1. Risk Stratification as a Tool to Rationalize Quarantine of Health Care Workers Exposed to COVID-19 Cases: Evidence From a Tertiary Health Care Center in India
- Author
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Vignesh Dwarakanathan, Aftab Ahmad, Shashi Kant, Arvind Kumar, Rakesh Lodha, Mohan Bairwa, Naveet Wig, Ravneet Kaur, Arti Kapil, Shivram Dhakad, and Pooja Pandey
- Subjects
medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Public Health, Environmental and Occupational Health ,030209 endocrinology & metabolism ,Guideline ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Hygiene ,law ,Family medicine ,Health care ,Workforce ,Quarantine ,Pandemic ,Medicine ,030212 general & internal medicine ,business ,Personal protective equipment ,Contact tracing ,media_common - Abstract
Quarantine of health care workers (HCWs) exposed to COVID-19-confirmed cases is a well-known strategy for limiting the transmission of infection. However, during a pandemic situation in a resource-constraint setting, we require an evidence-based guideline for quarantining HCWs. We developed an algorithm for exposure-based risk stratification and quarantine of HCWs. We did contact tracing and risk stratification of 3853 HCWs, of whom 560 (14.5%) were categorized as high-risk contacts. High-risk contacts were quarantined for 14 days and underwent testing for COVID-19, while low-risk contacts continued their work with adherence to physical distancing, hand hygiene, appropriate use of personal protective equipment, and self-monitoring of symptoms. Overall, 118 (3.1%) contacts tested positive for COVID-19. The positivity rate among high-risk contacts was 7.1% (95% confidence interval = 5.2-9.6). Our strategy of risk stratification prevented 3215 HCWs from being quarantined and thus saved 45 010 person-days of health workforce in the institution.
- Published
- 2020