• Justin Kua, Reshma Patel, Eveliina Nurmi, Sarah Tian, Harpreet Gill, WongDanny J NDJN0000-0002-3524-1766Health Services Research Centre, National Institute of Academic Anaesthesia, Royal College of Anaesthetists, London, UK.Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK., Calvin Moorley, Dmitri Nepogodiev, Imran Ahmad, and Kariem El-Boghdadly.
• Department of Targeted Intervention, Centre for Perioperative Medicine, UCL Division of Surgery and Interventional Science, University College London, University of London, London, United Kingdom.
• PeerJ. 2021 Jan 1; 9: e10891.

ObjectiveTo establish the prevalence, risk factors and implications of suspected or confirmed coronavirus disease 2019 (COVID-19) infection among healthcare workers in the United Kingdom (UK).DesignCross-sectional observational study.SettingUK-based primary and secondary care.ParticipantsHealthcare workers aged ≥18 years working between 1 February and 25 May 2020.Main Outcome MeasuresA composite endpoint of laboratory-confirmed diagnosis of SARS-CoV-2, or self-isolation or hospitalisation due to suspected or confirmed COVID-19.ResultsOf 6,152 eligible responses, the composite endpoint was present in 1,806 (29.4%) healthcare workers, of whom 49 (0.8%) were hospitalised, 459 (7.5%) tested positive for SARS-CoV-2, and 1,776 (28.9%) reported self-isolation. Overall, between 11,870 and 21,158 days of self-isolation were required by the cohort, equalling approximately 71 to 127 working days lost per 1,000 working days. The strongest risk factor associated with the presence of the primary composite endpoint was increasing frequency of contact with suspected or confirmed COVID-19 cases without adequate personal protective equipment (PPE): 'Never' (reference), 'Rarely' (adjusted odds ratio 1.06, (95% confidence interval: [0.87-1.29])), 'Sometimes' (1.7 [1.37-2.10]), 'Often' (1.84 [1.28-2.63]), 'Always' (2.93, [1.75-5.06]). Additionally, several comorbidities (cancer, respiratory disease, and obesity); working in a 'doctors' role; using public transportation for work; regular contact with suspected or confirmed COVID-19 patients; and lack of PPE were also associated with the presence of the primary endpoint. A total of 1,382 (22.5%) healthcare workers reported lacking access to PPE items while having clinical contact with suspected or confirmed COVID-19 cases.ConclusionsSuspected or confirmed COVID-19 was more common in healthcare workers than in the general population and is associated with significant workforce implications. Risk factors included inadequate PPE, which was reported by nearly a quarter of healthcare workers. Governments and policymakers must ensure adequate PPE is available as well as developing strategies to mitigate risk for high-risk healthcare workers during future COVID-19 waves.© 2021 Kua et al.

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