A longitudinal environmental surveillance study for SARS-CoV-2 from the emergency department of a teaching hospital in Hong Kong
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AbstractBackground
Understanding factors associated with SARS-CoV-2 exposure risk in the hospital setting may help improve infection control measures for prevention.
Aim
To monitor SARS-CoV-2 exposure risk among healthcare workers and to identify risk factors associated with SARS-CoV-2 detection.
Methods
Surface and air samples were collected longitudinally over 14 months spanning 2020-2022 at the Emergency Department (ED) of a teaching hospital in Hong Kong. SARS-CoV-2 viral RNA was detected by real-time reverse-transcription polymerase chain reaction. Ecological factors associated with SARS-CoV-2 detection were analysed by logistic regression. A sero-epidemiological study was conducted in January to April 2021 to monitor SARS-CoV-2 seroprevalence. A questionnaire was used to collect information on job nature and use of personal protective equipment (PPE) of the participants.
Findings
SARS-CoV-2 RNA was detected at low frequencies from surfaces (0.7%, n=2562) and air samples (1.6%, n=128). Crowding was identified as the main risk factor, as weekly ED attendance (OR=1.002, p=0.04) and sampling after peak-hours of ED attendance (OR=5.216, p=0.03) were associated with the detection of SARS-CoV-2 viral RNA from surfaces. The low exposure risk was corroborated by the zero seropositive rate among 281 participants by April 2021.
Conclusion
Crowding may introduce SARS-CoV-2 into ED through increased attendances. Multiple factors may have contributed to the low contamination of SARS-CoV-2 at the ED, including hospital infection control measures for screening ED attendees, high PPE compliance among healthcare workers, and various public health and social measures implemented to reduce community transmission in Hong Kong where a dynamic zero COVID-19 policy was adopted.
Understanding factors associated with SARS-CoV-2 exposure risk in the hospital setting may help improve infection control measures for prevention.
Aim
To monitor SARS-CoV-2 exposure risk among healthcare workers and to identify risk factors associated with SARS-CoV-2 detection.
Methods
Surface and air samples were collected longitudinally over 14 months spanning 2020-2022 at the Emergency Department (ED) of a teaching hospital in Hong Kong. SARS-CoV-2 viral RNA was detected by real-time reverse-transcription polymerase chain reaction. Ecological factors associated with SARS-CoV-2 detection were analysed by logistic regression. A sero-epidemiological study was conducted in January to April 2021 to monitor SARS-CoV-2 seroprevalence. A questionnaire was used to collect information on job nature and use of personal protective equipment (PPE) of the participants.
Findings
SARS-CoV-2 RNA was detected at low frequencies from surfaces (0.7%, n=2562) and air samples (1.6%, n=128). Crowding was identified as the main risk factor, as weekly ED attendance (OR=1.002, p=0.04) and sampling after peak-hours of ED attendance (OR=5.216, p=0.03) were associated with the detection of SARS-CoV-2 viral RNA from surfaces. The low exposure risk was corroborated by the zero seropositive rate among 281 participants by April 2021.
Conclusion
Crowding may introduce SARS-CoV-2 into ED through increased attendances. Multiple factors may have contributed to the low contamination of SARS-CoV-2 at the ED, including hospital infection control measures for screening ED attendees, high PPE compliance among healthcare workers, and various public health and social measures implemented to reduce community transmission in Hong Kong where a dynamic zero COVID-19 policy was adopted.
Acceptance Date27/05/2023
All Author(s) ListYung L, Leung LY, Lee KH, Morrell S, Fong MW, Fung NHY, Cheng KL, Kaewpreedee P, Li Y, Cowling BJ, Lau EH, Hui DS, Graham CA, Yen H
Journal nameJournal of Hospital Infection
Year2023
Month8
Volume Number138
PublisherElsevier
Pages34 - 41
ISSN0195-6701
eISSN1532-2939
LanguagesEnglish-United States
KeywordsSARS-CoV-2, COVID-19, environmental surveillance, Emergency Department
