Risk of COVID-19 Among Front-Line Health-Care Workers and The General Community: A Prospective Cohort Study

Nguyen LH, Drew DA, Graham MS, et al. Lancet Public Health. 2020. Published Online July 31, 2020 [CrossRef]

The authors sought to assess risk of COVID-19 among front-line health-care workers compared with the general community and the effect of personal protective equipment (PPE) on risk. They did a prospective, observational cohort study in the UK and the USA of the general community, including front-line health-care workers, using self-reported data from the COVID Symptom Study smartphone application (app) from March 24 (UK) and March 29 (USA) to April 23, 2020. Participants were voluntary users of the app and at first use provided information on demographic factors (including age, sex, race or ethnic background, height and weight, and occupation) and medical history, and subsequently reported any COVID-19 symptoms. Among 2,035,395 community individuals and 99,795 front-line health-care workers, 5545 reported a positive COVID-19 test over 34 435 272 person-days. Compared with the general community, front-line health-care workers were at increased risk for reporting a positive COVID-19 test (adjusted HR 11·61, 95% CI 10·93–12·33). Secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were important factors. The authors conclude that the health-care systems should ensure adequate availability of PPE and develop additional strategies to protect health-care workers from COVID-19, particularly those from Black, Asian, and minority ethnic backgrounds.