Black Race, Community Predict COVID-19 Infection More Than Workplace

While there is no doubt that pharmacists and other healthcare professionals have a heightened risk of COVID-19 exposure because they care for sick patients, not every infection is related to workplace exposure. Find out how researchers determined that Black race and community spread might have been an even bigger factor in a large healthcare system.

ATLANTA – Because of their exposure to infected patients, healthcare workers are considered to be at higher risk of COVID-19. But not everyone gets sick at their workplace, and racial disparities don’t stop at the door to the hospital or clinic, however, a new study demonstrates.

The extensive survey of healthcare workers found that community and demographic factors, such as contact with a confirmed or suspected COVID-19-positive case outside the workplace and Black race, were stronger predictors of COVID-19 infection than occupational exposure. The results were published in Annals of Internal Medicine.

For the study, researchers from Emory University Medical School and Rollins School of Public Health analyzed data from a cross-sectional survey of health care workers conducted from April to June 2020 within their health care system. Their goals was to quantify occupational, community, and demographic risk factors for SARS-CoV-2 seropositivity. “Identifying occupational risk factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among health care workers (HCWs) can improve HCW and patient safety,” they explain. .

Results demonstrated an overall SARS-CoV-2 seroprevalence of 3.8% among the healthcare workers after the initial surge of the epidemic. When the authors adjusted for possible bias due to voluntary participation in testing, Black race was determined to bel a stronger predictor of infection than workplace exposure.

Employees and medical staff members, who had elected to participate in the SARS-CoV-2 serology testing offered to all HCWs as part of a quality initiative, completed a survey on exposure to COVID-19 and use of personal protective equipment. Researchers took a close look at the following as potential risk factors for COVID-19 infection:

• Demographic factors;
• Residential zip code incidence of infection;
• Occupational exposure to HCWs or patients who tested positive; and
• Use of personal protective equipment.

With 582 HCWs positive among 10,275 participants – 35% of the Emory Healthcare workforce, SARS-CoV-2 seropositivity was estimated to be 3.8% (95% CI, 3.4%-4.3. The authors report that community contact with a person known or suspected to have COVID-19 (adjusted odds ratio [aOR], 1.9 [CI, 1.4 to 2.6]; 77 positive persons [10.3%]) and community COVID-19 incidence (aOR, 1.5 [CI, 1.0 to 2.2]) increased the odds of infection, adding, “Black individuals were at high risk (aOR, 2.1 [CI, 1.7 to 2.6]; 238 positive persons [8.3%]).”

The report cautions, however, that “participation rates were modest and key workplace exposures, including job and infection prevention practices, changed rapidly in the early phases of the pandemic.”