Muhajarine N, McRae D, Pisolkar V, et al. Saskatchewan’s school re-opening plan in comparison to other provincial plans and federal recommendations. 2020 Aug 14; Document no.: EOC081401 SR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 34 p. (CEST Summary Report)
Miller, L; Mueller, M. What are the age restrictions for healthcare workers/volunteers? 2020 Oct 13; Document no.: EOC100801-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 5 p. (CEST evidence search report)
· Well established that older individuals, particularly those with pre-existing conditions are at increased risk of severe disease and/or complications with SARS-CoV-2 infection, and volunteers should take this into consideration
· No other evidence specific to healthcare workers or volunteers to guide age restriction policies
Badea, A; Groot, G; Miller, L; Mueller, M. What are the age restrictions for healthcare workers/volunteer? 2020 Oct 19; Document no.: EOC100801 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 8 p. (CEST rapid review report)
Fox, L; Young C; Howell-Spooner, B; What are the existing policies for the re-deployment or deployment of healthcare workers whose regular work has been disrupted by COVID-19 in high-resource clinical settings? 2020 Jul 29; Document no.: EOC072701-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 39 p. (CEST evidence search report)
Physician and nursing staff members can be redeployed from various clinical areas, but in particular non-acute or elective practice areas such as ambulatory settings and surgical practices.
Providing patient-care in new clinical areas can be restructured into a task-based format that utilizes the skills already possessed by redeployed clinicians and staff.
Medical students, residents, internationally trained medical graduates and other health professionals such as respiratory therapists and pharmacists should also be considered for redeployment to high-need areas.
Scope of practice limitations, practice permit approvals and licensing may pose as potential barriers to being able to optimize our healthcare workforce in a surge.
Efficient but effective training should be provided to all staff that have volunteered for redeployment, in preparation of the next surge.
The safety of all health professionals should be ensured throughout the redeployment process.
Radu, L; Badea, A; Groot, G; Fox, L; Howell-Spooner, B; Young, C. What are the existing policies for the re-deployment or deployment of healthcare workers whose regular work has been disrupted by COVID-19 in high-resource clinical settings? 2020 Jul 29; Document no.: EOC072701 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 16 p. (CEST rapid review report)
Healthcare worker (HCW) well-being has been significantly affected by the COVID-19 pandemic around the world, with significantly increased rates of burnout, PTSD, anxiety and depression leading to increased absenteeism, willingness to work and decreased worker retention
Many of the pre-existing programs for HCW well-being focused on single, isolated incidents, such as patient safety incidents. Some adaptation of programs aimed at military or disaster relief are more readily translatable to the COVID-19 pandemic context
The measurement of HCW well-being relies on self-reported measures and related outcomes (e.g. absenteeism, willingness to work, retention) and as such, most interventions are evaluated using self-reported satisfaction surveys
Organizational level recommendations focus on the provision of adequate staffing and equipment for work-life balance, as well as a supportive and safe work environment free of stigma of help-seeking behaviors
In order for successful program interventions, leadership must be genuine, transparent and accessible at all levels
Interventions such as education and training are recommended not only for HCW well-being, but also for disease specific and unfamiliar task knowledge
In the face of lockdowns and social distancing guidelines, the fostering of connectedness and peer support communities, including self-efficacy and self-advocacy, and including plans for remaining connected with isolating workers and reintegration programs has been found to be highly important to HCW
The centralization of support services into a wellness/resource hub increases awareness and accessibility as acceptability, and where possible the design of rest areas should promote well-being
Individual interventions providing education, training and psychological support are generally well received, but accessibility and meaningful use are heavily dependent on organizational support
Badea A; MacFadden, M; Bishop, S; Dalidowicz M; Stojanovic V. What are the interventions to ameliorate the impacts of the pandemic on Healthcare workers? 2022 Feb 17, Document no.: EOC211202 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2022. 20 p. (CEST rapid review report).
