Are you suffering from fever or chills Cough? Are you experiencing shortness of breath? Answering these questions and many others has become a part of daily life during the epidemic. The Massachusetts Department of Public Health Commissioner of Public Health issued a directive that requires all hospitals to check visitors and employees for signs and symptoms of COVID-19 by March 2020.
Mass General Brigham rapidly developed and launched COVID Pass, an attestation tool used daily that has recorded more than 15 million attestations since its inception. What is the effectiveness of attestation tools like COVID Pass in catching symptomatic employees before others go through the doors and transmit the virus? Brigham and Women’s Hospital investigators conducted a new analysis to assess the efficacy of daily symptomattestation to health care professionals in the Mass General Brigham network. The rates of cases were very low, but more than 100 employees who attested to symptoms using COVID Pass were successful in detecting COVID-19, proving the tool’s effectiveness in preventing transmission events. Results are published in Infection Control & Hospital Epidemiology.
We wanted to make sure that our employees didn’t bring COVID-19 into the hospital once the COVID-19 epidemic began. COVID Pass is just one of the many layers of protection however it gives employees a chance to stop and think about their own. If they do test positive for any symptoms, the tool will prompt them to get their blood sample tested and direct them to resources to help them get the test done.
Hojjat Salmasian MD MPH and PhD, Senior Author, Brigham’s Division of General Internal Medicine
In the course of a period of 99 days more than 2,000,000 attestations were analyzed by the research team. This was during the peak of the pandemic in Boston. The attestations included more than 65,000 employees from 52 clinics and hospitals within the Mass General Brigham hospital system. Employees who came to campus were screened daily before being allowed on the premises. Those who were screened daily and those who attested to at least one symptom were referred to Occupational Health Services for further examination and testing, if needed, before being cleared for work. Health care providers could also contact Occupational Health daily or get tested in case they were concerned about exposure or symptoms.
Of the 2 million attestations analyzed, 99.9 percent reported no symptoms. There were 2,062 workers who were able to prove at least one symptom. The most common symptoms was sore throat which was found to be present in 25 percent of all symptomatic tests. Of those, 905 employees were tested within 14 days and 114 (13 percent) tested positive for COVID-19.
“While there were a few positive cases, the evidence may not have helped keep some sick employees from campus, and could have prevented some transmissions,” said Ellen Kim MD, MPH, the lead author. She is a radiation oncologist at Brigham and Women’s Hospital and Dana-Farber Cancer Institute and a Clinical Informatics fellow with Mass General Brigham.
In the same time span, 1,289 employees tested positive for COVID-19. In the two weeks prior to the positive test, 9 per cent had been able to prove symptoms however 58% of them had no symptoms and 33% of them had not completed an attestation. The investigators identified this group as potentially concerned workers skipping attestation and directly calling Occupational Health, or scheduling a test. The employees only signed attestations when they were planning to to work in a clinical setting.
“COVID symptomattestation screening tools were utilized by hospitals all over the world,” said Adam Landman, MD interim chief information officer at Mass General Brigham. “This study supports the initial evidence for symptom-based screening of COVID-19 positive health care providers.”
The researchers compared data from health care employees who claimed to have were suffering from symptoms to the results of laboratory tests from Mass General Brigham facilities. If the patient was examined elsewhere, the results would not have been considered in the study. The authors also note that attestation takes place before an employee arrives at work. However when symptoms begin to manifest during the course of a day the symptoms may not have been recorded in the attestation.
“Our primary responsibility to our patients is to do no harm,” said Salmasian. “COVID Pass helped us find more than 100 cases of COVID-19. We also helped those employees receive the appropriate level of treatment and testing so that they would not transmit this disease to their patients or their colleagues. Although it might seem like a small number when you look at the thousands of tests, the potential damage that could be caused by one person who spreads the virus is enormous.
Kim, E., et al. (2021) COVID-19 screening system using daily symptom attestation to identify hospital employees who need to be tested to safeguard coworkers and patients. Infection Control and Hospital Epidemiology. doi.org/10.1017/ice.2021.461.
Content Source: https://www.news-medical.net/news/20211206/COVID-symptom-attestation-tool-for-health-care-workers-helps-protect-patients-and-co-workers.aspx