757177420976798).

Record type: Article

Abstract

Background: We report an outbreak of SARS coronavirus-2 (SARS-CoV-2) infection among healthcare workers (HCW) in an NHS elective healthcare facility.

Methodology: A narrative chronological account of events after declaring an outbreak of SARS-CoV-2 among HCWs. As part of the investigations, HCWs were offered testing during the outbreak. These were: (1) screening by real-time reverse transcriptase polymerase chain reaction (RT- PCR) to detect a current infection; and (2) serum samples to determine seroprevalence.

Results: Over 180 HCWs were tested by real-time RT-PCR for SARS-CoV-2 infection. The rate of infection was 15.2% (23.7% for clinical or directly patient-facing HCWs vs. 4.8% in non-clinical non-patient-facing HCWs). Of the infected HCWs, 57% were asymptomatic. Seroprevalence (SARS-CoV-2 IgG) among HCWs was 13%. It was challenging to establish an exact source for the outbreak. The importance of education, training, social distancing and infection prevention practices were emphasised. Additionally, avoidance of unnecessary transfer of patients and minimising cross-site working for staff and early escalation were highlighted. Establishing mass and regular screening for HCWs are also crucial to enabling the best care for patients while maintaining the wellbeing of staff.

Conclusion: To our knowledge, this is the first UK outbreak report among HCWs and we hope to have highlighted some key issues and learnings that can be considered by other NHS staff and HCWs globally when dealing with such a task in future.

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More information

Accepted/In Press date: 2020
e-pub ahead of print date: 14 December 2020
Published date: July 2021
Additional Information: Funding Information: We would like to thank patients and relatives at NHWH and staff who not only provided samples to investigate this outbreak, but also for their cooperation and professionalism during those challenging times. We would also like to thank all staff at the Southampton Specialist Virology Centre at the University Hospital Southampton, not only for their support with investigating this outbreak, but also for their continuous enthusiasm throughout the pandemic. We thank the clinical and nursing staff at UHS for re-accepting and looking after patients from NHWH and thanks to the managers who also provided valuable support to control this outbreak. The author(s) received no financial support for the research, authorship, and/or publication of this article. Publisher Copyright: © The Author(s) 2020. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: COVID-19, novel coronavirus, pandemic, SARS-CoV-2 IgG

Identifiers

Local EPrints ID: 448416
URI: http://eprints.soton.ac.uk/id/eprint/448416
ISSN: 1757-1774
PURE UUID: 8e1388fb-ceff-4f87-b459-35ae410b2a16
ORCID for Kordo Saeed: ORCID iD orcid.org/0000-0003-0123-0302

Catalogue record

Date deposited: 22 Apr 2021 16:30
Last modified: 17 Mar 2024 03:56

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Contributors

Author: Kordo Saeed ORCID iD
Author: Emanuela Pelosi
Author: Nitin Mahobia
Author: Nicola White
Author: Christopher Labdon
Author: Nusreen Ahmad-Saeed
Author: Ashley Grieves
Author: Penelope Johnstone
Author: David Higgs
Author: Sarah Jeramiah
Author: Sue Dailly
Author: Thelma Henderson
Author: Mary Stringfellow
Author: Eleri Wilson-Davies
Author: Paul Grundy

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