By Daniel R. Lucey MD, MPH, FIDSA
In its Wednesday Feb. 9 epidemiologic update, the Pan American Health Organization published an 18-nation listing of health care worker infections and deaths due to SARS-Cov-2 as of the day before.
As seen in the PAHO/WHO table below (page 18 of 21), the largest number of reported infections were in Brazil (457,686), the United States (393,104), Mexico (219,180) and Argentina (75,317).
The largest number of reported deaths were in Mexico (2,996), U.S. (1347), Peru (589) and Brazil (480).
These statistics for the U.S. are consistent with the U.S. Centers for Disease Control and Prevention website that is updated daily. As of today, the number of U.S. healthcare personnel infected is 402,451 and the number of reported deaths (an underestimate) is: 1,398.
For the PAHO/WHO report, the definition of a “health worker” is referenced in a Feb. 2 “special focus” WHO-Geneva report on infected health care workers:
“The term “health worker” includes allied health workers and auxiliary health workers such as cleaning and laundry personnel, x-ray physicians and technicians, clerks, phlebotomists, respiratory therapists, nutritionists, social workers, physical therapists, laboratory personnel, cleaners, admission/reception clerks, patient transporters, catering staff and so on . . .” (page 4 of 25).
In an International Journal of Infectious Diseases article with data on healthcare worker infections and deaths due to COVID-19 from a 37 nation survey, published online Oct. 29, an infectious disease colleague from Turkey, Dr. Hakan Erdem and I called for the WHO-Geneva to post such national data on their COVID-19 website in Geneva.
Examples of the major findings in the Feb. 9 PAHO report include:
- African Americans and Hispanic health workers had an increased risk of SARS CoV-2 infection.
- Education and training in infection prevention and control were associated with decreased risk of SARSCoV-2 infection in health workers.
- Certain exposures such as those involving intubations, other aerosol-generating procedures, direct patient contact, or contact with bodily secretions were found to be associated with increased infection risk compared with less intensive or direct exposure; though evidence was inconsistent, likely related to confounding factors such as those related to the availability, distribution, and use of PPE.
- Evidence on the association between health worker infection and use of individual PPE measures (masks, gloves, gown, eye protection) and hand hygiene was limited. However, most studies found that availability and appropriate use of PPE as recommended by local authorities was associated with decreased risk of SARS-CoV-2 infection. Evidence on the use of N95 or FFP2 respirators versus medical/surgical masks was inconclusive and limited to two inconsistent observational studies. Further information on the use of masks in health facilities can be found in the interim guidance on mask use in the context of COVID-19.
- Three studies found that universal masking in health facilities was associated with decreased risk of SARS-CoV-2 infection in health workers.
|Table 7. Confirmed COVID-19 cases and deaths among health care workers in the Americas. January 2020 to 8 February 2021*.
|Number of confirmed cases of COVID-19||Number of deaths|
|United States of America||393,104||1,347|
Daniel Lucey, M.D. MPH, FIDSA, FACP, is a Clinical Professor of Medicine at Dartmouth Geisel School of Medicine, Infectious Disease adjunct Professor at Georgetown Medical Center, senior scholar at Georgetown Law, Anthropology Research Associate at the Smithsonian Museum of Natural History and a member of the Infectious Diseases Society of America Global Health Committee. He served as a volunteer to outbreaks overseas including hands-on Ebola patient care in Sierra Leone and Liberia (Doctors without Borders) 2014, MERS 2013, SARS 2003, as well as HIV, H5N1, Zika, yellow Fever, and pneumonic plague 2017 (with WHO/USAID/CDC). Since Jan. 6, 2020 he has contributed over 75 posts to Science Speaks on COVID-19 and traveled to China in February 2020. He initially proposed, then fundraised and helped design the content for 2018-2022 Smithsonian Exhibition on Epidemics due to zoonotic viruses. From 1982-1988 he trained at University of California San Francisco and Harvard and was an attending physician at the NIH (NIAID) in the 1990s while in the US Public Health Service.