Investigation of Nosocomial SARS-CoV-2 Transmission from Two Patients to Health Care Workers Identifies Close Contact but not Airborne Transmission Events.

Abstract:

OBJECTIVE:To describe the pattern of transmission of SARS-CoV-2 during 2 nosocomial outbreaks of COVID-19 with regard to the possibility of airborne transmission. DESIGN:Contact investigations with active case finding were used to assess the pattern of spread from 2 COVID-19 index patients. SETTING:A community hospital and university medical center in the United States, in February and March, 2020, early in the COVID-19 pandemic. PATIENTS:Two index patients and 421 exposed health care workers. METHODS:Exposed staff were identified by analyzing the EMR and conducting active case finding in combination with structured interviews. Staff were tested for COVID-19 by obtaining oropharyngeal/nasopharyngeal specimens, with RT-PCR testing to detect SARS-CoV-2. RESULTS:Two separate index patients were admitted in February and March 2020, without initial suspicion for COVID-19 and without contact or droplet precautions in place; both patients underwent several aerosol generating procedures in this context. A total of 421 health care workers were exposed in total, and the results of the case contact investigations identified 8 secondary infections in health care workers. In all 8 cases, the staff had close contact with the index patients without sufficient personal protective equipment. Importantly, despite multiple aerosol generating procedures, there was no evidence of airborne transmission. CONCLUSION:These observations suggest that, at least in a healthcare setting, a majority of SARS-CoV-2 transmission is likely to take place during close contact with infected patients through respiratory droplets, rather than by long-distance airborne transmission.

authors

Bays DJ,Nguyen MH,Cohen SH,Waldman S,Martin CS,Thompson GR,Sandrock C,Tourtellotte J,Pugashetti JV,Phan C,Nguyen HH,Warner GY,Penn BH

doi

10.1017/ice.2020.321

subject

Has Abstract

pub_date

2020-07-03 00:00:00

pages

1-22

eissn

0899-823X

issn

1559-6834

pii

S0899823X20003219

pub_type

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