Another HCW COVID study from the UK
LOTS of fascinating stuff in this study. Outside of household contact with a case (aOR 4.63), working on a COVID-facing ward was the greatest risk factor (aOR 2.49). Black (1.61) & Asian (1.58) HCWs were at greater risk even adjusted for other factors.
One surprise was that porters/cleaners had the greatest risk among roles (uOR 2.82). The authors speculate about socioeconomic contributors outside of work. I also wonder about PPE, particularly before implementation of universal masking just as their epidemic was cresting.
Next greatest occupational risk was in physio/occ/SLP therapists (2.22), nurses (2.1), and junior doctors (1.87). Here I think it’s worth noting that RT doesn't exist in the UK; rather, it is a specialization route available to nurses, physios, and occupational therapists.
By physician specialty, excluding a couple of staff-based ward outbreaks, Medicine (3.99), ID/Respiratory (1.57), and Emergency Medicine (1.45) had the greatest risk, though suspected/confirmed cases were often admitted directly to the ward, bypassing the ED.
Accounting for working in a COVID-facing area, ICU was actually protective (0.46) relative to "other" specialty (whatever that means). This is a tantalizing finding because study ICUs used a level 2 PPE bundle (including FFP3=N99 mask) with dedicated space for donning/doffing
vs. everywhere else generally using level 1 PPE (procedure mask and optional (!) eye protection) for the majority of the epidemic.
No word on AGMP frequency, whether patients generally came to the ICU intubated/remained on a closed circuit for their stay, use of NIPPV or HFNC. Also no word on environmental controls (ACH/negative pressure).
All of this is within group analysis of the HCWs included in their study. It's also interesting to compare study PCR/seroprevalence to that of the general population (6.8%) in the UK (my table): 
Final thought: it's clear that HCWs are at greater risk than the general population. It's still unclear to what extent patient-HCW and HCW-HCW transmission contributes to this. The authors note that future viral genome sequence analysis might help (looking forward to that!). fin.
If you got this far, here are links to the study: medrxiv.org/content/10.110…
And supplementary material: medrxiv.org/content/10.110…
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