In the early months of the coronavirus disease 2019 (COVID-19) pandemic and before vaccine availability, there were concerns that infected emergency department (ED) health care personnel could present a threat to the delivery of emergency medical care. We examined how the pandemic affected staffing levels and whether COVID-19 positive staff were potentially infectious at work in a cohort of US ED health care personnel in 2020. The COVID-19 Evaluation of Risks in Emergency Departments (Project COVERED) project was a multicenter prospective cohort study of US ED health care personnel conducted from May to December 2020. During surveillance, health care personnel completed weekly electronic surveys and underwent periodic serology and nasal reverse transcription polymerase chain reaction testing for SARS-CoV-2, and investigators captured weekly data on health care facility COVID-19 prevalence and health care personnel staffing. Surveys asked about symptoms, potential exposures, work attendance, personal protective equipment use, and behaviors. We enrolled 1,673 health care personnel who completed 29,825 person weeks of surveillance. Eighty-nine (5.3%) health care personnel documented 90 (0.3%; 95% confidence interval [CI] 0.2% to 0.4%) person weeks of missed work related to documented or concerns for COVID-19 infection. Health care personnel experienced symptoms of COVID-19 during 1,256 (4.2%) person weeks and worked at least one shift whereas symptomatic during 1,042 (83.0%) of these periods. Seventy-five (4.5%) participants tested positive for SARS-CoV-2 during the surveillance period, including 43 (57.3%) who indicated they never experienced symptoms; 74 (98.7%; 95% CI 90.7% to 99.9%) infected health care personnel worked at least one shift during the initial period of infection, and 71 (94.7%) continued working until laboratory confirmation of their infection. Physician staffing was not associated with the facility or community COVID-19 levels within any time frame studied (Kendall tau’s 0.02, 0.056, and 0.081 for no shift, one-week time shift, and 2-week time shift, respectively). During the first wave of the pandemic, COVID-19 infections in ED health care personnel were infrequent, and the time lost from the workforce was minimal. Health care personnel frequently reported for work while infected with SARS-CoV-2 before laboratory confirmation. The ED staffing levels were poorly correlated with facility and community COVID-19 burden.

中文翻译：

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2019 年冠状病毒病紧急医疗保健人员感染：对 2020 年美国紧急医疗服务提供的影响

在 2019 年冠状病毒病 (COVID-19) 大流行的最初几个月和疫苗上市之前，有人担心受感染的急诊科 (ED) 医护人员可能会对紧急医疗护理的提供构成威胁。我们在 2020 年对一组美国急诊室医护人员中研究了大流行如何影响人员配置水平，以及 COVID-19 阳性员工在工作中是否具有潜在传染性。COVID-19 急诊科风险评估（Project COVERED）项目是一个多中心项目2020 年 5 月至 12 月对美国急诊室医护人员进行的前瞻性队列研究。在监测期间，医护人员完成每周电子调查，并定期接受 SARS-CoV-2 血清学和鼻逆转录聚合酶链反应检测，研究人员捕获每周数据关于医疗机构 COVID-19 患病率和医疗保健人员的人员配置。调查询问了症状、潜在接触、工作出勤、个人防护设备的使用和行为。我们招募了 1,673 名卫生保健人员，完成了 29,825 人周的监测。 89 名 (5.3%) 医护人员记录了 90 人周（0.3%；95% 置信区间 [CI] 0.2% 至 0.4%）因记录或担心 COVID-19 感染而缺勤的情况。医护人员在 1,256 人周 (4.2%) 期间出现了 COVID-19 症状，并至少工作了一个轮班，而其中 1,042 人周 (83.0%) 期间出现了症状。在监测期间，75 名参与者 (4.5%) 的 SARS-CoV-2 检测呈阳性，其中 43 名参与者 (57.3%) 表示他们从未出现过症状； 74 名（98.7%；95% CI 90.7% 至 99.9%）感染的医护人员在感染初期至少工作了一班，71 名（94.7%）继续工作直至实验室确认其感染。在所研究的任何时间范围内，医生人员配备与设施或社区的 COVID-19 水平无关（Kendall tau 对于不轮班、一周时班和两周时班分别为 0.02、0.056 和 0.081）。在第一波大流行期间，急诊室医护人员感染 COVID-19 的情况并不常见，而且劳动力损失的时间也很少。医护人员经常在实验室确诊之前就感染 SARS-CoV-2 来上班。急诊科人员配备水平与设施和社区的 COVID-19 负担相关性较差。