In the early months of the coronavirus disease 2019 (COVID-19) pandemic and before vaccine availability, there were concerns that infected emergency department (ED) health care personnel could present a threat to the delivery of emergency medical care. We examined how the pandemic affected staffing levels and whether COVID-19 positive staff were potentially infectious at work in a cohort of US ED health care personnel in 2020. The COVID-19 Evaluation of Risks in Emergency Departments (Project COVERED) project was a multicenter prospective cohort study of US ED health care personnel conducted from May to December 2020. During surveillance, health care personnel completed weekly electronic surveys and underwent periodic serology and nasal reverse transcription polymerase chain reaction testing for SARS-CoV-2, and investigators captured weekly data on health care facility COVID-19 prevalence and health care personnel staffing. Surveys asked about symptoms, potential exposures, work attendance, personal protective equipment use, and behaviors. We enrolled 1,673 health care personnel who completed 29,825 person weeks of surveillance. Eighty-nine (5.3%) health care personnel documented 90 (0.3%; 95% confidence interval [CI] 0.2% to 0.4%) person weeks of missed work related to documented or concerns for COVID-19 infection. Health care personnel experienced symptoms of COVID-19 during 1,256 (4.2%) person weeks and worked at least one shift whereas symptomatic during 1,042 (83.0%) of these periods. Seventy-five (4.5%) participants tested positive for SARS-CoV-2 during the surveillance period, including 43 (57.3%) who indicated they never experienced symptoms; 74 (98.7%; 95% CI 90.7% to 99.9%) infected health care personnel worked at least one shift during the initial period of infection, and 71 (94.7%) continued working until laboratory confirmation of their infection. Physician staffing was not associated with the facility or community COVID-19 levels within any time frame studied (Kendall tau’s 0.02, 0.056, and 0.081 for no shift, one-week time shift, and 2-week time shift, respectively). During the first wave of the pandemic, COVID-19 infections in ED health care personnel were infrequent, and the time lost from the workforce was minimal. Health care personnel frequently reported for work while infected with SARS-CoV-2 before laboratory confirmation. The ED staffing levels were poorly correlated with facility and community COVID-19 burden.

中文翻译：

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2019 年紧急医护人员的冠状病毒病感染：对美国紧急医疗服务提供的影响，2020 年


在 2019 冠状病毒病 （COVID-19） 大流行的最初几个月和疫苗可用之前，人们担心受感染的急诊科 （ED） 医护人员可能会对紧急医疗服务的提供构成威胁。我们研究了大流行如何影响 2020 年美国 ED 医护人员队列的 COVID-19 阳性员工在工作中是否具有潜在传染性。COVID-19 急诊科风险评估 （Project COVERED） 项目是 2020 年 5 月至 2020 年 12 月对美国急诊科医护人员进行的一项多中心前瞻性队列研究。在监测期间，医护人员每周完成一次电子调查，并定期接受 SARS-CoV-2 血清学和鼻腔逆转录聚合酶链反应检测，研究人员每周收集有关医疗机构 COVID-19 患病率和医护人员配备的数据。调查询问了症状、潜在接触、工作出勤率、个人防护设备的使用和行为。我们招募了 1,673 名医护人员，他们完成了 29,825 人周的监测。89 名 （5.3%） 医护人员记录了 90 （0.3%;95% 置信区间 [CI] 0.2% 至 0.4%） 周与记录或担心 COVID-19 感染相关的缺勤周。医护人员在 1,256 （4.2%） 人周期间出现 COVID-19 症状，并在其中 1,042 人 （83.0%） 期间至少轮班工作，同时出现症状。在监测期间，75 名 （4.5%） 参与者的 SARS-CoV-2 检测呈阳性，其中 43 名 （57.3%） 表示他们从未出现过症状;74 （98.7%;95% CI 90.7% 至 99.9%）感染的医护人员在感染初期至少工作了一个班次，71 人 （94.7%） 继续工作，直到实验室确认感染。在研究的任何时间范围内，医生人员配备与设施或社区 COVID-19 水平无关（Kendall tau 的 0.02、0.056 和 0.081 分别代表无班次、一周时间转移和 2 周时间转移）。在第一波大流行期间，急诊医护人员感染 COVID-19 的情况并不常见，从劳动力中损失的时间也很少。医护人员在实验室确诊前经常在感染 SARS-CoV-2 时报告工作。急诊科人员配备水平与设施和社区 COVID-19 负担的相关性差。