Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19
Nick K. Jones1,2,3,4*, Lucy Rivett1,2*, Dominic Sparkes1,2*, Sally Forrest3,4*, Sushmita Sridhar3,4,5, Jamie Young6, Joana Pereira-Dias3,4, Claire Cormie3,4, Harmeet Gill3,4, Nicola Reynolds7, Michelle Wantoch8,9, Matthew Routledge1,2, Ben Warne 1,4, Jack Levy10, William David Cordova Jiménez10, Fatima N. B. Samad10, Chris McNicholas11, Mark Ferris12, Jane Gray13, Michael Gill13, The CITIID-NIHR COVID-19 BioResource Collaboration, Martin Curran2, Stewart Fuller14, Afzal Chaudhry15, Ashley Shaw15, John R. Bradley3,16, Greg Hannon13, Ian Goodfellow17, Gordon Dougan3,4, Kenneth G.C. Smith3,4, Paul J. Lehner1,3,4, Giles Wright12, Nicholas J. Matheson1,3,4,18¶, Stephen Baker3,4¶, Michael P. Weekes1,3,4¶
Correspondence: Dr. Michael Weekes, mpw1001@cam.ac.uk
*Joint first authorship
¶Joint last authorship
1 Department of Infectious Diseases, Cambridge University NHS Hospitals Foundation Trust, Cambridge, UK
2 Clinical Microbiology & Public Health Laboratory, Public Health England, Cambridge, UK
3 Department of Medicine, University of Cambridge, Cambridge, UK
4 Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
5 Wellcome Sanger Institute, Hinxton, UK
6 Academic Department of Medical Genetics, University of Cambridge, Cambridge, UK
7 Wellcome-MRC Cambridge Stem Cell Institute, Jeffrey Cheah Biomedical Centre, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK
8 Wellcome - MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
9 Department of Haematology, School of Clinical Medicine, University of Cambridge
10 Institute for Manufacturing, Department of Engineering, University of Cambridge, Cambridge, UK
11 Improvement and Transformation Team, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
12 Occupational Health and Wellbeing, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
13 Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
14 National Institutes for Health Research Cambridge, Clinical Research Facility, Cambridge, UK
15 Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
16 National Institutes for Health Research Cambridge Biomedical Research Centre, Cambridge, UK
17 Division of Virology, Department of Pathology, University of Cambridge, Cambridge, UK
18 NHS Blood and Transplant, Cambridge, UK
The CITIID-NIHR COVID-19 BioResource Collaboration
Principal Investigators: Stephen Baker, John Bradley, Gordon Dougan, Ian Goodfellow, Ravi Gupta, Paul J. Lehner, Paul A. Lyons, Nicholas J. Matheson, Kenneth G.C. Smith, M. Estee Torok, Mark Toshner, Michael P. Weekes
Infectious Diseases Department: Nick K. Jones, Lucy Rivett, Matthew Routledge, Dominic Sparkes, Ben Warne
SARS-CoV-2 testing team: Claire Cormie, Sally Forrest, Harmeet Gill, Iain Kean, Joana Pereira-Dias, Nicola Reynolds, Sushmita Sridhar, Michelle Wantoch, Jamie Young
COG-UK Cambridge Sequencing Team: Sarah Caddy, Laura Caller, Theresa Feltwell, Grant Hall, William Hamilton, Myra Hosmillo, Charlotte Houldcroft, Aminu Jahun, Fahad Khokhar, Luke Meredith, Anna Yakovleva
NIHR BioResource: Helen Butcher, Daniela Caputo, Debra Clapham-Riley, Helen Dolling, Anita Furlong, Barbara Graves, Emma Le Gresley, Nathalie Kingston, Sofia Papadia, Hannah Stark, Kathleen E. Stirrups, Jennifer Webster
Research nurses: Joanna Calder, Julie Harris, Sarah Hewitt, Jane Kennet, Anne Meadows, Rebecca Rastall, Criona O,Brien, Jo Price, Cherry Publico, Jane Rowlands, Valentina Ruffolo, Hugo Tordesillas
CRUK: Michael Gill, Jane Gray, Greg Hannon
NIHR Cambridge Clinical Research Facility: Karen Brookes, Laura Canna, Isabel Cruz, Katie Dempsey, Anne Elmer, Naidine Escoffery, Stewart Fuller, Heather Jones, Carla Ribeiro, Caroline Saunders, Angela Wright
Cambridge Cancer Trial Centre: Rutendo Nyagumbo, Anne Roberts
Clinical Research Network Eastern: Ashlea Bucke, Simone Hargreaves, Danielle Johnson, Aileen Narcorda, Debbie Read, Christian Sparke, Lucy Worboys
Administrative staff, CUHNFT: Kirsty Lagadu, Lenette Mactavous
CUHNFT NHS Foundation Trust: Tim Gould, Tim Raine, Ashley Shaw
Cambridge Cancer Trials Centre: Claire Mather, Nicola Ramenatte, Anne-Laure Vallier
Legal/Ethics: Mary Kasanicki
CUHNFT Improvement and Transformation Team: Penelope-Jane Eames, Chris McNicholas, Lisa Thake
Clinical Microbiology & Public Health Laboratory (PHE): Neil Bartholomew, Nick Brown, Martin Curran, Surendra Parmar, Hongyi Zhang
Occupational Health: Ailsa Bowring, Mark Ferris, Geraldine Martell, Natalie Quinnell, Giles Wright, Jo Wright
Health and Safety: Helen Murphy
Department of Medicine Sample Logistics: Benjamin J. Dunmore, Ekaterina Legchenko, Stefan Gräf, Christopher Huang, Josh Hodgson, Kelvin Hunter, Jennifer Martin, Federica Mescia, Ciara O’Donnell, Linda Pointon, Joy Shih, Rachel Sutcliffe, Tobias Tilly, Zhen Tong, Carmen Treacy, Jennifer Wood
Department of Medicine Sample Processing and Acquisition: Laura Bergamaschi, Ariana Betancourt, Georgie Bowyer, Aloka De Sa, Maddie Epping, Andrew Hinch, Oisin Huhn, Isobel Jarvis, Daniel Lewis, Joe Marsden, Simon McCallum, Francescsa Nice, Ommar Omarjee, Marianne Perera, Nika Romashova, Mateusz Strezlecki, Natalia Savoinykh Yarkoni, Lori Turner
Epic team/other computing support: Barrie Bailey, Afzal Chaudhry, Rachel Doughton, Chris Workman
Statistics/modelling: Caroline Trotter
Department of Engineering: William David Cordova Jiménez, Jack Levy, Fatima N. B. Samad
Abstract
We previously demonstrated that 31/1,032 (3%) asymptomatic healthcare workers (HCW) from a large teaching hospital in Cambridge UK tested positive for SARS-CoV-2 in April 2020.1 26/169 (15%) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive. Here, we report on our ongoing studies, and provide a temporal analysis of SARS-CoV-2 infection rates during the ongoing UK ‘lockdown’. Corresponding with a decline in patient admissions with COVID-19, the proportion of both asymptomatic and symptomatic HCWs testing positive rapidly declined to near-zero between 25th April and 24th May 2020. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent ‘hubs’ of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organisations in other sectors may be able to resume on-site work safely.