COVID-19 Resource Center
COVID-19 Resource Center
Source/Disclosures
Disclosures: Chan previously served as an investigator on a clinical trial of diet and lifestyle using a separate smartphone app that was supported by Zoe Global, the company that codeveloped the app for this study. Please see the study for all other authors’ relevant financial disclosures.
August 10, 2020
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Frontline HCWs at least 3.4 times more likely to test positive for COVID-19

Source/Disclosures
Disclosures: Chan previously served as an investigator on a clinical trial of diet and lifestyle using a separate smartphone app that was supported by Zoe Global, the company that codeveloped the app for this study. Please see the study for all other authors’ relevant financial disclosures.
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Frontline health care workers are at least three times more likely to test positive for COVID-19 than the general community, with the highest risk for infection occurring among Black, Hispanic and Asian health care workers, according to a recent analysis.

Andrew T. Chan

The results, which were published in The Lancet Public Health, are from a prospective, observational cohort study of more than 99,000 frontline health care workers (HCWs) in the United States and United Kingdom.

“We continue to grapple with shortages of personal protective equipment (PPE), particularly for caregivers who are racial-ethnic minorities,” Andrew T. Chan, MD, MPH, professor of medicine at Harvard Medical School and chief of the clinical and translational epidemiology unit at Massachusetts General Hospital, told Healio. “Our results underscore the importance of providing adequate access to PPE and suggest that systemic racism associated with inequalities to access to PPE contributes to the disproportionate risk of infection faced by minority health care workers.”

Chan and colleagues analyzed self-reported data from more than 2 million community members and 99,795 HCWs to determine the effect of PPE on risk for COVID-19, as well as disparities in infection rates. The data came from COVID Symptom Study, a free smartphone app.

There were 5,545 positive COVID-19 test results overall. According to Chan and colleagues, HCWs faced a higher risk for reporting a positive COVID-19 result than the general population (adjusted HR = 11.61; 95% CI, 10.93-12.33). After the researchers adjusted the results to account for differences in testing frequency between HCWs and the general population, the risk was still more than three times higher (HR = 3.40; 95% CI, 3.37-3.43) for HCWs.

The incidence of COVID-19 was higher among Black, Asian and minority ethnic frontline HCWs (4.05%) than among non-Hispanic white HCWs (2.33%). This discrepancy was also present among the general population, with COVID-19 incidence rates of 0.19% and 0.5% among non-Hispanic white individuals and Black, Asian and ethnic minority groups, respectively.

Chan said further studies are necessary to evaluate PPE and testing data.

“These results are among the first to provide a concrete estimate of the increased risk faced by health care workers and the importance of adequate PPE,” Chan concluded. “It also highlights that systemic inequalities are inherent in our health care system and contribute to the disparities we see in infection risk among racial ethnic minorities.”