Dalidowicz, M; Ellsworth, C. What COVID-19 community transmission indicators are used in school reopening plans? 2020 Aug 12; Document no.: EOC081201-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 12 p. (CEST evidence search report)
· Potential impact on reproductive rate (R) of the seven “returning to school” scenarios that were modeled by SAGE exhibited an increase in R due to reopening of school. The scale of increase depended on current value of R within each community and mitigation plans within the community, especially the adherence to social distancing measures. · CDC recommended using additional indicators such as healthcare capacity, new cases, and percent of positive cases to decide school operations along with community spread levels: none-to-minimal, minimal-to-moderate, substantial-controlled, and substantial-uncontrolled. · Combination of strategies such as mask usage, physical distancing, hygiene measures, classroom cohorting, symptomatic screening, testing and tracing of students, staff and teachers along with low levels of community transmission can aid in maintaining low level of R. · Increasing testing and contract tracing can impede an epidemic rebound. · Intersectoral partnerships with local authorities, dedicated personnel (such as coordinators) for testing and tracing along with appropriate communication with parents, teachers and staff should be followed to open schools safely.
Pisolkar, V; McRae, D; Muhajarine, N; Dalidowicz, M; Ellsworth, C. What COVID community transmission indicators are used in school reopening plans? 2020 Aug 26; Document no.: EOC081201 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 23 p. (CEST rapid review report)
There are no published or grey literature that directly address the review questions
· A number of principle based guidelines/recommendations/criteria are available and reviewed. It appears that the WHO interim guidance "Considerations in adjusting public health and social measures in the context of COVID-19" is the best piece of evidence available right now. It is included in the reference list below.
Badea, A; Reeder, B; Groot, G; Miller, L; Young, C. What is the best evidence to guide the sequence or priority of re-opening each type of healthcare service and how have the closures impacted patients? 2020 Apr 24; Document no.: EOC042202 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 11 p. (CEST rapid review report)
Miller, L; Young, C. What is the best evidence to guide the sequence or priority of re-opening each type of healthcare service and how have the closures impacted patients? 2020 Apr 23; Document no.: EOC042202-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 5 p. (CEST evidence search report)
Miller, L; Young, C. What is the best evidence to guide the sequence or priority of re-opening each type of healthcare service and how have the closures impacted patients? 2020 May 6; Document no.: EOC042202-02 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 31 p. (CEST evidence search report)
Duncan, V; Howell-Spooner, B. What proportion of healthcare workers are rt-PCR positive and IgM or IgG positive? 2020 Jun 2; Document no.: LAB040802v3-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 22 p. (CEST evidence search report)
Several references provide estimates of the proportion of HCW infected with SARS-CoV2 that range from 0.9% -20%. A recent review from Alberta Health Services that examined the COVID-19 rt-PCR test results among HCW indicates that in that province 2.4% of physicians and 0.9% of non-MD HCW who were tested were positive for SARS-CoV-2 compared to 3.5% of the general population.
In the studies reviewed, the majority of cases are confirmed by RT-PCR, while only one reference also used serology testing.
Vanstone, J; Reeder, B; Duncan, V; Howell-Spooner, B. What proportion of healthcare workers are rt-PCR positive and IgM or IgG positive? 2020 Jun 2; Document no.: LAB040802v3 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 10 p. (CEST rapid review report)
Young, C; Fox, L. What surveillance strategy is most effective for COVID-19 testing in healthcare workers? 2020 Nov 6; Document no.: EOC110401-01 ESR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 30 p. (CEST evidence search report)
An optimal surveillance strategy for COVID-19 infection in healthcare workers (HCWs) has yet to be determined.
Weekly screening of HCWs for infection through polymerase chain reaction (PCR) testing would reduce their contribution to SARS-CoV-2 transmission by approximately one quarter.
Any testing surveillance strategy should be in addition to other strategies already in place to identify symptomatic HCW.
Any strategy needs to take into consideration the availability of testing (i.e. feasibility) and the level of community transmission (i.e. the risk of asymptomatic HCWs entering the facility and spreading the virus).
HCWs could be categorized as high, medium, or low risk based upon their exposure to COVID-19 and the frequency of surveillance could be designed accordingly.
Newaz, S; Lee, S; Reeder, B; Groot, G; Young, C; Fox, L. What surveillance strategy is most effective for COVID-19 testing in healthcare workers? 2020 Nov 10; Document no.: EOC110401 RR. In: COVID-19 Rapid Evidence Reviews [Internet]. SK: SK COVID Evidence Support Team, c2020. 26 p. (CEST rapid review report)
