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Effect of a national policy of universal masking and uniform criteria for severe acute respiratory coronavirus virus 2 (SARS-CoV-2) exposure on hospital staff infection and quarantine

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

Published online by Cambridge University Press:  03 May 2021

Elizabeth Temkin ,
Mitchell J. Schwaber ,
Azza Vaturi ,
Eyal Nadir ,
Rama Zilber ,
Osnat Barel ,
Lidia Pavlov  and
Yehuda Carmeli
Elizabeth Temkin*
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel
Mitchell J. Schwaber
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Azza Vaturi
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel
Eyal Nadir
Affiliation:
Division of Epidemiology, Israel Ministry of Health, Jerusalem, Israel
Rama Zilber
Affiliation:
Nursing Administration, Israel Ministry of Health, Jerusalem, Israel
Osnat Barel
Affiliation:
Nursing Administration, Israel Ministry of Health, Jerusalem, Israel
Lidia Pavlov
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health, Tel Aviv, Israel
Yehuda Carmeli
Affiliation:
National Institute for Antibiotic Resistance and Infection Control, Israel Ministry of Health and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
*
Author for correspondence: Elizabeth Temkin, E-mail: lizt@tlvmc.gov.il
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Abstract

Objective:

To determine the effect of 2 regulations issued by the Israel Ministry of Health on coronavirus disease 2019 (COVID-19) infections and quarantine among healthcare workers (HCWs) in general hospitals.

Design:

Before-and-after intervention study without a control group (interrupted time-series analysis).

Setting:

All 29 Israeli general hospitals.

Participants:

All HCWs.

Interventions:

Two national regulations were issued on March 25, 2020: one required universal masking of HCWs, patients, and visitors in general hospitals and the second defined what constitutes HCW exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2) and when quarantine is required.

Results:

Overall, 283 HCWs were infected at work or from an unknown source. Before the intervention, the number of HCWs infected at work increased by 0.5 per day (95% confidence interval [CI], 0.2–0.7; P < .001), peaking at 16. After the intervention, new infections declined by 0.2 per day (95% CI, −0.3 to −0.1; P < .001). Before the intervention, the number of HCWs in quarantine or isolation increased by 97 per day (95% CI, 90–104; P < .001), peaking at 2,444. After the intervention, prevalence decreased by 59 per day (95% CI, −72 to −46; P < .001). Epidemiological investigations determined that the most common source of HCW infection (58%) was a coworker.

Conclusions:

Universal masking in general hospitals reduced the risk of hospital-acquired COVID-19 among HCWs. Universal masking combined with uniform definitions of HCW exposure and criteria for quarantine limited the absence of HCWs from the workforce.

Type
Original Article
Information
Infection Control & Hospital Epidemiology , Volume 43 , Issue 6 , June 2022 , pp. 757 - 763
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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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