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  • Healthcare personnel at non–acute-care facilities are at risk of COVID-19 from workplace and community exposures

  • Armaghan-e-Rehman Mansoor, Caroline O’Neil, David McDonald, Victoria Fraser, Hilary Babcock, Jennie Kwon
  • Journal:
    Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue S2 / June 2023
    Published online by Cambridge University Press:
    29 September 2023, p. s6
    • Article
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  • Background: Healthcare personnel (HCP) working in non–acute-care facilities are at high risk of COVID-19. We sought to determine SARS-CoV-2 seroprevalence, and analyzed behaviors and activities related to COVID-19 acquisition in this cohort. Methods: Between May and June 2021, HCP were enrolled at a skilled nursing facility and a memory care facility in St. Louis, Missouri. Data regarding demographics, prior SARS-CoV-2 testing, symptoms consistent with COVID-19 in the previous 6 months, COVID-19 vaccination, personal protective equipment (PPE) use, and COVID-19 exposures were collected via survey. Blood specimens were obtained to determine SARS-CoV-2 nucleocapsid IgG antibody seroprevalence (Abbott Laboratories). Study protocol was approved by the Washington University Institutional Review Board. Results: The survey was completed by 74 HCP. 82% of participants were female, and 31% reported >10 years of healthcare experience. The overall SARS-CoV-2 seropositivity rate was 8.9% (5 HCP). Of the surveyed HCP, 50% reported symptoms concerning for COVID-19 in the prior 6 months. Headache (38%), fatigue (35%) and fever (27%) were the most common self-reported symptoms. Among symptomatic HCP, only 35% sought medical care for these symptoms. All HCP reported having taken at least 1 COVID-19 test prior to study enrollment. Of note, 18.9% (14 HCP) had a self-reported prior positive SARS-CoV-2 PCR test, of whom 9 HCP were seronegative. All seronegative HCP with a self-reported history of COVID-19 reported infection >3 months before study participation. Completion of a primary COVID-19 vaccination series was reported by 86% of HCP. Known exposure to COVID-19 at work was reported by 28% of HCP. When asked about PPE at the time of workplace exposure, N95 mask use was reported by 81%, gloves by 57%, gowns by 33%, face shields by 29% and surgical masks by 14%. Known specific exposure to COVID-19 outside work was reported by 31% of HCP. Conclusions: One year after the initial COVID-19 pandemic impacted the St. Louis region, HCP at non–acute-care facilities had a SARS-CoV-2 seroprevalence of 8.9%. Similar frequency of exposures were reported from both the workplace and community, with high rates of PPE use at the workplace. HCP in such settings remain at high risk of COVID-19 exposure from workplace and community exposures. Ongoing efforts are needed to maintain PPE use to prevent SARS-CoV-2 transmission within non–acute-care facilities, and continue access to timely COVID-19 screening for HCP.

    Disclosure: None

  • Seroprevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) antibodies among healthcare personnel in the Midwestern United States, September 2020–April 2021

  • Rachel E. Bosserman, Christopher W. Farnsworth, Caroline A. O’Neil, Candice Cass, Daniel Park, Claire Ballman, Meghan A. Wallace, Emily Struttmann, Henry Stewart, Olivia Arter, Kate Peacock, Victoria J. Fraser, Philip J. Budge, Margaret A. Olsen, Carey-Ann D. Burnham, Hilary M. Babcock, Jennie H. Kwon, for the CDC Prevention Epicenters
  • Journal:
    Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue 1 / 2023
    Published online by Cambridge University Press:
    04 August 2023, e133
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  • Objective:

    To determine the prevalence of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) IgG nucleocapsid (N) antibodies among healthcare personnel (HCP) with no prior history of COVID-19 and to identify factors associated with seropositivity.

    Design:

    Prospective cohort study.

    Setting:

    An academic, tertiary-care hospital in St. Louis, Missouri.

    Participants:

    The study included 400 HCP aged ≥18 years who potentially worked with coronavirus disease 2019 (COVID-19) patients and had no known history of COVID-19; 309 of these HCP also completed a follow-up visit 70–160 days after enrollment. Enrollment visits took place between September and December 2020. Follow-up visits took place between December 2020 and April 2021.

