Skip to main content Accessibility help
×
Home

Containment of COVID-19 cases among healthcare workers: The role of surveillance, early detection, and outbreak management

  • Liang En Wee (a1) (a2), Xiang Ying Jean Sim (a2) (a3), Edwin Philip Conceicao (a3), May Kyawt Aung (a3), Jia Qing Goh (a4), Dennis Wu Ting Yeo (a4), Wee Hoe Gan (a5), Ying Ying Chua (a2), Limin Wijaya (a2), Thuan Tong Tan (a2), Ban Hock Tan (a2), Moi Lin Ling (a3) and Indumathi Venkatachalam (a2) (a3)...

Abstract

Objective:

Staff surveillance is crucial during the containment phase of a pandemic to help reduce potential healthcare-associated transmission and sustain good staff morale. During an outbreak of SARS-COV-2 with community transmission, our institution used an integrated strategy for early detection and containment of COVID-19 cases among healthcare workers (HCWs).

Methods:

Our strategy comprised 3 key components: (1) enforcing reporting of HCWs with acute respiratory illness (ARI) to our institution’s staff clinic for monitoring; (2) conducting ongoing syndromic surveillance to obtain early warning of potential clusters of COVID-19; and (3) outbreak investigation and management.

Results:

Over a 16-week surveillance period, we detected 14 cases of COVID-19 among HCWs with ARI symptoms. Two of the cases were linked epidemiologically and thus constituted a COVID-19 cluster with intrahospital HCW–HCW transmission; we also detected 1 family cluster and 2 clusters among HCWs who shared accommodation. No transmission to HCWs or patients was detected after containment measures were instituted. Early detection minimized the number of HCWs requiring quarantine, hence preserving continuity of service during an ongoing pandemic.

Conclusions:

An integrated surveillance strategy, outbreak management, and encouraging individual responsibility were successful in early detection of clusters of COVID-19 among HCWs. With ongoing local transmission, vigilance must be maintained for intrahospital spread in nonclinical areas where social mingling of HCWs occurs. Because most individuals with COVID-19 have mild symptoms, addressing presenteeism is crucial to minimize potential staff and patient exposure.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Containment of COVID-19 cases among healthcare workers: The role of surveillance, early detection, and outbreak management
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Containment of COVID-19 cases among healthcare workers: The role of surveillance, early detection, and outbreak management
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Containment of COVID-19 cases among healthcare workers: The role of surveillance, early detection, and outbreak management
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Author for correspondence: Dr Liang En Wee, Singapore General Hospital, Outram Road, Singapore169608, E-mail: ian.wee@mohh.com.sg

