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Infectious diseases

Healthcare workers at greater risk of COVID-19 despite 'adequate' PPE, finds research

A study that analysed data from users of the COVID Symptom Tracker App suggests that further infection control measures may be needed to protect frontline staff.

Open access article

The Royal Pharmaceutical Society has made this article free to access in order to help healthcare professionals stay informed about an issue of national importance.

To learn more about coronavirus, please visit: https://www.rpharms.com/resources/pharmacy-guides/wuhan-novel-coronavirus

Pharmacist wearing PPE

Source: TIROT / BSIP / SCIENCE PHOTO LIBRARY

The study suggests that further infection control measures may be needed to protect frontline staff

Frontline healthcare workers are three times more likely to test positive for coronavirus compared with the general population — even if they use adequate personal protective equipment (PPE), a study has found.

The findings, reported in Lancet Public Health on 31 July 2020, found that the risk was greater for healthcare workers from a black, Asian and minority ethnic (BAME) background, who were five times more likely to test positive.

Researchers analysed data from 2,035,395 users of the COVID Symptom Tracker App between 24 March and 23 April 2020 in the US and UK, of whom 99,795 were frontline healthcare workers.

Sebastien Ourselin, head of the School of Biomedical Engineering and Imaging Sciences at King’s College London and one of the authors of the paper, said that the findings “have tremendous impact for healthcare workers and hospitals”.

“The data is clear in revealing that there is still an elevated risk of SARS-CoV-2 infection despite availability of PPE,” he said.

In the paper, the authors note that while “ensuring the adequate allocation of PPE is important to alleviate structural inequities in COVID risk”, it may not be enough, adding that as “infection risk was increased even with adequate PPE, our results suggest the need to ensure proper use of PPE and adherence to other infection control measures”.

“Further intervention studies investigating modifiable risk factors for healthcare worker-related SARS-CoV-2 infection, ideally accounting for differential exposure according to race and ethnic background and care location, are urgently needed,” it continued.

In April 2020, NHS England said employers should “risk assess staff at potentially greater risk” of COVID-19, including people from BAME backgrounds.

But results of a joint survey by the UK Black Pharmacists Association (UKBPA) and the Royal Pharmaceutical Society (RPS), carried out in June 2020, found that more than two-thirds of BAME pharmacists said they had yet to be offered a COVID-19 risk assessment, almost two months after NHS England said employers should risk assess all staff.

Elsy Gomez Campos, president of the UKBPA, said the findings reported in Lancet Public Health provided “additional evidence of the risk healthcare staff from BAME backgrounds are facing while fighting the pandemic”.

“The fight against COVID-19 will be a lengthy one. It is essential that staff complete the now mandatory risk assessment and put in place appropriate measures to minimise the risk of contracting COVID-19.

“This is not the time to discriminate or put obstacles in the way of safety. Everyone in our profession, without exception, should step up and act decisively and responsibly to protect those that are putting their life at risk regardless of their skin colour or ethnicity.”

Sandra Gidley, president of the RPS, said that “urgent action is needed to protect our pharmacy teams, especially as there is increasing talk of a potential ‘second wave’”.

“There is a huge need for continued supplies of good-quality PPE, but this alone is not enough and other appropriate infection control measures should also be put into place,” she said. “Without this, the protection of our staff is jeopardised and ultimately could harm their ability to deliver vital care and pharmacy services to the public.”

Gidley added that the RPS is re-running its risk assessment survey “to assess whether progress has been made”.

A spokesperson for the Department of Health and Social Care (DHSC) told The Pharmaceutical Journal that the government has delivered “more than 2.4 billion items of PPE so far, with 30 billion items ordered for the future”.

The DHSC also said that NHS England and Improvement had set up five workstreams to support BAME workers, after learning of the disproportionate effect COVID-19 has on these staff. Within these workstreams are improved risk assessments of existing and returning staff; work to ensure training and compliance on use of PPE; and improved data collection on staff testing and absence, including breakdowns by protected characteristics.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2020.20208236

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