Health workers were more than three times more likely to test positive for the virus than the general population, with the rate for ethnic minority medical workers increasing five-fold.
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According to a study by several British hospitals at the height of the pandemic, intensive care physicians were significantly less likely to be infected with Covid-19 than cleaners and other health care workers in departments that were classified as lower-risk.
The research also found that black, Asian, and ethnic minority people were almost twice as likely to be infected as white counterparts.
Several studies follow to suggest that race, income, and assignment of personal protective equipment (PPE) all distort the burden of infection.
The researchers said the results could be due to those who work in intensive care units (ITU) being prioritized for the highest levels of masks and other equipment.
“We assumed that ICUs were at the highest risk … But ITU staff are relatively well protected compared to other areas,” said lead author Alex Richter, professor of immunology at the University of Birmingham.
In the study published in the journal thoraxResearchers tested more than 500 employees at the Birmingham University Hospitals NHS Foundation Trust, which operates multiple hospitals and employs more than 20,000 people.
All staff were at work in late April when cases peaked about a month after the UK lockdown.
At the time, the Trust was taking in five patients with severe Covid-19 infection every hour, but the capacity to conduct infection tests was severely limited, even for healthcare workers.
The researchers offered two different tests to employees who had no symptoms – one to see if they were currently infected and one to test for antibodies that suggest they previously had the virus.
Almost 2.5 percent – 13 of 545 – of the employees tested positive for SARS-CoV-2, the virus responsible for the Covid-19 infection.
The researchers also took blood samples from 516 employees and found that 24 percent of them had antibodies to the virus. This generally equates to six percent in the Midlands region of England at the time.
Ten out of 29 detergents involved in the study – or 34.5 percent – had antibodies that suggest a previous infection.
Rates were similar for clinicians working in acute and general internal medicine – 33 percent and 30 percent, respectively – while ICU staff had the lowest rates (15 percent, or nine out of 61 participants).
The authors said it was not clear from their observational study whether the higher rates of infection in some employees were “due to a higher risk of exposure to the virus or a higher risk of infection upon exposure”.
“Whatever the cause, this finding urgently requires further investigation, especially given the ethnic differences in the outcome of Covid-19,” they said.
A number of studies in the general population have shown that people with minority backgrounds in the UK and the United States are disproportionately more likely to die of Covid-19 than their white counterparts.
Last month a study was published in The Lancet Public Health The Journal found that frontline health workers were more than three times more likely to test positive for the virus than the general population at the start of the pandemic, with the rate for ethnic minority medical workers increasing five-fold.
Commentary on the study in thoraxTim Cook, professor of anesthesia at the University of Bristol, said this adds to the research that those who work in intensive care are at lower risk than those in other parts of a hospital.
He said the availability and type of PPE could be a factor, as well as familiarity with stricter precautions for sterility and infection prevention in emergency rooms.
He added that recent studies indicated that patients were more contagious when their illness started, and therefore may be less likely to spread the virus when treated in the intensive care unit.
“Those who care for patients earlier in their illness may be at higher risk. This has implications for the management of all patient-contact staff on the wards,” he added.