High numbers of COVID-19 patients transit through non-COVID wards, and associated healthcare workers have high infection rates: An observational cross-sectional study

Abstract

Infection risk is high in healthcare workers working with COVID-19 patients but the risk in non-COVID clinical environments is less clear. We measured infection rates early in the pandemic by SARS-CoV-2 antibody and/or a positive PCR test in 1118 HCWs within various hospital environments with particular focus on non-COVID clinical areas. Infection risk on non-COVID wards was estimated through the surrogate metric of numbers of patients transferred from a non-COVID to a COVID ward. Staff infection rates increased with likelihood of COVID exposure and suggested high risk in non-COVID clinical areas (non patient-facing 23.2% versus patient-facing in either non-COVID environments 31.5% or COVID wards 44%). High numbers of patients admitted to COVID wards had initially been admitted to designated non-COVID wards (22-48% at peak). Infection risk was high during a pandemic in all clinical environments and non-COVID designation may provide false reassurance. Our findings support the need for common personal protective equipment standards in all clinical areas, irrespective of COVID/non-COVID designation.

Fig 1. Adjusted predicted probabilities of infection for the patient facing variable using different patient-facing groupings where these are adjusted for age, gender, BAME, public transport and household contacts.

Non patient-facing cohort compared to all patient-facing subcategories.

Fig 2. Breakdown of the routes of admission of adult COVID patients into a COVID ward during the initial pandemic.

* Start of national UK lockdown. ** Mandatory admissions testing commenced.