Implementation of a COVID-19 surveillance programme for healthcare workers in a teaching hospital in an upper-middle-income country

• Main Authors: Wan, Kim Sui, Tok, Peter Seah Keng, Yoga Ratnam, Kishwen Kanna, Aziz, Nuraini, Isahak, Marzuki, Ahmad Zaki, Rafdzah, Nik Farid, Nik Daliana, Hairi, Noran Naqiah, Rampal, Sanjay, Ng, Chiu Wan, Samsudin, Mohd Fauzy, Venugopal, Vinura, Asyraf, Mohammad, Damanhuri, Narisa Hatun, Doraimuthu, Sanpagavalli, Arumugam, Catherine Thamarai, Marthammuthu, Thaneswaran, Nawawi, Fathhullah Azmie, Baharudin, Faiz, Chong, Diane Woei Quan, Jayaraj, Vivek Jason, Magarita, Venna, Ponnampalavanar, Sasheela, Hasnan, Nazirah, Kamarulzaman, Adeeba, Said, Mas Ayu
• Format: Article
• Published: Public Library of Science 2021
• Subjects: R Medicine
• Online Access: http://eprints.um.edu.my/25954/; https://doi.org/10.1371/journal.pone.0249394
• Institution: Universiti Malaya

Introduction The reporting of Coronavirus Disease 19 (COVID-19) mortality among healthcare workers highlights their vulnerability in managing the COVID-19 pandemic. Some low- and middleincome countries have highlighted the challenges with COVID-19 testing, such as inadequate capacity, untrained laboratory personnel, and inadequate funding. This article describes the components and implementation of a healthcare worker surveillance programme in a designated COVID-19 teaching hospital in Malaysia. In addition, the distribution and characteristics of healthcare workers placed under surveillance are described. Material and methods A COVID-19 healthcare worker surveillance programme was implemented in University Malaya Medical Centre. The programme involved four teams: Contact tracing, risk assessment, surveillance and outbreak investigation. Daily symptom surveillance was conducted over fourteen days for healthcare workers who were assessed to have low-, moderate- and high-risk of contracting COVID-19. A cross-sectional analysis was conducted for data collected over 24 weeks, from the 6th of March 2020 to the 20th of August 2020. Results A total of 1,174 healthcare workers were placed under surveillance. The majority were females (71.6%), aged between 25 and 34 years old (64.7%), were nursing staff (46.9%) and had no comorbidities (88.8%). A total of 70.9% were categorised as low-risk, 25.7% were moderate-risk, and 3.4% were at high risk of contracting COVID-19. One-third (35.2%) were symptomatic, with the sore throat (23.6%), cough (19.8%) and fever (5.0%) being the most commonly reported symptoms. A total of 17 healthcare workers tested positive for COVID-19, with a prevalence of 0.3% among all the healthcare workers. Risk category and presence of symptoms were associated with a positive COVID-19 test (p<0.001). Fever (p<0.001), cough (p = 0.003), shortness of breath (p = 0.015) and sore throat (p = 0.002) were associated with case positivity. Conclusion COVID-19 symptom surveillance and risk-based assessment have merits to be included in a healthcare worker surveillance programme to safeguard the health of the workforce. © 2021 Wan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.