Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-16T09:18:36.073Z Has data issue: false hasContentIssue false
  • English
  • Français

Coronavirus disease 2019 (COVID-19) screening system utilizing daily symptom attestation helps identify hospital employees who should be tested to protect patients and coworkers

Part of: SARS-CoV-2/COVID-19

Published online by Cambridge University Press:  10 November 2021

Ellen Kim Open the ORCID record for Ellen Kim [Opens in a new window] ,
Charles A. Morris ,
Michael Klompas Open the ORCID record for Michael Klompas [Opens in a new window] ,
Haipeng Zhang ,
Adam B. Landman ,
Sunil Eappen ,
Karen Hopcia ,
Dean M. Hashimoto  and
Hojjat Salmasian Open the ORCID record for Hojjat Salmasian [Opens in a new window]
Ellen Kim*
Affiliation:
Department of Radiation Oncology, Brigham and Women’s Hospital, Boston, Massachusetts
Charles A. Morris
Affiliation:
Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
Michael Klompas
Affiliation:
Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts
Haipeng Zhang
Affiliation:
Department of Palliative Medicine, Dana-Farber Cancer Institute, Boston, Massachusetts
Adam B. Landman
Affiliation:
Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
Sunil Eappen
Affiliation:
Department of Anesthesiology, Brigham and Women’s Hospital, Boston, Massachusetts
Karen Hopcia
Affiliation:
Department of Occupational Health Services, Mass General Brigham, Boston, Massachusetts
Dean M. Hashimoto
Affiliation:
Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts Department of Occupational Health Services, Mass General Brigham, Boston, Massachusetts
Hojjat Salmasian
Affiliation:
Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
*
Author for correspondence: Ellen Kim, E-mail: ellen_kim@dfci.harvard.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To investigate the effectiveness of a daily attestation system used by employees of a multi-institutional academic medical center, which comprised of symptom-screening, self-referrals to the Occupational Health Services team, and/or a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) test.

Design:

We conducted a retrospective cohort study of all employee attestations and SARS-CoV-2 tests performed between March and June 2020.

Setting:

A large multi-institutional academic medical center, including both inpatient and ambulatory settings.

Participants:

All employees who worked at the study site.

Methods:

Data were combined from the attestation system (COVIDPass), the employee database, and the electronic health records and were analyzed using descriptive statistics including χ2, Wilcoxon, and Kruskal-Wallis tests. We investigated whether an association existed between symptomatic attestations by the employees and the employee testing positive for SARS-CoV-2.

Results:

After data linkage and cleaning, there were 2,117,298 attestations submitted by 65,422 employees between March and June 2020. Most attestations were asymptomatic (99.9%). The most commonly reported symptoms were sore throat (n = 910), runny nose (n = 637), and cough (n = 570). Among the 2,026 employees who ever attested that they were symptomatic, 905 employees were tested within 14 days of a symptomatic attestation, and 114 (13%) of these tests were positive. The most common symptoms associated with a positive SARS-CoV-2 test were anosmia (23% vs 4%) and fever (46% vs 19%).

Conclusions:

Daily symptom attestations among healthcare workers identified a handful of employees with COVID-19. Although the number of positive tests was low, attestations may help keep unwell employees off campus to prevent transmissions.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 11 , November 2022 , pp. 1656 - 1660
Check for updates
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Kelley, E. Hospital visitor restrictions guidance, March 16, 2020. Massachusetts state government website. https://www.mass.gov/doc/hospital-visitor-restrictions-guidance-march-16-2020/download. Published March 16, 2020. Accessed November 8, 2021.Google Scholar
Zhang, H, Dimitrov, D, Simpson, L, et al. A web-based, mobile-responsive application to screen health care workers for COVID-19 symptoms: rapid design, deployment, and usage. JMIR Form Res 2020;4:e19533.CrossRefGoogle ScholarPubMed
Juusola, JL, Brandeau, ML, Long, EF, Owens, DK, Bendavid, E. The cost-effectiveness of symptom-based testing and routine screening for acute HIV infection in men who have sex with men in the United States. AIDS 2011;25:1779–1787.CrossRefGoogle Scholar
Gidengil, C, Fischer, S, Broten, N. A framework for evaluating approaches to symptom screening in the workplace during the COVID-19 pandemic. RAND Perspect 2020. doi: 10.7249/PEA653-1.Google Scholar
Klompas, M, Baker, MA, Rhee, C, et al. A SARS-CoV-2 cluster in an acute-care hospital. Ann Intern Med 2021;174:794–802.CrossRefGoogle Scholar
Shenoy, ES, Weber, DJ. Routine surveillance of asymptomatic healthcare personnel for severe acute respiratory coronavirus virus 2 (SARS-CoV-2): not a prevention strategy. Infect Control Hosp Epidemiol 2021;42:592–597.CrossRefGoogle ScholarPubMed
Sacks, CA, Dougan, M, McCoy, TH, et al. The association between symptoms and COVID-19 test results among healthcare workers. Ann Surg 2020;272:e329–e332.CrossRefGoogle ScholarPubMed
Dugdale, CM, Rubins, DM, Lee, H, et al. COVID-19 diagnostic clinical decision support: a pre–post implementation study of CORAL (COvid Risk cALculator). Clin Infect Dis 2021. doi: 10.1093/cid/ciab111.Google Scholar
Marshall, M. COVID’s toll on smell and taste: what scientists do and don’t know. Nature 2021;589:342–343.CrossRefGoogle Scholar
Dawson, P, Rabold, EM, Laws, RL, et al. Loss of taste and smell as distinguishing symptoms of coronavirus disease 2019. Clin Infect Dis 2021;72:682–685.CrossRefGoogle ScholarPubMed
Widera, E, Chang, A, Chen, HL. Presenteeism: a public health hazard. J Gen Intern Med 2010;25:1244–1247.CrossRefGoogle ScholarPubMed
Jena, AB, Meltzer, DO, Press, VG, Arora, VM. Why physicians work when sick. Arch Intern Med 2012;172:1107–1108.CrossRefGoogle ScholarPubMed
Giæver, F, Lohmann-Lafrenz, S, Løvseth, LT. Why hospital physicians attend work while ill? The spiralling effect of positive and negative factors. BMC Health Serv Res 2016;16:548.CrossRefGoogle ScholarPubMed
Horng, S, O’Donoghue, A, Dechen, T, et al. Secondary use of COVID-19 symptom incidence among hospital employees as an example of syndromic surveillance of hospital admissions within 7 days. JAMA Netw Open 2021;4:e2113782.CrossRefGoogle ScholarPubMed