A hospital-wide response to multiple outbreaks of COVID-19 in Health Care WorkersLessons learned from the field

Buising, K.; Williamson, D.; Cowie, B.; MacLachlan, J.; Orr, L.; MacIsaac, C.; Williams, E.; Bond, K.; Muhi, S.; McCarthy, J.; Maier, A.; Irving, L.; Heinjus, D.; Kelly, C.; Marshall, C.

Objective: To describe COVID-19 infections amongst healthcare workers (HCWs) at the Royal Melbourne Hospital from 1st July to 31st August 2020 Design: Prospective observational study Setting: A 550 bed tertiary referral hospital in metropolitan Melbourne Participants: All HCWs identified with COVID-19 infection in the period of interest Results: 262 HCW infections were identified over 9 weeks. 68.3% of infected HCWs were nurses and the most affected locations were the geriatric and rehabilitation wards. Clusters of infection occurred in staff working in wards with patients known to have COVID-19 infection. Staff infections peaked when COVID-19 infected inpatient numbers were highest, and density of patients and certain patient behaviours were noted by staff to be linked to possible transmission events. Three small outbreaks on other wards occurred but all were recognised and brought under control. Availability of rapid turn-around staff testing, and regular review of local data and obtaining feedback from staff helped identify useful interventions which were iteratively implemented. Attention to staff wellbeing was critical to the response and a comprehensive support service was implemented. Conclusion(s): A comprehensive multimodal approach to containment was instituted with iterative refinement based on frontline workers observations and ongoing analysis of local data in real time.