Assessment of Covid-19 Infection Rates in Healthcare Workers Using a Desynchronization Strategy

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads rapidly and causes a
pandemic of coronavirus disease 2019 (COVID-19, the disease caused by SARS-CoV-2). Protecting
and supporting caregivers is essential to maintain the workforce in the hospital to treat
patients.

The use of recommended barrier precautions such as masks, gloves and gowns is of highest
priority in the care of all patients with respiratory symptoms. However, given the long
incubation period of 5 days there will be undiagnosed but infected patients with clinically
mild cases, atypical presentations or even no symptoms at all. Thus, healthcare workers are
on the one side at risk to get infected by asymptomatic patients and on the other side are
critically needed for later phases of the epidemic, when the resources will in all likelihood
be scarce or depleted.

One potential strategy to maintain workforce throughout an epidemic is to reduce the
workforce in the early phases. Reducing workforce at early phases might potentially reduce
in-hospital infection of the caregivers and reduces early burnout. One way of reducing the
active workforce is to postpone all elective and non-urgent medical interventions to later
phases of the epidemic.

Desynchronization of infection rates in healthcare workers will potentially reduce the early
infection rates and therefore maintain workforce for late time points of the epidemic. Given
the current threat of the COVID-19 epidemic, the department for Visceral Surgery and
Medicine, Bern University Hospital, has decided to limit its elective interventions to
oncological and life-saving procedures only. At the same time, the medical team were split in
two teams, each working for 7 days followed by 7 days off, called a desynchronization
strategy. Contacts between the two teams are avoided. This new regulation took effect on
March 16th 2020.

Currently available resources to perform tests for SARS-CoV-2 infection are limited for the
clinical routine and are therefore not available for research purposes. Thus, in the context
of a clinical study the investigators aim to perform additional testing of SARS-CoV-2 of
healthcare workers and patients in order to determine the clinical consequences of such
desynchronization strategy, firstly within the current epidemic and secondly for future
outbreaks.

The main aim of present study is to determine if the infection rate between the two
populations (at work versus at home) is different. Secondary aims are to determine if the
workforce can be maintained for longer periods compared standard of care, and if the
infection rate among patients hospitalized for other reasons varies compared to the
community.