key: cord-0956204-l81s6t78 authors: Pan, Sung-Ching; Hsu, Mu-Ching; Chang, Hsin-Hsin; Wang, Jann-Tay; Lai, Yu-Ling; Chen, Pau-Chung; Chang, Sui-Yuan; Sheng, Wang-Huei; Chen, Yee-Chun; Chen, Shyr-Chyr; Chang, Shan-Chwen title: Prospective health surveillance for COVID-19 among health care workers at a university medical center in Taiwan, January to June 2020 date: 2021-07-23 journal: J Formos Med Assoc DOI: 10.1016/j.jfma.2021.07.018 sha: dca8eafefebed6affa9b3c5b2a6e53c75f88db52 doc_id: 956204 cord_uid: l81s6t78 Background Healthcare personnel (HCP) at the front line of care are exposed to occupational hazards that place them at risk for infection, which then endanger patient safety and compromise the capability of the healthcare workforce. As of March 8, 2021 more than 420,170 HCP in US had been infected with SARS CoV-2 with 1,388 deaths. In two Taiwan hospitals COVID-19 outbreaks involved HCP and resulted in shutdown of service. This report describes our prospective health surveillance of the HCP and COVID-19 containment measures in a teaching hospital in Taiwan during Jan. 1 through June 30, 2020. Methods We prospectively monitored incidents, defined as an HCP with the predefined symptoms, reported by HCP through the web-based system. HCP were managed based on an algorithm that included SARS CoV-2 RNA PCR testing. Infection prevention and control policy/practice were reviewed. Results This hospital took care of 17 confirmed COVID-19 cases during the study period and the first Case was admitted on January 23, 2020. Among the 14,210 HCP, there were 367 incident events. Of 283 HCP tested for SARS CoV-2, 179 had predefined symptoms. These included 10 HCP who met the national case definition for COVID-19 infection and 169 based on Extended COVID-19 Community Screening program. The other 104 asymptomatic HCP were tested based on hospital policy. All of them had tested negative. Conclusion We attribute our success in preventing COVID-19 infections among HCP to rapid, proactive, decisive, integrated national and institutional response in the early stages of the epidemic Healthcare personnel (HCP) at the front line of care are exposed to occupational 3 hazards that place them at risk for infection, which then endanger patient safety and 4 compromise the capability of the healthcare workforce. As of March 8, 2021 more 5 than 420,170 HCP in US had been infected with SARS CoV-2 with 1,388 deaths. In 6 two Taiwan hospitals COVID-19 outbreaks involved HCP and resulted in shutdown 7 of service. This report describes our prospective health surveillance of the HCP and 8 COVID-19 containment measures in a teaching hospital in Taiwan during Jan. 1 9 through June 30, 2020. 10 We prospectively monitored incidents, defined as an HCP with the predefined 12 symptoms, reported by HCP through the web-based system. HCP were managed 13 based on an algorithm that included SARS CoV-2 RNA PCR testing. Infection 14 prevention and control policy/practice were reviewed. symptoms. These included 10 HCP who met the national case definition for COVID-20 program. The other 104 asymptomatic HCP were tested based on hospital policy. All 22 of them had tested negative. 23 We attribute our success in preventing COVID-19 infections among HCP to rapid, 25 proactive, decisive, integrated national and institutional response in the early stages of 26 the epidemic 27 Introduction 31 Taiwan has experienced epidemic/pandemic due to the novel coronaviruses SARS and 32 novel influenza H1N1 and H7N9. [1] [2] [3] [4] Healthcare personnel (HCP) are at the front line 33 of care and are exposed to occupational hazards that place them at risk for infection. 1 The government restricted hospital visits stepwise to protect healthcare settings. 22 162 These restrictions include the number and duration of visitors or bedside caregivers. 163 givers and visitors for 28 days just in case that they will be informed if a clustering of 165 infection occurs in the unit. Any patient, visitor or HCP who has potential risk such as 166 oversea travel in the preceding 14 days is not allowed to enter the hospital with 167 exemption. 168 Risk assessment is conducted for patients or visitor to restrict the hospital entry. For This study has several limitations. First of all, the zero hospital-acquired infection 317 during the study period was based both on the compliance of national guidelines and 318 program, as well as the low prevalence of community COVID-19. Thus, the study result 319 may not be generalized in the presence of high activity of community spread of COVID-320 19. In that situation, additional strategies are warranted. Second, the HCP were exposed to 321 only 17 confirmed cases during the study period, but 29 HCP were exposed to confirmed 322 cases before they were isolated in negative pressure rooms and 64 HCP returned from 323 countries where COVID-19 outbreak in the community were confirmed. None of the HCP 324 became infected. A study from Korea showed that none of 184 HCP exposed to 13 325 patients with COVID-19 before recognizing their disease infections was infected 326 based on molecular testing. 41 A recent review based on available data from 41 327 countries showed the median HCP infection percentage among total cases was 328 10.04% (range 0-24.09%) and countries in Asia seem to have lower infection rates 329 among HCPs (<3%). 42 This could possibly be attributed either to the readiness of 330 these countries to deal with outbreaks. The third limitation is that the diagnosis of 331 COVID-19 infection in this study is based on RT-PCR for HCP with symptoms or 332 epidemiological risk. Some may argue there may have asymptomatic infection among 333 the HCP remained undiagnosed in the absence of periodical mass screening program. 334 Through another cross sectional study in this hospital during July 1 to Aug. 31, 2020, 335 all of the participated HCP (n=194) were seronegative, too. 43 Thus, the finding is in 336 line with our study to demonstrate the importance of an IPC policy and practice in the 337 hospital level and national level. Infection 365 control and SARS transmission among healthcare workers SARS in 368 hospital emergency room Self-402 reported olfactory and taste disorders in SARS-CoV-2 patients: a cross-sectional 403 study Combined interventions to suppress R0 and border 405 quarantine to contain COVID-19 in Taiwan Taiwan Centers for Infection Control Taiwan Centers for Infection Control. 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