Health Care Workers Must Be Tested To Prevent Hospital Transmission – Dr. Musa Mohd Nordin

By CodeBlue | 19 April 2020

By increasing the testing of HCW, unnecessary self-isolation can be avoided and they can continue to join the otherwise depleted workforce.

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Hospitals are facing significant staff shortages due to self-isolation of HCW upon contact tracing.

One department in a private hospital was closed due to an infected staff member and 17 others were given leave of absence.

In the UK, significant staff shortages led to the adjustment of the ratio of critical care nurses to patients from 1:1 to 1:6. Intensivist to patient ratio was adjusted from 1:8 to 1:30.

1. Prevent unnecessary quarantine to bolster workforce

Due to the absence of COVID19 testing, large numbers of HCW were being allowed self-isolation.

Studies have shown that only 1 in 7 quarantined HCW were positive for the virus.

By increasing the testing of HCW, unnecessary self-isolation can be avoided and they can continue to join the otherwise depleted workforce.

2. Reduce in-hospital COVID19 transmission

57 (41%) of 138 patients in a centre in Wuhan, China acquired COVID19 whilst in hospital. Half of the HCW at the Emergency Room in Royal Gwent Hospital, Newport, Wales, tested positive for COVID19

Studies have shown that 12-44% of secondary cases were infected during the pre-symptomatic phase of illnesses from index cases.

Asymptomatic HCWs are a potential source of infection and should be tested.

Testing of HCW could reduce in-hospital transmission.

3. Protect the HCW

Eric Topol, the chief editor of Medscape tweeted; “1 of 5 of the COVID19 infections in Iowa are in the healthcare workforce. So many are related to lack of PPE, likely not just in one state. It’s inexcusable. And patient care is compromised as a result.”

In Italy and Spain, one in ten persons who tested positive for COVID19 were doctors and nurses. The shortage of PPE has led our HCW going into battle with homemade face shield, black bin liners armory and toy guns.

As the lady YBMK exclaimed in the Parody COVID2019 Pagi Jumaat; “What! You mean you putting our frontliners lives at risk because tak cukup PPE? This is totally unacceptable. I will not allow any of my KKM staff to do screening or treat an ILI/SARI case or our team of anesthesiologists and intensivist to manage their patients in ICU without PPE …PERIOD”

It is the basic responsibility of the Health Ministry to provide adequate and appropriate PPE, to protect the HCW at the frontline of COVID19 duties.

In an effort to protect the healthcare workforce, to ensure they remain healthy, are not burnt out, to alleviate their and their families anxiety, to remain COVID19-free, and to limit nosocomial transmission of COVID19, some institutions are advocating weekly or fortnightly COVID19 screening of HCWs operating in high risk zones.

There is therefore a very convincing rationale for the mass testing of both symptomatic and asymptomatic HCW to mitigate workforce depletion by unnecessary isolation, reduce the spread of COVID19 in hospital settings and to protect the lives and welfare of the healthcare workforce.

The MOH is ramping up its testing capacity to 17,000 tests per day. This is one of a few pre-requisites in its efforts to flatten the COVID19 epidemic curve and its preparations for easing Movement Control Order (MCO) towards normalcy.

Apart from arming the HCW with the basic essentials of surgical masks, isolation gowns, gloves and face shields, the MOH must now seriously consider the testing of their most invaluable assets, their symptomatic and asymptomatic healthcare workforce to reduce the risk of hospital acquired infections.

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