Healthcare workers, especially those on the frontline, are among those most at risk of contracting COVID-19. A study has revealed how one patient infected with the virus in a high dependency unit in The Royal Hospital spread the disease among 46 people – 26 nurses, 12 patients, seven doctors and one paramedical personnel.
In July 2020, an epidemiological investigation was conducted when a patient was diagnosed with COVID-19 infection. The patient had stayed in an open high dependency unit (HDU) cubicle at The Royal Hospital with four other patients for 48 to 72 hours, including 48 hours of non-invasive ventilation (NIV), before COVID-19 diagnosis and implementation of contact and airborne isolation precautions.
NIV is the use of breathing support administered through a face mask, nasal mask or a helmet.
According to the study, published in Oman Medical Journal, a total of 22 healthcare workers (HCWs) were assigned to the HDU but were unaware of the patient’s COVID-19 status at the time of contact and, as a result, were only wearing surgical masks as per hospital policy.
All exposed cases were screened by SARS-CoV-2 real-time polymerase chain reaction. A total of 38 HCWs and 28 patients were scr-eened after exposure to the index case, and 46 (69.7 per cent) tested positive for SARS-CoV-2.
‘Twenty-two HCWs and four patients (over half of those who tested positive – 56.5 per cent) were in the same cubicle as the index case and were identified as close contacts with significant exposure. An additional seven patients and 13 HCWs were exposed indirectly through contact with other HCWs or patients in the same ward. Out of the 12 exposed patients, three died from their original disease (two had advanced malignancies and one had terminal cardiomyopathy), while none of the HCWs required hospitalisation,’ the study found.
The study concluded that knowledge gaps on the potential role of NIV in airborne transmission of SARS-CoV-2 may result in serious outbreaks among HCWs if appropriate protective measures are not taken, and could deprive patients of lifesaving procedures due to safety concerns among HCWs. ‘Following this incident, the hospital issued more regulations to prevent similar ways of contracting COVID-19, including wearing N95 masks when dealing with patients on NIV regardless of their COVID-19 status, restricting NIV use to predetermined areas, and screening all patients requiring NIV for SARS-CoV-2.’
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