sick worker
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Healthcare workers who choose to stay on the job while sick may have a sense of controllable risk. That perception appears to have played a role in the behaviors seen in a new study, which found that nearly 50% of workers in a healthcare system, including long-term care units, continued working despite having symptoms of COVID-19.

The investigation included all healthcare workers at the Veterans’ Affairs Boston Healthcare System. Study participants tested positive for SARS-CoV-2 infection by polymerase chain reaction (PCR) assay between December 2020, and September 2021.

The VA system provides long-term care, and outpatient and tertiary inpatient care in eastern Massachusetts. All healthcare workers in the system were required to perform a self-review of COVID-19 symptoms each day, and to stay home or leave work if they were symptomatic. In addition, they received access to free PCR tests and were required to test if they had COVID-19 symptoms, had experienced community exposure or were part of contact tracing. 

Long-term care units and the acute spinal cord injury unit had weekly and biweekly mandatory surveillance testing. 

Symptomatic workers

Not only was the prevalence of COVID-19 presenteeism 49.8%, but half of these workers had “relatively specific symptoms of COVID-19,” suggesting that at least some were aware that they were ill, the researchers reported. 

In addition, the rates of presenteeism did not differ between direct patient care providers and workers who did not provide direct care. This result suggests that the level of transmission risk from healthcare worker to patient did not by itself modify the workers’ choice to come to work, the researchers noted.

The findings highlight the need for healthcare employers to keep COVID-19 infection prevention and control strategies in place, they said.

“Targeted surveillance during community surges or in high-risk settings could be utilized to mitigate risks related to noncompliance with self-screening or misinterpretation of symptoms among [healthcare workers],” the authors concluded.

Full findings were published in Infection Control & Hospital Epidemiology

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