A multicentre study on quarantined healthcare workers during the first wave of COVID-19 pandemic: Lessons learned in a resource limited setting

Introduction: Facing a pandemic is quite challenging for resource-poor healthcare settings. As the COVID-19 pandemic unfolded, healthcare workers (HCWs) had to work with insufficient skills, knowledge and experience regarding the novel coronavirus, which increased their risk of infection. Methods: This study aimed to determine the personal protective equipment (PPE) usage, exposure characteristics, clinical outcomes and seroprevalence of SARS-CoV-2 antibodies among a group of quarantined HCWs in seven hospitals in the Western province of Sri Lanka, during the first wave of the pandemic. Data were collected using an intervieweradministered questionnaire and a serum sample was collected at six weeks of exposure to detect SARSCoV- 2 specific IgG antibodies. Both descriptive statistics and chi square test were performed to identify distribution patterns and associations. Results: Of 167 quarantined HCWs, 89(53.3%) had high-risk exposures, while 78 (46.4%) reported lowrisk exposures. Eighty-four HCWs have been exposed when interacting with the patient’s environment and 90.5% of them were not using recommended PPE. None of the HCWs wore N95 or higher respirators when performing aerosolgenerating procedures. SARS-COV-2 RT-PCR assay was performed only on 117 (70.1%) HCWs, with 49.6% of them being subjected to the test after 14days of exposure. SARS-CoV-2 specific IgG antibodies were detected in 31(18.6%) HCWs. A high seroprevalence was observed among HCWs over 40 years (n=13, 29.5%) (P=0.029). Conclusions: This study illustrated an imperfect adherence to PPE recommendations and high transmission of COVID-19 amongst HCWs. The observed inappropriate use of RT-PCR assay and unwarranted quarantining of HCWs in a limited resource setting is concerning.