    Methods:

    At each study visit, participants underwent SARS-CoV-2 IgG N-antibody testing using the Abbott SARS-CoV-2 IgG assay and completed a survey providing information about demographics, job characteristics, comorbidities, symptoms, and potential SARS-CoV-2 exposures.

    Results:

    Participants were predominately women (64%) and white (79%), with median age of 34.5 years (interquartile range [IQR], 30–45). Among the 400 HCP, 18 (4.5%) were seropositive for IgG N-antibodies at enrollment. Also, 34 (11.0%) of 309 were seropositive at follow-up. HCP who reported having a household contact with COVID-19 had greater likelihood of seropositivity at both enrollment and at follow-up.

    Conclusions:

    In this cohort of HCP during the first wave of the COVID-19 pandemic, ∼1 in 20 had serological evidence of prior, undocumented SARS-CoV-2 infection at enrollment. Having a household contact with COVID-19 was associated with seropositivity.

  • Knowledge, beliefs, and practices related to coronavirus disease 2019 (COVID-19) infection and vaccination in healthcare personnel working at nonacute care facilities

  • Armaghan-e-Rehman Mansoor, Caroline A. O’Neil, David McDonald, Victoria J. Fraser, Hilary M. Babcock, Jennie H. Kwon, for the CDC Prevention Epicenters Program
  • Journal:
    Infection Control & Hospital Epidemiology / Volume 44 / Issue 10 / October 2023
    Published online by Cambridge University Press:
    29 March 2023, pp. 1657-1662
    Print publication:
    October 2023
    • Article
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  • Objective:

    To characterize experiences, beliefs, and perceptions of risk related to coronavirus disease 2019 (COVID-19), infection prevention practices, and COVID-19 vaccination among healthcare personnel (HCP) at nonacute care facilities.

    Design:

    Anonymous survey.

    Setting:

    Three non–acute-care facilities in St. Louis, Missouri.

    Participants:

    In total, 156 HCP responded to the survey, for a 25.6% participation rate). Among them, 32% had direct patient-care roles.

    Methods:

    Anonymous surveys were distributed between April-May 2021. Data were collected on demographics, work experience, COVID-19 exposure, knowledge, and beliefs about infection prevention, personal protective equipment (PPE) use, COVID-19 vaccination, and the impact of COVID-19.

    Results:

    Nearly all respondents reported adequate knowledge of how to protect oneself from COVID-19 at work (97%) and had access to adequate PPE supplies (95%). Many HCP reported that wearing a mask or face shield made communication difficult (59%), that they had taken on additional responsibilities due to staff shortages (56%), and that their job became more stressful because of COVID-19 (53%). Moreover, 28% had considered quitting their job. Most respondents (78%) had received at least 1 dose of COVID-19 vaccine. Common reasons for vaccination were a desire to protect family and friends (84%) and a desire to stop the spread of COVID-19 (82%). Potential side effects and/or inadequate vaccine testing were cited as the most common concerns by unvaccinated HCP.

    Conclusions:

    A significant proportion of HCP reported increased stress and responsibilities at work due to COVID-19. The majority were vaccinated. Improving workplace policies related to mental health resources and sick leave, maintaining access to PPE, and ensuring clear communication of PPE requirements may improve workplace stress and burnout.

  • Clinical and occupational risk factors for coronavirus disease 2019 (COVID-19) in healthcare personnel

  • Jennie H. Kwon, Philip J. Budge, Caroline A. O’Neil, Kate Peacock, Eva M. Aagaard, Victoria J. Fraser, Margaret A. Olsen, Hilary Babcock, for the CDC Prevention Epicenters Program
  • Journal:
    Antimicrobial Stewardship & Healthcare Epidemiology / Volume 2 / Issue 1 / 2022
    Published online by Cambridge University Press:
    18 July 2022, e123
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  • Objective:

    To identify characteristics associated with positive severe acute respiratory coronavirus virus 2 (SARS-CoV-2) polymerase chain reaction (PCR) tests in healthcare personnel.

