Implementation of a COVID-19 surveillance programme for healthcare workers in a teaching hospital in an upper-middle-income country

Wan, Kim Sui; Tok, Peter Seah Keng; Yoga Ratnam, Kishwen Kanna; Aziz, Nuraini; Isahak, Marzuki; Ahmad Zaki, Rafdzah; Nik Farid, Nik Daliana; Hairi, Noran Naqiah; Rampal, Sanjay; Ng, Chiu-Wan; Samsudin, Mohd Fauzy; Venugopal, Vinura; Asyraf, Mohammad; Damanhuri, Narisa Hatun; Doraimuthu, Sanpagavalli; Arumugam, Catherine Thamarai; Marthammuthu, Thaneswaran; Nawawi, Fathhullah Azmie; Baharudin, Faiz; Chong, Diane Woei Quan; Jayaraj, Vivek Jason; Magarita, Venna; Ponnampalavanar, Sasheela; Hasnan, Nazirah; Kamarulzaman, Adeeba; Said, Mas Ayu

INTRODUCTION: The reporting of Coronavirus Disease 19 (COVID-19) mortality among healthcare workers highlights their vulnerability in managing the COVID-19 pandemic. Some low- and middle-income countries have highlighted the challenges with COVID-19 testing, such as inadequate capacity, untrained laboratory personnel, and inadequate funding. This article describes the components and implementation of a healthcare worker surveillance programme in a designated COVID-19 teaching hospital in Malaysia. In addition, the distribution and characteristics of healthcare workers placed under surveillance are described. MATERIAL AND METHODS: A COVID-19 healthcare worker surveillance programme was implemented in University Malaya Medical Centre. The programme involved four teams: contact tracing, risk assessment, surveillance and outbreak investigation. Daily symptom surveillance was conducted over fourteen days for healthcare workers who were assessed to have low-, moderate- and high-risk of contracting COVID-19. A cross-sectional analysis was conducted for data collected over 24 weeks, from the 6(th) of March 2020 to the 20(th) of August 2020. RESULTS: A total of 1,174 healthcare workers were placed under surveillance. The majority were females (71.6%), aged between 25 and 34 years old (64.7%), were nursing staff (46.9%) and had no comorbidities (88.8%). A total of 70.9% were categorised as low-risk, 25.7% were moderate-risk, and 3.4% were at high risk of contracting COVID-19. One-third (35.2%) were symptomatic, with the sore throat (23.6%), cough (19.8%) and fever (5.0%) being the most commonly reported symptoms. A total of 17 healthcare workers tested positive for COVID-19, with a prevalence of 0.3% among all the healthcare workers. Risk category and presence of symptoms were associated with a positive COVID-19 test (p<0.001). Fever (p<0.001), cough (p = 0.003), shortness of breath (p = 0.015) and sore throat (p = 0.002) were associated with case positivity. CONCLUSION: COVID-19 symptom surveillance and risk-based assessment have merits to be included in a healthcare worker surveillance programme to safeguard the health of the workforce.