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Are health care workers who deal directly with patients at higher risk of contracting COVID-19 than hospital personnel working in housekeeping, lab and administrative positions?
A study aiming to answer that question is now actively recruiting participants in six Canadian cities, including Halifax, Sherbrooke, Montreal, Hamilton, Calgary, and Edmonton.
The study is supported by Canada’s COVID-19 Immunity Task Force and led by doctors Brenda Coleman and Allison McGeer from Toronto’s Sinai Health and the University of Toronto’s Dalla Lana School of Public Health.
They’ll follow participants for a year, monitoring antibody levels and looking at those with and without COVID-19 symptoms.
“What the epidemiologist in me really wants to know is what the risk factors for infection are. Is it exposure to patients? Is it exposure to sick colleagues or sick housemates? What is it that puts you at higher risk? Are there certain procedures within the hospital,” Coleman said in an interview Thursday morning.
“Imagine a respiratory therapist or a physician who is having to do something with the lungs and doing things where people are actually having to breathe on them without a mask or any sort of protection. The health care worker has one, but the patient can’t obviously. Is it aerosol generating procedures like that that put people at higher risk?”
Coleman said they also want to know if certain units are more likely to be impacted, like emergency departments where many people are coming and going without always knowing what’s making them sick.
Although health care workers are on the front lines and at a high risk for exposure to the virus, there isn’t much data showing the extent of infection in this population. Coleman said that’s in part because many are asymptomatic and therefore aren’t being tested.
“We really want to know what the extent of infection is….Not only because we don’t want them (health care workers) to become sick,” Coleman said. “We don’t want them to take it home to their families, we don’t want them to pass it on to their coworkers, and we don’t want them to pass it on to their patients who are already sick.”
But the study isn’t just about hospital health care workers. It will also examine levels of infection in housekeeping, lab, and administrative staff.
“They’re in the hospital, they’re exposed to peers who maybe are directly exposed to patients, and they’re also exposed to patients themselves,” Coleman said. “Maybe not for two or three or five minutes, but passing them in the halls and that sort of thing. And if there are contaminants on things like handrails and elevator buttons, they can still be infected.”
Armed with more knowledge about increased risk factors and protective measures people are taking at work and at home, researchers expect to better understand where and why people are being infected. That will make it easier to find solutions to minimize those risks.
Researchers will also ask participants about their intentions to vaccinate against the virus if/when a vaccine becomes available. Those who get vaccinated will be asked for blood samples to determine if antibody levels remain high over time and to see if their immune systems react as expected.
Participants will be required to provide three blood samples over the course of a year. If they become ill and/or get vaccinated, they’ll be asked to provide more. They also need to fill out a few short questionnaires about their exposure risk factors. They’ll then respond to a weekly questionnaire which consists of two questions: have you been tested and have you had symptoms.
Finally, Coleman said they’ll ask about their stress levels.
“Working in the health care environment during a pandemic can be very stressful, and we’re going to ask them about their experience of working during that,” Coleman said.
This study is one of two examining how often and why health care workers are contracting the virus. Another parallel study led by Nicola Cherry at the University of Alberta is enrolling 5,000 health care workers in B.C., Alta, Ont. and Que. The participants include physicians in all four provinces, nurses and health care aides in Alberta, and personal support workers in Ontario.
Although an official website hasn’t yet been set up, Coleman said Halifax health care workers and hospital staff interested in participating in the national study can email them at covid.study@sinaihealth.ca.
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