Healthcare Workers With COVID-19 Relatively Young, Mostly Female: CDC

The Centers for Disease Control and Prevention (CDC) has released its first report on US healthcare personnel (HCP) who’ve developed COVID-19, with details published in Morbidity and Mortality Weekly Report.

Fully three-quarters of these providers were women, and the median age was 42 years. Less than half had an underlying medical condition. Although most healthcare workers did not require hospitalization, severe disease and death were reported across age groups.

Yet the data don’t fully capture the pandemic’s effect on the medical profession. Around 459,000 cases and 17,000 deaths related to COVID-19 had occurred in the United States as of April 9, 2020. (As of April 14, these numbers were approximately 605,000 and 25,000, respectively.) For the current analysis, which considered data from February 12 to April 9, 315,531 COVID-19 cases were reported to the CDC using a standardized form, with only 49,370 (16%) of those forms specifying whether the patient worked in healthcare; in total, 9,282 (19%) were identified as HCPs.

“Healthcare personnel are essential workers defined as paid and unpaid persons serving in healthcare settings who have the potential for direct or indirect exposure to patients or infectious materials,” members of the CDC COVID-19 Response Team specify.

They urge: “It is critical to make every effort to ensure the health and safety of this essential national workforce of approximately 18 million HCP, both at work and in the community. . . . Improving surveillance through routine reporting of occupation and industry not only benefits HCP, but all workers during the COVID-19 pandemic.”

Older Providers at Risk

Eighty percent of those HCPs reported having contact with a lab-confirmed COVID-19 patient in the 2 weeks prior to becoming sick, with 55% saying this contact occurred in a healthcare setting rather than in their household or community.

Information on race was available for just 41% of the HCPs: 72% were white, 21% black, 5% Asian, and 2% other or multiple races. Among the 39% of HCPs who reported ethnicity, 10% were Hispanic/Latino.

Half of the CDC records included information on underlying health conditions, a category that included: chronic lung disease (asthma, chronic obstructive pulmonary disease, and emphysema); diabetes mellitus; cardiovascular disease; chronic renal disease; chronic liver disease; immunocompromised condition; neurologic disorder, neurodevelopmental or intellectual disability; pregnancy; current smoker; former smoker; or other chronic disease. Just 38% of the HCP patients reported at least one of the above.

In HCPs who reported having symptoms, nearly all (92%) said they had fever, cough, and/or shortness of breath. Two-thirds had muscle aches, while 65% experienced headaches. Loss of smell or taste was mentioned for 16%.

Approximately 8% to 10% of these clinicians were hospitalized and 2% to 5% were admitted to the ICU. The death rate was approximately 0.3% to 0.6%. Mortality was starkly higher in providers ages 65 or above—reaching 37%—though these individuals made up only 6% of the population.

The fact that not all of these patients contracted their disease in the workplace is noteworthy, according to the CDC’s response team. Beyond tracing recognized occupational exposures, further “measures that will likely reduce the risk for infected HCP transmitting the virus to colleagues and patients include screening all HCP for fever and respiratory symptoms at the beginning of their shifts, prioritizing HCP for testing, and ensuring options to discourage working while ill (eg, flexible and nonpunitive medical leave policies),” they advise, emphasizing the importance of personal protective equipment (PPE) as well as training on preventive measures.

In terms of mitigating risk to providers, the authors say, age “should be considered when mobilizing retired HCP to increase surge capacity, especially in the face of limited PPE availability [and may encourage] preferential assignment of retired HCP to lower-risk settings (eg, telemedicine, administrative assignments, or clinics for non-COVID-19 patients).”

This dilemma of how to both protect and utilize older healthcare professionals was explored in a recent feature on TCTMD.