    Design:

    Retrospective cohort study.

    Setting:

    A multihospital healthcare system.

    Participants:

    Employees who reported SARS-CoV-2 exposures and/or symptoms of coronavirus disease 2019 (COVID-19) between March 30, 2020, and September 20, 2020, and were subsequently referred for SARS-CoV-2 PCR testing.

    Methods:

    Data from exposure and/or symptom reports were linked to the corresponding SARS-CoV-2 PCR test result. Employee demographic characteristics, occupational characteristics, SARS-CoV-2 exposure history, and symptoms were evaluated as potential risk factors for having a positive SARS-CoV-2 PCR test.

    Results:

    Among 6,289 employees who received SARS-CoV-2 PCR testing, 873 (14%) had a positive test. Independent risk factors for a positive PCR included: working in a patient care area (relative risk [RR], 1.82; 95% confidence interval [CI], 1.37–2.40), having a known SARS-CoV-2 exposure (RR, 1.20; 95% CI, 1.04–1.37), reporting a community versus an occupational exposure (RR, 1.87; 95% CI, 1.49–2.34), and having an infected household contact (RR, 2.47; 95% CI, 2.11–2.89). Nearly all HCP (99%) reported symptoms. Symptoms associated with a positive PCR in a multivariable analysis included loss of sense of smell (RR, 2.60; 95% CI, 2.09–3.24) or taste (RR, 1.75; 95% CI, 1.40–2.20), cough (RR, 1.95; 95% CI, 1.40–2.20), fever, and muscle aches.

    Conclusions:

    In this cohort of >6,000 healthcare system and academic medical center employees early in the pandemic, community exposures, and particularly household exposures, were associated with greater risk of SARS-CoV-2 infection than occupational exposures. This work highlights the importance of COVID-19 prevention in the community and in healthcare settings to prevent COVID-19.

  • Chapter 2 - British Decadence and Renaissance Italy

  • Edited by Alex Murray, Queen's University Belfast
  • Book:
    Decadence
    Published online:
    24 September 2020
    Print publication:
    15 October 2020, pp 47-64

  • Summary

    Walter Pater’s Studies in the History of the Renaissance (1873) was a foundational text for British Decadence. John Ruskin had vilified Renaissance Italy for its moral and aesthetic depravity, but for Pater and his followers the works of artists such as Botticelli, Michelangelo and Leonardo Da Vinci became vehicles for a radical aesthetic that elevated intensity of experience as the goal of life and saw art as the most crystalized form of that experience. The Renaissance offered sensual enjoyment that could transform and re-enchant the experience of modernity. This chapter argues that it was the aesthetic and moral ambiguousness of the Renaissance that appealed to the Decadent imagination – its audacious blurring of the boundaries between good and evil, the spiritual and the carnal, beauty and ugliness, legitimate and illicit pleasures; its radical unsettling of conventional demarcations of gender, sexuality, place and historical period. For Decadent writers and artists such ambiguities were intellectually and personally liberating. Renaissance Italy provided a creative space in which to explore contemporary uncertainties and to mobilize a distinctively Decadent style.

Women Writing Art History in the Nineteenth Century
  • Looking Like a Woman
  • Hilary Fraser
  • Published online:
    05 September 2014
    Print publication:
    04 September 2014
  • This book sets out to correct received accounts of the emergence of art history as a masculine field. It investigates the importance of female writers from Anna Jameson, Elizabeth Eastlake and George Eliot to Alice Meynell, Vernon Lee and Michael Field in developing a discourse of art notable for its complexity and cultural power, its increasing professionalism and reach, and its integration with other discourses of modernity. Proposing a more flexible and inclusive model of what constitutes art historical writing, including fiction, poetry and travel literature, this book offers a radically revisionist account of the genealogy of a discipline and a profession. It shows how women experienced forms of professional exclusion that, whilst detrimental to their careers, could be aesthetically formative; how working from the margins of established institutional structures gave women the freedom to be audaciously experimental in their writing about art in ways that resonate with modern readers.

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