In an analysis of information from the U.K. and U.S., frontline healthcare workers had a nearly 12-times higher risk of testing positive for COVID-19 compared with individuals in the general community, and those workers with inadequate access to personal protective equipment (PPE) had an even higher risk. The study, which was conducted by a team led by researchers at Massachusetts General Hospital (MGH), King’s College London, and Zoe Global Ltd is available in medRxiv.

Healthcare workers on the front lines of the battle against COVID-19 face a high risk of becoming infected and are confronted with the possibility of not only getting sick and dying, but also of bringing the infection home to their families and contributing to spread in their communities.

“The limited availability of adequate PPE such as masks, gowns, and gloves, has raised concerns about whether our healthcare system is able to fully protect our healthcare workers,” said senior author Andrew T. Chan, MD, PhD, Chief of the Clinical and Translational Epidemiology Unit at MGH and Director of Cancer Epidemiology at the MGH Cancer Center. “We conducted this study to understand the magnitude of risk for healthcare workers and what the impact of PPE shortages might be on infection rates.”

For the study, the investigators used a novel smartphone app — called the COVID Symptom app — to examine the risk of testing positive for COVID-19 and/or developing symptoms associated with infection among 2,135,190 individuals in the U.K. and the U.S. between March 24 and April 23, 2020.

Among 2,035,395 community individuals and 99,795 frontline healthcare workers, 5,545 new reports of a positive COVID-19 test were documented. Compared with the general community, frontline healthcare workers had an 11.6-times higher risk of testing positive and those who reported that they had inadequate access to PPE had a 23% higher risk. Also, compared with healthcare workers reporting adequate PPE who did not care for patients with COVID-19, workers caring for patients with documented COVID-19 had a nearly 5-times higher risk of testing positive if they had adequate PPE and a nearly 6-times higher risk if they had inadequate PPE.

The finding that healthcare workers have a substantially higher risk of COVID-19 infection supports the importance of providing adequate supplies of PPE to those on the front lines.

“However, adequate supplies of PPE are not enough to completely protect workers taking care of COVID-19 patients—we also need to focus our energy on making sure that healthcare workers are trained in the proper use of PPE and that the PPE is high quality,” said Dr. Chan. “We also must be vigilant about implementing other infection control measures to minimize infection of healthcare workers, including promptly and effectively testing and isolating COVID-19 patients and ensuring that the patient care environment is adequately disinfected.”‍

About the Massachusetts General Hospital‍

Massachusetts General Hospital, founded in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH Research Institute conducts the largest hospital-based research program in the nation, with an annual research budget of more than $925 million and comprises more than 8,500 researchers working across more than 30 institutes, centers and departments. In August 2018 the MGH was once again named to the Honor Roll in the U.S. News & World Report list of "America’s Best Hospitals."