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. 2023;55(2):2293306.
doi: 10.1080/07853890.2023.2293306. Epub 2024 Jan 11.

The impact of government pandemic policies on the vulnerability of healthcare workers to SARS-CoV-2 infection and mortality in Jakarta Province, Indonesia

Rina Agustina  1   2 , Davrina Rianda  2   3 , Aly Lamuri  4 , Karina Rahmadia Ekawidyani  1   5 , Deviana Ayushinta Sani Siregar  2 , Dyana Santika Sari  2 , Prashti Mutia Wulan  2 , Natasha Dianasari Devana  1 , Ari Fahrial Syam  6 , Ahmad Jabir Rahyussalim  7 , Dwi Oktavia Handayani  8 , Widyastuti Widyastuti  8 , Anuraj Harish Shankar  9   10 , Ngabila Salama  8
Affiliations

The impact of government pandemic policies on the vulnerability of healthcare workers to SARS-CoV-2 infection and mortality in Jakarta Province, Indonesia

Rina Agustina et al. Ann Med. 2023.

Erratum in

  • Correction.
    [No authors listed] [No authors listed] Ann Med. 2023;55(2):2317590. doi: 10.1080/07853890.2024.2317590. Epub 2024 Feb 16. Ann Med. 2023. PMID: 38364222 Free PMC article. No abstract available.

Abstract

Introduction: Healthcare workers (HCWs) are on the frontlines of the COVID-19 pandemic, putting them at a higher risk of infection and disease than non-HCWs. We analysed the effects of government policies for the public and for HCWs on the likelihood of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and mortality among HCWs during the first 8 months of the pandemic in Jakarta province, the capital city and COVID-19 hotspot in Indonesia.

Methods: We conducted a retrospective cohort study using secondary data from the Jakarta provincial government from March to October 2020, which included sociodemographic characteristics, symptoms, comorbidities and COVID-19 diagnosis history for all cases. A generalized linear mixed-effect regression model was used to determine the effect of each month on the odds ratio (OR) of COVID-19 cases and deaths for HCW compared with non-HCW, assuming that monthly trends were influenced by varying government policies.

Results: A total of 894,487 suspected and confirmed COVID-19 cases in health facilities in Jakarta province were analysed. The OR of confirmed cases for HCW was 2.04 (95% CI 2.00-2.08; p < .001) compared to non-HCW. Despite this higher OR for infection, the case fatality rate (2.32 per 100) and OR (1.02, 95% CI 0.93-1.11; p = .65) of COVID-19 deaths for HCW were similar to those of non-HCW. We observed a trend towards a lower number of COVID-19 patients in hospitals and lower odds of COVID-19 cases among HCWs during the April-to-July 2020 phase compared to the August-to-October phase. This chronologically aligned with more extensive policies to support hospital-based, community-based and well-being-related actions to protect HCW.

Conclusions: HCW had higher odds of having SARS-CoV-2 infection, yet similar odds of death from COVID-19, as compared to non-HCW. Government policies with collective efforts to prevent hospital overcapacity during high transmission and burden periods of the pandemic should be prioritized.

Keywords: COVID-19; Indonesia; SARS-CoV-2; healthcare worker; policy.

Plain language summary

Healthcare workers (HCWs) had higher exposure and odds of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection than non-HCWs but a similar risk of death, consistent with previous studies.Government policies favouring reduced workloads of HCW and interventions to promote resilience can be achieved through combined hospital-based, community-based and well-being-related approaches.Studies to identify the patterns and trends of COVID-19 cases and deaths, hospital admissions and policy dynamics are important to promote evidence-based decision-making by the government.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Likelihood of COVID-19 cases and deaths among HCWs and non-HCWs in Jakarta, and the number of hospitals’ beds and patients, in response to the dynamics of government policies.
Figure 2.
Figure 2.
Comparison of monthly variance of the odds ratio between HCW and non-HCW (intercept) in having COVID-19 (a) confirmed cases and (b) mortality.
See this image and copyright information in PMC

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