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. 2022 Sep:122:115-122.
doi: 10.1016/j.ijid.2022.05.013. Epub 2022 May 13.

Ethnicity and risk for SARS-CoV-2 infection among the healthcare workforce: Results of a retrospective cohort study in rural United Kingdom

Maxime Inghels  1 , Ros Kane  2 , Priya Lall  3 , David Nelson  4 , Agnes Nanyonjo  4 , Zahid Asghar  2 , Derek Ward  5 , Tracy McCranor  6 , Tony Kavanagh  6 , Todd Hogue  7 , Jaspreet Phull  6 , Frank Tanser  8
Affiliations

Ethnicity and risk for SARS-CoV-2 infection among the healthcare workforce: Results of a retrospective cohort study in rural United Kingdom

Maxime Inghels et al. Int J Infect Dis. 2022 Sep.

Abstract

Background: The reason why Black and South Asian healthcare workers are at a higher risk for SARS-CoV-2 infection remain unclear. We aimed to quantify the risk for SARS-CoV-2 infection among healthcare staff who belong to the ethnic minority and elucidate pathways of infection.

Methods: A one-year follow-up retrospective cohort study has been conducted among National Health Service employees who were working at 123 facilities in Lincolnshire, UK.

Results: Overall, 13,366 professionals were included. SARS-CoV-2 incidence per person-year was 5.2% (95% CI: 3.6-7.6%) during the first COVID-19 wave (January-August 2020) and 17.2% (13.5-22.0%) during the second wave (September 2020-February 2021). Compared with White staff, Black and South Asian employees were at higher risk for SARS-CoV-2 infection during both the first wave (hazard ratio, HR 1.58 [0.91-2.75] and 1.69 [1.07-2.66], respectively) and the second wave (HR 2.09 [1.57-2.76] and 1.46 [1.24-1.71]). Higher risk for SARS-CoV-2 infection persisted even after controlling for age, sex, pay grade, residence environment, type of work, and time exposure at work. Higher adjusted risk for SARS-CoV-2 infection were also found among lower-paid health professionals.

Conclusion: Black and South Asian health workers continue to be at higher risk for SARS-CoV-2 infection than their White counterparts. Urgent interventions are required to reduce SARS-CoV-2 infection in these ethnic groups.

Keywords: COVID-19; Ethnicity; Health profession; Risk factors; SARS-CoV-2; United Kingdom.

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Figures

Figure 1
Figure 1
Evolution of the number of positive SARS-CoV-2 test by facility size. Note1: each rectangle represents a facility. The height of the rectangle is depending on the number of documented SARS-CoV-2-positive tests. Note2: Data were obtained through February 10, 2021.
Figure 2
Figure 2
Cumulative event curves, on the basis of Kaplan-Meyer estimates of COVID-19-positive tests among healthcare professional by ethnic background (A), by staff group (B), by sex (C), and NHS salary grade (D). NHS: National Health Service. Note1: two-sided P-values were computed using the log-rank test. Note2: NHS body band 1 is corresponding to the lower salary grade while NHS body band 9 is corresponding to the higher pay grade
Figure 3
Figure 3
Hazard ratio of COVID-19 positive test among healthcare professional by time period, bivariate and multivariate Cox models. NHS: National Health Service. * adjusted for age, contract type, index of multiple deprivation, urban-rural classification, number of non-COVID diseases, number of isolation days and number of other leave of absence days. The associated result table with all the covariables can be found in Table S2 and Table S3 in supplementary materials Note1: two-sided P-values were computed using Wald-test adjusted for clustering. Note2: NHS body band 1 is corresponding to the lower salary grade while NHS body band 9 is corresponding to the higher pay grade Note3: logarithmic scale has been used for the hazard ratio axis
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