A mixed-methods study of risk factors and experiences of healthcare workers tested for the novel coronavirus in Canada
Abstract
Objectives
We aimed to investigate the contribution of occupational and non-work-related factors to the risk of novel coronavirus (SARS-CoV-2) infection among healthcare workers (HCWs) in Vancouver Coastal Health, British Columbia, Canada. We also aimed to examine how HCWs described their experiences.
Methods
We conducted a matched case-control study using data from online and phone questionnaires with optional open-ended questions completed by HCWs who sought SARS-CoV-2 testing between March 2020 and March 2021. Conditional logistic regression and thematic analysis were utilized.
Results
Data from 1340 HCWs were included. Free-text responses were provided by 257 respondents. Adjusting for age, gender, race, occupation, and number of weeks since pandemic was declared, community exposure to a known COVID-19 case (adjusted odds ratio -aOR: 2.45; 95% CI 1.67-3.59), and difficulty accessing personal protective equipment -PPE- (aOR: 1.84; 95% CI 1.07-3.17) were associated with higher infection odds. Care-aides/licensed practical nurses had substantially higher risk (aOR: 2.92; 95% CI 1.49-5.70) than medical staff who had the lowest risk. Direct COVID-19 patient care was not associated with elevated risk. HCWs’ experiences reflected the phase of the pandemic when they were tested. Suboptimal communication, mental stress, and situations perceived as unsafe were common sources of dissatisfaction.
Conclusions
Community exposures and occupation were important determinants of infection among HCWs in our study. The availability of PPE and clear communication enhanced a sense of safety. Varying levels of risk between occupational groups call for wider targeting of infection prevention measures. Strategies for mitigating community exposure and supporting HCW resilience are required.
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