References

Hide All
1.Huang, CL, Wang, YM, Li, XW, et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020 [Epub ahead of print]. doi: 10.1016/S0140-6736(20)30183-5.
2.Aghaizu, A, Elam, G, Ncube, F, et al.Preventing the next ‘SARS’—European healthcare workers’ attitudes towards monitoring their health for the surveillance of newly emerging infections: qualitative study. BMC Public Health 2011;11:541.
3.Jiang, L, Ng, IHL, Hou, Y, et al.Infectious disease transmission: survey of contacts between hospital-based healthcare workers and working adults from the general population. J Hosp Infect 2018;98:404411.
4.Escudero, IH, Chen, MI, Leo, YS. Surveillance of severe acute respiratory syndrome (SARS) in the post-outbreak period. Singapore Med J 2005;46:165171.
5.Kawana, A, Teruya, K, Kirikae, T, et al.“Syndromic surveillance within a hospital” for the early detection of a nosocomial outbreak of acute respiratory infection. Jpn J Infect Dis 2006;59:377379.
6.Dwosh, HA, Hong, HH, Austgarden, D, Herman, S, Schabas, R. Identification and containment of an outbreak of SARS in a community hospital. CMAJ 2003;168:14151420.
7.Chen, QS, Wang, SY, Jing, CX, Liu, GN, Chi, GB, Dong, XM. Effects of surveillance system and preventive measures on the control of severe acute respiratory syndrome in a university in Guangdong Province of China [in Chinese]. Zhonghua Yu Fang Yi Xue Za Zhi 2003;37:240242.
8.Wong, JEL, Leo, YS, Tan, CC. COVID-19 in Singapore—current experience: critical global issues that require attention and action. JAMA 2020 [Epub ahead of print]. doi: 10.1001/jama.2020.2467.
9.Tan, CC. SARS in Singapore—key lessons from an epidemic. Ann Acad Med Singapore 2006;35:345349.
10.Hui, DSC, Zumla, A. Severe acute respiratory syndrome: historical, epidemiologic, and clinical features. Infect Dis Clin North Am 2019;33:869889.
11.Guan, WJ, Ni, ZY, Hu, Y, et al.Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:17081720.
12.Tan, YM, Chow, PK, Tan, BH, et al.Management of inpatients exposed to an outbreak of severe acute respiratory syndrome (SARS). J Hosp Infect 2004;58:210215.
13.Wang, Y, Chen, Y, Qin, Q. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol 2020 Mar 5 [Epub ahead of print]. doi: 10.1002/jmv.25748.
14.Pung, R, Chiew, CJ, Young, BE, et al.Investigation of three clusters of COVID-19 in Singapore: implications for surveillance and response measures. Lancet 2020 [Epub ahead of print]. doi: 10.1016/S0140-6736(20)30528-6.
15.Wong, SC-Y, Kwong, RT-S, Wu, TC, et al.Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong. J Hosp Infect 2020 [Epub ahead of print]. doi: 10.1016/j.jhin.2020.03.036.
16.McMichael, TM, Clark, S, Pogosjans, S, et al.COVID-19 in a long-term care facility—King County, Washington, February 27–March 9, 2020. Morb Mortal Wkly Rep 2020;69:339342.
17.Tan, CC. SARS in Singapore—key lessons from an epidemic. Ann Acad Med Singapore 2006;35:345349.
18.Lau, SK, Anderson, DE, Chan, KS, et al.Epidemiologic features and clinical course of patients infected with SARS-CoV-2 in Singapore. JAMA 323:14881494.
19.Ives, J, Greenfield, S, Parry, JM, et al.Healthcare workers’ attitudes to working during pandemic influenza: a qualitative study. BMC Public Health 2009;9:56.
20.Fink, D, Cropley, I, Jacobs, M, Mepham, S. Febrile illness in healthcare workers caring for Ebola virus disease patients in a high-resource setting. Euro Surveill 2017;22(4): pii: 30449. doi: 10.2807/1560-7917.ES.2017.22.4.30449.
21.Webster, RK, Liu, R, Karimullina, K, Hall, I, Amlôt, R, Rubin, G. A systematic review of infectious illness presenteeism: prevalence, reasons and risk factors. BMC Public Health 2019;19:799.
22.Chiu, S, Black, CL, Yue, X, et al.Working with influenza-like illness: presenteeism among US healthcare personnel during the 2014–2015 influenza season. Am J Infect Control 2017;45:12541258.
23.Jiang, L, Ng, HL, Ho, HJ, et al.Contacts of healthcare workers, patients, and visitors in general wards in Singapore. Epidemiol Infect 2017;145:30853095.
24.Seale, H, Leask, J, Po, K, MacIntyre, CR. “Will they just pack up and leave?” —attitudes and intended behaviour of hospital health care workers during an influenza pandemic. BMC Health Serv Res 2009;9:30.
25.Mackay, IM, Arden, KE. MERS coronavirus: diagnostics, epidemiology and transmission. Virol J 2015;12:222243.

Containment of COVID-19 cases among healthcare workers: The role of surveillance, early detection, and outbreak management

  • Liang En Wee (a1) (a2), Xiang Ying Jean Sim (a2) (a3), Edwin Philip Conceicao (a3), May Kyawt Aung (a3), Jia Qing Goh (a4), Dennis Wu Ting Yeo (a4), Wee Hoe Gan (a5), Ying Ying Chua (a2), Limin Wijaya (a2), Thuan Tong Tan (a2), Ban Hock Tan (a2), Moi Lin Ling (a3) and Indumathi Venkatachalam (a2) (a3)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed.