06/06/2020

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How May Doctors and Nurses Have Coronavirus?

Few jurisdictions are tracking and publicly reporting how many healthcare workers have been infected.

Marcia Frellick

As of the first week in April, California reported that 1651 healthcare workers were infected with the novel coronavirus that causes COVID-19. But just how many healthcare workers are infected nationwide is unknown.

Although states and cities are regularly updating and publicly reporting overall COVID-19 infection numbers and deaths, few jurisdictions are tracking and publicly reporting how many healthcare workers have been infected.

Without that data, it’s hard to determine areas in greatest need of personal protective equipment (PPE) or staff, Bianca Kiyoe Frogner, PhD, director of the University of Washington Center for Health Workforce Studies in Seattle, told Medscape Medical News.

Nationwide healthcare workers are being prioritized for testing, but without public reporting of data, it’s a guess where the greatest risks lie, she said.

“Currently, the only consistent and reliable daily data point available from all 50 states is the number of deaths,” Pinar Karaca-Mandic, PhD, a health economist at the University of Minnesota, and colleagues point out in an article about COVID-19 data reporting published online April 7 in in Health Affairs.

But even tracking of deaths is an overall statistic and not specific to healthcare workers and the healthcare infrastructure, they note.

The Centers for Disease Control and Prevention (CDC) so far has not tracked infections among healthcare workers. However, the agency “is actively looking into the number of healthcare workers with COVID-19 and hopes to make this information public soon,” a spokesperson told Medscape Medical News.

Johns Hopkins’ COVID-19 tracker is a widely used resource for global and national numbers, but it does not specify how many healthcare workers have been infected.

New York state, the current epicenter of the crisis, does not track infections by healthcare workers.

“The Department of Health does not collect occupational status when someone is tested in New York state,” Jill Montag, a spokesperson for the New York State Department of Health told Medscape Medical News. “While we are prioritizing testing for healthcare workers, nursing home employees, and first responders on the front lines, we do not have data of positive test results by occupation.”

Similarly, the Detroit Department of Health says the department does not track the number of infections specifically among healthcare workers, telling Medscape Medical News, “We do not request employment history when conducting tests.”

California Sets a Standard

California stands out in its public reporting of infected healthcare workers. This week, local health departments started reporting not only the numbers of healthcare workers infected at their workplace, but also the number of healthcare workers affected, regardless of where they were exposed.

“Since COVID-19 is moving rapidly within the community, healthcare workers now appear just as likely, if not more so, to become infected by COVID-19 outside the workplace,” the California Department of Public Health said in a statement published online April 8.

For instance, as of April 8 in California, 299 healthcare workers acquired COVID-19 in a healthcare setting; 462 were exposed via travel, close contacts, or community transmission; and 890 reported exposure but the source is not known.

Ohio also tracks cases among its healthcare workforce and reports the statistics publicly. As of April 9, the state reported a total of 5512 cases, with 1137 (21%) of those among healthcare workers.

Ohio Department of Health Spokesperson Melanie Amato told Medscape Medical News, “We decided to track the number of healthcare workers so we could show how important it is to have PPE for these workers to continue and try to protect them from getting sick. We also wanted to be transparent in our testing and tracking throughout Ohio.”

BuzzFeed News reported that 10 other states are reporting infections among healthcare workers. As of April 9, the numbers were as follows: Alabama (393), Arkansas (158), Idaho (143), Maine (97), New Hampshire (241), Oklahoma (229), Oregon (153), Pennsylvania (850), Rhode Island (257), and West Virginia (76). Additionally, Washington, DC, reported 29 cases among healthcare workers.

A Washington state official told BuzzFeed News that the state is asking people with confirmed COVID-19 about their professions, but the state is not disclosing the numbers because information is incomplete.

Officials in Illinois and New Jersey also told BuzzFeed that the information is not publicly available.

There are several reasons healthcare workers are not being tracked as a subset, Frogner, from the University of Washington, said. One is that the question of what someone does for a living is not being asked at the point of testing. Even if that question were asked, the follow-up questions needed may be too cumbersome, such as those around whether the person is currently actively employed and what their job entails.

Another reason is that there doesn’t seem to be a repository for the data, she said.

“I have put out calls through social media saying, ‘Who’s collecting this data?’ and I’ve had radio silence,” Frogner said. “It seems it may be individual researchers trying to track this.”

Additionally, there may be some political aspects behind not publicly reporting the data as well, she said. Publishing the numbers may invite scrutiny about testing practices.

“Those may be questions that healthcare systems are not ready to answer or interested in answering right now because they may be focusing more on the patients and not so much the providers,” Frogner said.

Ideally, information would be reported not only on how many healthcare workers are sick but also whether they are doctors, nurses, receptionists, janitorial, or food staff workers, she said.




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