Healthcare workers less likely to die than non-healthcare workers after contracting Covid-19: study

A new study has found that healthcare workers (HCWs) were less likely to die after being hospitalised with Covid-19 than non-healthcare workers, although mortality was proportionally higher among frontline workers in the early days of the pandemic.

The study — led by researchers from the National Institute for Communicable Diseases (NICD), Right to Care, National Institute for Occupational Health, Wits University and University of Johannesburg — also showed that in-hospital mortality among healthcare workers was associated with age, race, comorbidities and health sector, as well as when the infection occurred.

“We found that the risk of in-hospital Covid-19 mortality among hospitalised healthcare workers was lower when compared to non-HCWs,” the authors said, adding that hospitalisation among healthcare workers decreased during the second wave as a result of better resources in health facilities and improved preparedness to manage the disease.

“In addition, acquired immunity from infections in the first wave could have led to a decline in HCW [healthcare workers] Covid-19 cases in the second wave,” the report said.

The study, which drew on the Datcov national hospital surveillance system, covered Covid-19 patients aged 20 to 65 who were admitted to both public and private health facilities between March 5 2020 and April 30 this year, with a further distinction made between healthcare workers and non-healthcare workers.

The World Health Organisation (WHO) estimated that healthcare workers account for up to 14% of Covid-19 cases, as they were the first to come into contact with and take care of  infected patients.

SA has an estimated 1.25 million healthcare workers spread across the public and private sectors.

Some 169,678 confirmed infections were recorded in the age group during the study period, of which 6,364 were healthcare workers.

The total number of deaths was 30,191, of whom 603 were healthcare workers.

The study found that the majority of healthcare worker and non-healthcare worker hospital admissions were women (71.9% for HCWs and 55.4% for non-HCWs) in the age group 50-59 years.

Healthcare workers in the study were less likely to be male, more likely to be aged between 30 and 59 and admitted in the private health sector, while the public health sector showed decreased odds of hospital mortality.

“This may be expected, as most healthcare workers access the private healthcare sector to seek treatment,” the study said.

The study also showed that healthcare workers admitted to hospital with Covid-19 were more likely to be white.

“White and coloured HCWs were, however, less likely than black healthcare workers to have mortality as an outcome.”

Hypertension, diabetes, chronic renal diseases, malignancy and current and past tuberculosis (TB) history were also significant factors in mortality among healthcare workers.

However, while obesity has been shown to increase Covid-19 mortality, the study did not find this to be significant in Covid-19 deaths among healthcare workers. HIV was also not associated with increased mortality among healthcare workers.

“The lack of association in this study could be that HIV-infected HCWs may be receiving anti-retroviral treatment (ART),” it said.

However, TB remained a high-risk factor for healthcare workers as a result of poor TB infection and control measures, with the study showing that current and past TB history was associated with mortality among healthcare workers.

“There have been reports that show that HCWs who care directly and indirectly for TB patients irregularly use appropriate respiratory protection, resulting in high prevalences of TB among HCWs.”

The good news, however, was that the vaccine rollout was expected to reduce Covid-19 cases and mortality among healthcare workers, even as the country is gripped by a surge of infections.

TimesLIVE