• BMJ open · Jul 2021

    National cross-sectional survey of 1.14 million NHS staff SARS-CoV-2 serology tests: a comparison of NHS staff with regional community seroconversion rates.

    • ColtartCordelia E MCEM0000-0003-0176-8831Institute for Global Health, University College London, London, UK aidan.fowler@dhsc.gov.uk cordelia.coltart@ucl.ac.uk.Chief Medical Officer's Office, Department of Health and Social Care, London, UK., David Wells, Esther Sutherland, and Aidan Fowler.
    • Institute for Global Health, University College London, London, UK aidan.fowler@dhsc.gov.uk cordelia.coltart@ucl.ac.uk.
    • BMJ Open. 2021 Jul 13; 11 (7): e049703.

    ObjectivesAn initial report of findings from 1.14 million SARS CoV-2 serology tests in National Health Service (NHS) staff to compare NHS staff seroconversion with community seroconversion rates at a regional level.DesignA national cross-sectional survey.SettingA SARS-CoV-2 antibody testing programme offered across all NHS Trusts.Participants1.14 million NHS staff.InterventionSARS-CoV-2 antibody testing.Primary And Secondary Outcome MeasuresSARS-CoV-2 antibody testing was used to estimate the seroprevalence of SARS-CoV-2 in NHS staff by region, compared with community seroprevalence as determined by the COVID-19 Infection Survey (Office for National Statistics). We also explored seroprevalence trends by regional COVID-19 activity, using regional death rates as a proxy for COVID-19 'activity'.Results1 146 310 tests were undertaken on NHS staff between 26 May and 31 August 2020. 186 897 NHS tests were positive giving a seroconversion rate of 16.3% (95% CI 16.2% to 16.4%), in contrast to the national community seroconversion rate of 5.9% (95% CI 5.3% to 6.6%). There was significant geographical regional variation, which mirrored the trends seen in community prevalence rates. NHS staff were infected at a higher rate than the general population (OR 3.1, 95% CI 2.8 to 3.5). NHS seroconversion by regional death rate suggested a trend towards higher seroconversion rates in the areas with higher COVID-19 'activity'.ConclusionsThis is the first cross-sectional survey assessing the risk of COVID-19 disease in healthcare workers at a national level. It is the largest study of its kind. It suggests that NHS staff have a significantly higher rate of COVID-19 seroconversion compared with the general population in England, with regional variation across the country which matches the background population prevalence trends. There was also a trend towards higher seroconversion rates in areas which had experienced high COVID-19 clinical activity. This work has global significance in terms of the value of such a testing programme and contributing to the understanding of healthcare worker seroconversion at a national level.© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

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