Australian doctors, nurses and other healthcare workers are nearly three times more likely to get COVID-19 than other Australians, according to new research which estimates how Australian health workers’ risk of SARS-CoV-2 infection differs from that of the broader community.
“Despite low community prevalence during the period studied, which was prior to the second wave in Victoria, we identified 536 cases of COVID-19 among Australia healthcare workers up to the beginning of July, meaning that more than one in 20 of Australia’s COVID-19 cases were potentially acquired on the job, in our health system,” said Professor Raina MacIntyre, head of global biosecurity at UNSW Sydney’s Kirby Institute.
This finding should inform work health and safety procedures in Australian hospitals, and that efforts for national reporting on COVID-19 among healthcare workers should be accelerated, said Professor MacIntyre.
They also call for hospital workers to be rostered in cohorts to minimise the impact of outbreaks, better ventilation in hospitals and for improved PPE guidelines.
“Even without counting more than 3500 health workers infected in the second wave, these numbers from early in the pandemic suggest some system failures to protect our first line health responders,” said Professor MacIntyre.
“The safety of healthcare workers should be urgently addressed.”
To conduct the research, which was published in the International Journal of Nursing Studies, the team searched government reports, websites and media reports to create a comprehensive line listing of Australian healthcare worker infections and nosocomial outbreaks – i.e. outbreaks starting in hospitals – between 25 January and 8 July 2020.
They calculated rates of infections and odds ratios for healthcare workers per state, by comparing overall cases to estimated healthcare worker cases.
“We showed that outbreaks in hospitals settings have serious consequences, with a hospital in Tasmania closing in order to quarantine contacts of hospital staff,” said Ashley Quigley, first author and Masters student at UNSW Sydney’s Kirby Institute.
“We need to remember that it’s not just those who contract COVID-19 that are impacted by these outbreaks.
“We showed for every health worker outbreak, hundreds, and in one case over a thousand staff, can be furloughed.
“There are flow-on effects from a depleted workforce while hundreds to thousands of health worker contacts are quarantined.”
The data for this study were based on open-source reporting of health care worker cases, which may vary depending on each state’s individual data publishing policies. The researchers used media reports, which have not been verified.
“In most cases, however, there were multiple media reports about each outbreak, often with quotes from health officials. This means we have likely underestimated the true number of healthcare worker infections, so this study presents a minimum estimate,” said Professor MacIntyre.
There is also a potential effect of testing rates on the identification of COVID-19 cases, and the researchers accounted for this by representing the daily testing rates in conjunction with the daily healthcare worker infections reported.
“A large proportion of healthcare worker infections did not have the source of infection reported, and we were unable to obtain further data, nor verify reported sources,” said Professor MacIntyre.
“These limitations highlight the need for formal reporting, proper outbreak investigation and contact tracing during hospital outbreaks.”
While Australians should celebrate the country’s low daily notification counts, Professor MacIntyre said we’re nowhere near out of the woods.
“Healthy doctors and nurses are an essential line of defence against this virus. Continuing hospital outbreaks also threaten economic recovery, as seen in Victoria when a recent community cluster was linked to a hospital outbreak, long after the second wave was over.
“Controlling health system outbreaks and protecting health workers is key to ensuring safe re-opening of society,” said Professor MacIntyre.
“Several countries such as Taiwan, China and Singapore have demonstrated low health worker infections. We should learn from them and the precautionary approach they have used to protecting health workers.”
As the whole profession is working to create COVID-safe workplaces, the Australian Institute of Health & Safety has been working to raise concerns about WHS standards in the healthcare sector, especially hospitals and aged care.
Across Victoria, more than 3500 healthcare workers contracted COVID-19 and the Victorian Government confirmed that around 73 per cent of these cases were acquired in the workplace.
“We all need to be able to rely on our healthcare sector to support us when we need them, and that means ensuring workers on the frontline of this crisis – nurses, doctors, other hospital staff and aged care workers – are properly protected,” said David Clarke, CEO of the AIHS. “In addition to the basic rights of workers to be protected and the responsibilities of employers to do that, when healthcare worker infections get out of control, patients suffer, and the resilience of our whole healthcare system is threatened.”
Worker transmission of COVID-19 in healthcare is still the major blind spot for many expert panels advising governments across Australia, according to Clarke, who said there are two main reasons for this:
“As health and safety experts, we know there are reasonable, practical things that can be done to reduce transmission rates in the workplace,” said Clarke.
“We want to ensure that in every state and territory, and the federal government has access to our expertise and knowledge.”