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. 2023 Oct 20;3(1):e180.
doi: 10.1017/ash.2023.442. eCollection 2023.

SARS-CoV-2 infection among healthcare workers: the role of occupational and household exposures during the first three pandemic waves in Quebec, Canada

Affiliations

SARS-CoV-2 infection among healthcare workers: the role of occupational and household exposures during the first three pandemic waves in Quebec, Canada

Sara Carazo et al. Antimicrob Steward Healthc Epidemiol. .

Abstract

Objective: We described the evolution of SARS-CoV-2 source of infection in a cohort of healthcare workers (HCWs) of Quebec, Canada, during the first three pandemic waves. We also estimated their household secondary attack rate (SAR) and its risk factors.

Design: Cross-sectional surveys.

Participants: HCWs with a SARS-CoV-2 infection confirmed by polymerasa chain reaction and diagnosed between March 2020 and May 2021.

Methods: We collected demographic, clinical, vaccination, and employment information, self-reported perceived source of infection, and transmission to household members during the first three pandemic waves. SAR was calculated for households with ≥2 members where the HCW was the index case. A Poisson regression model estimated the association between risk factors and SAR.

Results: Among the 11,670 HCWs completing the survey, 91%, perceived their workplace as the source of infection during the first wave (March-July 2020), 71% during the second wave (July 2020-March 2021), and 40% during the third wave (March-May 2021). Conversely, HCWs reported an increasing proportion of household-acquired infections with each wave from 4% to 14% and 33%, respectively. The overall household SAR of 7,990 HCWs living with ≥1 person was 30% (95%CI: 29-30). SAR increased with the presence of symptoms, older age, and during Alpha-variant predominant period.

Conclusions: HCWs and their household members were largely affected during the first pandemic waves of COVID-19, but the relative importance of occupational exposure changed overtime. Pandemic preparedness in healthcare settings is essential to protect HCWs from emerging biological hazard exposures.

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Conflict of interest statement

SC and GDS report funding from the Ministère de la santé et des services sociaux du Québec to conduct this work, paid to their institution. GD reports participation as a medical advisor on the provincial public health scientific committee on COVID-19 for Quebec Ministry of Health. DT is supported by a research career award from the Fonds de recherche du Québec-Santé, paid to his institution. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Weekly number of overall, healthcare workers and survey participants with a PCR-confirmed SARS-CoV-2 infection, and vaccine coverage among healthcare workers in Quebec from March 1, 2020, to May 29, 2021. Note: HCW, healthcare worker.
Figure 2.
Figure 2.
Population flowchart of healthcare workers participating to the epidemiologic survey. Note: HCW, healthcare worker.
Figure 3.
Figure 3.
Self-reported perceived source of infection by month, wave, and type of facility among healthcare workers participating to the survey (March 2020 to May 2021).
Figure 4.
Figure 4.
Type of index case (HCW, other adult, or child) in households of infected HCWs where at least two people were living. Note: HCW, healthcare worker.

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