London School of Hygiene & Tropical Medicine

During the first peak of the COVID-19 pandemic in Scotland, whilst the absolute risk remained low, patient-facing healthcare workers were at three-fold higher risk of hospitalisation with COVID-19 than the general population, according to new research published in the BMJ.

The study involving the London School of Hygiene & Tropical Medicine (LSHTM) and jointly led by scientists at the University of Glasgow and Public Health Scotland, also found that individuals living in the same households as a patient-facing healthcare worker were at two-fold higher risk than the general population.

Healthcare workers and individuals living in their households also accounted for one in six of all individuals hospitalised with COVID-19 in Scotland. 

Dr Anoop Shah, from LSHTM and study co-author, said: ‘Healthcare workers are integral in maintaining a functioning health system. Our analysis evaluated the risk of hospitalisation from COVID-19 in healthcare workers and their families. Overall, the absolute risk of healthcare workers being hospitalised is quite small. However, those healthcare workers delivering direct patient care and their household members are at a higher risk of COVID-19 hospitalisation with significant implications for not only their health, but also in continuing to deliver healthcare for the general population."

The researchers conducted an analysis of national records to compare the risk of hospitalisation with COVID-19 among healthcare workers (age 18-65 years), their households, and other members of the general population during the peak period for COVID-19 infection in Scotland (1st March 2020 to 6th June 2020).

In total, the study looked at 158,445 health care workers – the majority being patient facing (57%) – and 229,905 other individuals of all ages living in their households

The study also found that, among healthcare workers, those who worked in front-door patient facing roles such as in emergency medicine departments, were at higher risk than staff in other patient-facing settings.

For most patient-facing healthcare workers and their households, the estimated absolute risk of COVID-19 hospitalisation over the duration of the first peak of the pandemic was less than 1 in 200. However, in older men with co-existing diseases, who worked in patient facing roles, the risk did reach 1% and above.

The risk of COVID-19 hospitalisation in non-patient facing healthcare workers and their households was similar to the risk in the general population.

Dr David McAllister, Wellcome Trust Intermediate Clinical Fellow and Beit Fellow, who is a public health doctor based at the University of Glasgow, said: “Healthcare workers continue to play a vital role in our response to the pandemic, every day.  It is vital that we understand the risks associated with COVID-19 for them and their families, and not just for their own health, but also so that we can protect and plan for the workforce in the future.

“This work helps us to do that.  It highlights that whilst the risk for many healthcare staff is similar to that of the general population, there is higher risk to some staff.  Knowing this can help us to take action to protect those staff at greatest risk as we work through this pandemic.  With other organisations across Scotland, we are working to make sure that we do that.”

Publication

Anoop S V Shah, Rachael Wood, Ciara Gribben,  David Caldwell,  Jennifer Bishop,  Amanda Weir, Sharon Kennedy,  Martin Reid, Alison Smith-Palmer,  David Goldberg, Jim McMenamin,  Colin Fischbacher, Chris Robertson, Sharon Hutchinson, Paul McKeigue, Helen Colhoun, David A McAllister. Risk of hospitalisation with coronavirus disease 2019 in healthcare workers and their households: a nationwide linkage cohort study BMJ. DOI:10.1136/bmj.m3582