Risk Stratification as a Tool to Rationalize Quarantine of Health Care Workers Exposed to COVID-19 Cases: Evidence From a Tertiary Health Care Center in India
Ravneet Kaur, Shashi Kant, Mohan Bairwa, Arvind Kumar, Shivram Dhakad, Vignesh Dwarakanathan, Aftab Ahmad, Pooja Pandey, Arti Kapil, Rakesh Lodha, Naveet Wig
Abstract
Quarantine of health care workers (HCWs) exposed to COVID-19-confirmed cases is a well-known strategy for limiting the transmission of infection. However, during a pandemic situation in a resource-constraint setting, we require an evidence-based guideline for quarantining HCWs. We developed an algorithm for exposure-based risk stratification and quarantine of HCWs. We did contact tracing and risk stratification of 3853 HCWs, of whom 560 (14.5%) were categorized as high-risk contacts. High-risk contacts were quarantined for 14 days and underwent testing for COVID-19, while low-risk contacts continued their work with adherence to physical distancing, hand hygiene, appropriate use of personal protective equipment, and self-monitoring of symptoms. Overall, 118 (3.1%) contacts tested positive for COVID-19. The positivity rate among high-risk contacts was 7.1% (95% confidence interval = 5.2-9.6). Our strategy of risk stratification prevented 3215 HCWs from being quarantined and thus saved 45 010 person-days of health workforce in the institution.