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Friday, January 22, 2021
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Coronavirus Considerations

Covid-19   Vaccines   Hospitals & Health Systems   Policy  Workplace Safety

Today’s Read: 3.5 minutes

Coronavirus is top of mind with the FDA advisory panel meeting yesterday and moving the Pfizer/BioNTech vaccine one step closer to possible EUA. Also, nurses are the most at risk from work-related exposures. 

Also, happy first night of Hanukkah!

MORNING BRIEF

Work-related exposure puts nurses most at risk

A study of 6,510 healthcare professionals working in a well-resourced health system—with continuous and adequate PPE—found that 4.8% of its HCPs tested positive for Covid-19 through June. This is the largest systematically-collected cohort study of Covid-19 risk for HCPs in the U.S.

It found that without adjusting for community spread, researchers found the positive rate by occupational group to be:

  • Support services (i.e., Environmental Services, Food Services, etc.):  10.4%
  • Medical assistants:  10.1%
  • Respiratory technicians:  9.3%
  • Nurses:  7.6%
  • Admins:  3.8%
  • Physicians:  3.3%

However, after adjusting for self-reported out-of-hospital exposure to someone with Covid-19 and demographics, nurses were the only occupational group to be significantly more likely to have tested positive.

The authors suggest a few notable takeaways:

  • Community transmission was the largest risk factor for HCPs in a well-resourced health system not overwhelmed with hospitalized Covid-19 patients.
  • Nurses are at the highest work-related exposure due to their essential role on the care team relying on frequent and close contact with patients.
  • Participation in high-flow oxygen therapy and hemodialysis were associated with a higher transmission risk, but other airway procedures (including intubation and bronchoscopy) were not associated with higher transmission risk.
  • Approximately 1 in 5 participants who were seropositive did not think they had Covid-19, which is consistent with prior estimates of asymptomatic rates of Covid-19 infection.

The study concludes that maintaining sufficient levels of PPE and encouraging staff vigilance (inside and outside of the hospital) combine to be highly effective in minimizing Covid-19 transmission risk over acute exposure periods. However, the authors acknowledge that both variable PPE supply and prolonged exposure may result in higher transmission rates among HCPs.

One step closer

On Thursday a FDA advisory panel recommended the approval of the Pfizer/BioNTech coronavirus vaccine for emergency use in a 17-4 vote that included one abstention. This sets up the agency to make the final decision about granting the vaccine EUA within days.

If approved, millions of doses will be shipped to vaccinate healthcare workers and nursing home residents. Curious about what the panel discussed? STAT kept notes here.

Next week, the same panel will meet on Moderna’s Covid-19 vaccine candidate.

Covid-19 vaccine distribution by the numbers

On December 1, 2020, the CDC issued an initial recommendation that healthcare personnel and residents of long-term care facilities should be the first to be offered a COVID-19 vaccine once it is authorized or approved by the FDA. (This could happen next week.)

We know that there are 40 million doses (or enough to vaccinate 20 million people) to go around before the end of December, but how does that compare to the population of the prioritized or Phase 1A groups? Kaiser Family Foundation did the math. Here are the numbers:

  • 19.7 million adults working in healthcare settings, of which roughly 15.5 million are estimated to have direct patient contact
  • 1.2 million nursing facility residents and about 800,000 assisted living facility residents
  • 17.6 million people or about 7% of the adult population in the U.S. are either healthcare workers with direct patient contact or residents in either nursing facility or assisted living facilities

In theory, there should be enough vaccine doses to cover this first group, but much of this will be determined by distribution and how much each state receives.

Happy Hanukkah

Tonight is the first night of Hanukkah and whether you’ve planned your meals or not, here’s a collection of recipes that you (or a loved one) can make to keep you nourished for all 8 days. And if you don’t celebrate the holiday, there are enough potato recipes here to find a new comfort food favorite. Enjoy!

ONE BIG NUMBER

$400,000

The amount of money it will cost each of the 13,598 school districts in the U.S. to hire enough nurses, even if they serve only part-time, to safely re-open schools, according to the National Association of School Nurses.

DAILY DIVERSION

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