Surveillance and identification of clusters of healthcare workers with coronavirus disease 2019 (COVID-19): Multidimensional interventions at a comprehensive cancer center

• Published in: Infection Control & Hospital Epidemiology 2021-07, Vol.42 (7), p.797-802
• Main Authors: Ariza-Heredia, Ella J, Frenzel, Elizabeth, Cantu, Sherry, Carlson, Mary, Thomas, Georgia, Khawaja, Fareed, Raad, Issam I, Chemaly, Roy F
• Format: Article
• Language: English
• Subjects: Asymptomatic; Cancer; Contact Tracing; Coronaviruses; COVID-19; Disease control; Disease transmission; Employees; Health care; Health Personnel; Hospitals; Humans; Infections; Masks; Neoplasms; Nosocomial infection; Original; Pandemics; Patients; Quality improvement; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Social distancing
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/ice.2020.1315

Cases of novel coronavirus disease 2019 (COVID-19) were first reported in Wuhan, China, in December 2019. In this report, we describe 3 clusters of COVID-19 infections among healthcare workers (HCWs), not associated with patient exposure, and the interventions undertaken to halt ongoing exposure and transmission at our cancer center. A cluster of cases was defined as 2 or more cases of severe acute respiratory coronavirus virus 2 (SARS-CoV-2)-positive COVID-19 among HCWs who work in the same unit area at the same time. Cases were identified by real-time reverse transcription polymerase chain reaction testing. Contact tracing, facility observations, and infection prevention assessments were performed to investigate the 3 clusters between March 1 and April 30, 2020, with subsequent implementation of containment strategies. The initial cluster involved HCWs from an ancillary services unit, with contacts traced back to a gathering in a break room in which 1 employee was symptomatic, although not yet diagnosed with COVID-19, with subsequent transmission to 7 employees. The second cluster involved 4 employees and was community related. The third cluster involved only 2 employees with possible transmission while working in the same office at the same time. A step-up approach was implemented to control the spread of infection among employees, including universal masking, enhanced cleaning, increase awareness, and surveillance testing. No nosocomial transmission to patients transpired. To our knowledge, this is the first report of a hospital-based cluster of COVID-19 infections among HCWs in a cancer hospital describing our steps to mitigate further transmission.