Is COVID-19 contraction risk lower in ER than in routine activities?

With COVID-19 continuing to spread, some might assume that the one place to avoid is a hospital emergency room. After all, the space is filled with health care providers who work in close contact with sick people.

This assumption could be harmful to a person in need of emergent medical care, and now, thanks to a study we recently conducted, we also know it’s likely incorrect.

Our study found that health care professionals who work in communities with a low prevalence of COVID-19 and who undergo daily health screenings are unlikely to be carriers of the coronavirus.

Hospitals nationwide have reported a significant drop in emergency department visits for major acute conditions. These patients may seek medical attention too late for adequate treatment, which could have serious, even fatal, consequences.

Findings from our research – conducted in an Orange County, Calif., pediatric emergency department during California’s projected peak of coronavirus-related use of hospital resources – underscore the fact that it is safe to visit the hospital when the need arises.

The results are very encouraging, and we want the community to know that the chances of acquiring COVID-19 during a visit to a pediatric emergency department could be the same or lower than during routine activities. Our hope is this will reassure parents that they should not delay care for any emergent health care needs their child may have – anything from appendicitis to a broken bone.

Here’s a look at the details of our study: We followed participating patient-facing staff at our emergency department during a month-long period this spring. Participants were asymptomatic and had no fever, as all employees undergo daily pre-shift screening and have their temperatures taken prior to entering the hospital.

The results? Just one of 145 subjects was positive for COVID-19.

These findings shine an encouraging light on a topic where data are currently limited. Preliminary data from California suggest that while health care workers represent 10 percent of all known COVID-19 cases in the state, only 18 percent of those cases were known to be acquired in a health care setting. This indicates the workers likely contracted the disease outside of work.

The low rate of infection in our emergency department could be attributed to many factors, including the lower percentage of infection in the surrounding community, and people in the community following safety guidelines like social distancing and wearing masks.

We also know that pediatric health care workers might be expected to have a lower risk of infection than those in an adult health care setting due to a lower rate of high-risk aerosolization procedures such as intubation in younger patients.

The study findings bolster our commitment to taking every precaution we can to prevent the spread of COVID-19 in our care settings. In fact, we’ve expanded the COVID-19 staff testing beyond our emergency department and into our pediatric intensive care units and operating rooms. Patient-facing providers there have been tested for COVID-19 and are re-tested weekly for antibodies to check for exposure and to minimize any spread within the health care environment.

While the effects of the coronavirus continue to be devastating, we’re hopeful that our study will reassure our brave health care workers that they can continue to administer care to their patients without risk – and also encourage parents not to delay medical care for their children.

After all, we cannot allow avoiding medical care during COVID-19 to become a public health crisis of its own.

Terence Sanger is a pediatric neurologist.

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