key: cord-0689492-aweykx1u authors: Cuadros-González, Juan title: SARS-CoV-2 infection among hospital workers. What about us? date: 2021-08-02 journal: Enferm Infecc Microbiol Clin (Engl Ed) DOI: 10.1016/j.eimce.2021.03.004 sha: 855d1f1892c3832448c84ce8e8bdd81e3bee3239 doc_id: 689492 cord_uid: aweykx1u nan but later the virus spread and ended up affecting non-healthcare personnel to a great extent as well. 14 This issue of the journal presents two seroprevalence studies carried out in Spanish hospitals after the first pandemic wave. The results vary between a prevalence of antibodies of 6.6% described by Gras-Valenti et al. in a total of 4179 workers 15 from Alicante and 31% in 2590 workers from Madrid. 16 These two studies differ in the type of personnel studied (hospital and primary care personnel vs hospital), the serological parameters determined (IgG, IgM/IgA vs IgG) and the prevalence of COVID in the general population of the hospital environment, variables that could explain the differences in infection rates. Seroprevalence studies have been published in other hospitals in our country with disparate results, from 11% in a study carried out a few weeks after the start of the pandemic in a large university hospital, 17 to 37% in another study carried out in a hospital in Madrid, where the first wave had a strong impact 14 and the percentage of infection was determined taking into account not only the serological study, but also the previous diagnoses made by PCR. 18, 19 The role of asymptomatic infection as an amplifying factor of infection in a closed institution is well reflected in the series by Galán et al. 16 where it is shown how up to 48.5% of the seropositive workers did not present any symptoms. Serological studies in health workers played a very important role in the first months of the pandemic. When there were no effective treatments or vaccines in sight, the hospital staff wanted to know if he/she had developed immunity to know his risk of infection and transmission to the family environment. 9 However, the initial uncertainty about the protective meaning of the antibodies and the doubts regarding the reliability of the technologies that were progressively available (rapid tests in lateral flow format, ELISA and CLIA) 20 delayed the availability of the results. The arrival on the market of imported reagents, acquired in many cases without the endorsement of analytical or clinical validation studies, initially generated many problems, not only in Spain. In the United Kingdom, for example, the government immobilized a purchase of several million rapid tests due to poor sensitivity and specificity, which showed that it did not correspond to what the package insert indicated. 21 However, it has already been proven that some rapid tests had a similar performance to ELISAs test for detecting IgG from the 3-4 week after the onset of symptoms and can be very useful for serosurveys when no other techniques are available, as it was shown in the ENE-COVID study and others carried out after the first wave of the pandemic. 18 In this sense, it is essential to guaran-tee the capacity of Clinical Microbiology laboratories to carry out analytical and clinical validation studies of new reagents quickly and independently before starting their clinical use. We do not yet know how long this pandemic will continue and neither if any of the variants of the SARS-CoV-2 virus will continue to circulate for many years. In any case, it is clear that the protection of healthcare personnel must be an absolute priority in the future and it is very likely that some current established practices will continue for months or years, such as the use of masks and PPE in some areas of hospitals or the establishment of clean and dirty circuits. Another fundamental aspect will also be to have a truly functional and operational National Pandemic Preparedness and Reaction Plan, which should include such basic aspects as the establishment of sufficient reserves of protection material and the strengthening of Public Health Networks. In addition, another priority objective should be investment in R&D in Health Sciences and, in the healthcare field, to increase the diagnostic capacity of Clinical Microbiology Laboratories, reinforcing such aspects as continuous 24/7 care and molecular diagnosis, and also improving the sequencing capacity and developing a National Strategy for Digital Health. Although in most of the countries of the Northern Hemisphere all health personnel are already vaccinated, we must not forget that in the rest of the planet, health workers continue to be exposed to the virus every day in very difficult conditions. Although the COVAX initiative (COVID-19 Vaccine Global Access) 22 was born with the objective that all countries have equitable access to vaccines, the reality has been very different and it was not until the end of February that the first shipments of the AstraZeneca vaccine arrived to the African continent in Ghana and Ivory Coast. 23 It is our obligation to contribute in solidarity to ensure that most of the world's population is vaccinated as soon as possible, since we can only get out of this pandemic together. The resilience of the Spanish health system against the COVID-19 pandemic Over 17,000 health workers have died from COVID-19, showing urgent need for rapid vaccine rollout Cerca de 570.000 trabajadores de la salud se han infectado y 2.500 han muerto por COVID-19 en las Américas -OPS/OMS|Organización Panamericana de la Salud Actualización de la situación COVID 19 Long-term follow-up of recovered patients with COVID-19 A review of persistent post-COVID syndrome (PPCS) The impact of the COVID-19 pandemic on the mental health of healthcare professionals Prevalence and risk factors for mortality related to {COVID}-19 in a severely affected area of Is the coronavirus airborne? Experts can't agree Efficacy of face mask in preventing respiratory virus transmission: a systematic review and metaanalysis CoViD-19 e dispositivi di protezione individuale: qualcuno di noi morirà per la loro carenza SARS-CoV-2 infection among hospital workers of one of the most severely affected institutions in Madrid Spain: a surveillance cross-sectional study Estudio de sero-epidemiología de la infección por SARS-CoV-2 en profesionales sanitarios de un departamento sanitario Hospital-Wide SARS-CoV-2 seroprevalence in health care workers in a Spanish teaching hospital Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital Alltest rapid lateral flow immunoassays is reliable in diagnosing SARS-CoV-2 infection from 14 days after symptom onset: a prospective singlecenter study Seroprevalence of antibodies against SARS-CoV-2 among health care workers in a large Spanish reference hospital Antibody testing for COVID-19: a report from the National COVID Scientific Advisory Panel Paid $20 million for new coronavirus tests. They didn't work Covax must go beyond proportional allocation of covid vaccines to ensure fair and equitable access COVID-19: Where are we on vaccines and variants?