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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
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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
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Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America

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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