Black and Latinx healthcare workers and support staff, both with and without patient care responsibilities, are at a higher risk for contracting the coronavirus disease (COVID-19) compared to doctors and nurses, said Emily S. Barrett, an associate professor at the Rutgers School of Public Health and a member of the Environmental and Occupational Health Sciences Institute.
Barrett co-authored the study “Risk factors for SARS-CoV-2 infection in hospital workers: results from a screening study in New Jersey, U.S. in Spring 2020,” which was published by Oxford University Press on behalf of the Infectious Diseases Society of America (IDSA).
“We partnered with Robert Wood Johnson Hospital to offer COVID-19 virus and antibody testing to ensure the safety of this critical workforce,” Barrett said.
Approximately 3,904 employees and clinicians were screened for COVID-19 virus positivity and serum IgG (Immunoglobulin G) from April 28 to June 30, according to the study. The team evaluated positive tests in relation to demographic, occupational characteristics and prior COVID-19 symptoms using multivariable logistic regression models, according to the study.
While the source of the infections currently remains unknown, there are multiple speculations, Barrett said.
“One possibility is that the infections were acquired in the community, another possibility is that exposures could have occurred in the hospital setting and that support staff, who typically wear less PPE (personal protective equipment), may have had less protection against infection,” Barrett said.
Inequities in factors like poverty and healthcare access contribute highly to increased risk of infection, according to the Centers for Disease Control and Prevention. Barrett said the study's results were consistent with findings from the general public that Black and Latinx communities face elevated risks of COVID-19 infection.
The proportion of participants testing positive was highest for phlebotomists, maintenance, dining services and support roles, despite having lower levels of direct patient care duties, according to the study. Black and Latinx workers had two-fold increased odds of a positive test compared to white workers after adjusting for job role, patient care responsibilities and other factors, according to the study.
“We observed that 40 (percent) of workers who tested positive reported no symptoms, suggesting they may have been coming to work while actively infected,” Barrett said.
Asymptomatic patients present a clear risk to hospital operations as protecting the healthcare workforce during the pandemic is a top priority, she said.
“While our results don’t indicate a danger of hospital systems being overwhelmed, they do suggest that continued testing of health care personnel, particularly as the pandemic resurges, will be important,” Barrett said.
Overall, the categories of healthcare workers at the highest risk for infection include support staff and underrepresented minorities with and without patient care responsibilities, according to the study. Due to this, future research is necessary in order to examine potential sources of community and nosocomial exposure among these under-observed groups, according to the study.
“At minimum, our results suggest that hospitals should carefully consider infection risks to all employees (not just those treating COVID-19 positive patients) and provide appropriate PPE to ensure the safety of staff and patients alike,” Barrett said.