1. Epidemiology and Global Health
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Effective control of SARS-CoV-2 transmission between healthcare workers during a period of diminished community prevalence of COVID-19

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Cite this article as: eLife 2020;9:e59391 doi: 10.7554/eLife.59391

Abstract

Previously we showed that 31/1,032 (3%) asymptomatic healthcare workers (HCW) from a large teaching hospital in Cambridge UK tested positive for SARS-CoV-2 in April 2020. 26/169 (15%) HCWs with symptoms of coronavirus disease 2019 (COVID-19) also tested positive (Rivett et al., 2020). Here we show that the proportion of both asymptomatic and symptomatic HCWs testing positive rapidly declined to near-zero between 25th April and 24th May 2020, corresponding with a decline in patient admissions with COVID-19 during the ongoing UK 'lockdown'. These data demonstrate how infection prevention and control measures including staff testing may help prevent hospitals from becoming independent 'hubs' of SARS-CoV-2 transmission, and illustrate how, with appropriate precautions, organisations in other sectors may be able to resume on-site work safely.

Article and author information

Author details

  1. Nick K Jones

    Department of Infectious Diseases, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-4475-7761
  2. Lucy Rivett

    Department of Infectious Diseases, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  3. Dominic Sparkes

    Department of Infectious Diseases, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  4. Sally Forrest

    Cambridge Institute for Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  5. Sushmita Sridhar

    Cambridge Institute for Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-7453-7482
  6. Jamie Young

    Academic Department of Medical Genetics, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  7. Joana Pereira-Dias

    Cambridge Institute for Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  8. Claire Cormie

    Cambridge Institute for Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  9. Harmeet Gill

    Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  10. Nicola Reynolds

    Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  11. Michelle Wantoch

    Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  12. Matthew Routledge

    Department of Infectious Diseases, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  13. Ben Warne

    Department of Medicine, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  14. Jack Levy

    Department of Engineering, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  15. WIlliam David Córdova Jiménez

    Department of Engineering, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  16. Fathima Nisha Begum Samad

    Department of Engineering, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  17. Chris McNicholas

    Improvement and Transformation, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  18. Mark Ferris

    Department of Occupational Health and Wellbeing, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  19. Jane Gray

    Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  20. Michael Gill

    Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  21. The CITIID-NIHR COVID-19 BioResource Collaboration

    Cambridge Institute for Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  22. Martin D Curran

    Clinical Microbiology & Public Health Laboratory, Public Health England (PHE), Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  23. Stewart Fuller

    Clinical Research Facility, National Institutes for Health Research, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  24. Afzal Chaudhry

    Chief Medical Information Officer, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    Afzal Chaudhry, Afzal Chaudhry reports grants from Cambridge Biomedical Research Centre at CUHNFT, during the conduct of the study..
  25. Ashley Shaw

    Medical Director, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  26. John R Bradley

    Department of Medicine, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  27. Gregory J Hannon

    Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-4021-3898
  28. Ian G Goodfellow

    Department of Pathology, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    Ian G Goodfellow, Ian Goodfellow reports grants from Wellcome Trust (Senior Research Fellowships), grants from Wellcome Trust (Collaborative Award), grants from Addenbrooke's Charitable Trust, during the conduct of the study..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-9483-510X
  29. Gordon Dougan

    Department of Medicine, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    Gordon Dougan, Gordon Dougan reports grants from NIHR, during the conduct of the study..
  30. Kenneth G C Smith

    Department of Medicine, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    Kenneth G C Smith, Kenneth G.C. Smith reports grants from Wellcome Trust, during the conduct of the study..
  31. Paul J Lehner

    Cambridge Institute for Medical Research, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    Paul J Lehner, Paul J. Lehner reports grants from Wellcome Trust Principal Research Fellowship, grants from Addenbrooke's Charitable Trust, during the conduct of the study..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0001-9383-1054
  32. Giles Wright

    Department of Occupational Health and Wellbeing, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
    Competing interests
    No competing interests declared.
  33. Nicholas J Matheson

    Department of Medicine, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    Nicholas J Matheson, Nicholas J. Matheson reports grants from Medical Research Council (Clinician Scientist Fellowship), grants from NHS Blood and Transfusion, during the conduct of the study..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0002-3318-1851
  34. Stephen Baker

    Department of Medicine, University of Cambridge, Cambridge, United Kingdom
    Competing interests
    Stephen Baker, Stephen Baker reports grants from Wellcome Trust (Senior Research Fellowships), from Addenbrooke's Charitable Trust, during the conduct of the study..
  35. Michael P Weekes

    Cambridge Institute for Therapeutic Immunology and Infectious Disease, University of Cambridge, Cambridge, United Kingdom
    For correspondence
    mpw1001@cam.ac.uk
    Competing interests
    Michael P Weekes, Michael P. Weekes reports grants from Wellcome Trust (Senior Research Fellowships), from Addenbrooke's Charitable Trust, during the conduct of the study..
    ORCID icon "This ORCID iD identifies the author of this article:" 0000-0003-3196-5545

Funding

Wellcome (108070/Z/15/Z)

  • Michael P Weekes

Addenbrooke's Charitable Trust, Cambridge University Hospitals

  • Paul J Lehner

Addenbrooke's Charitable Trust, Cambridge University Hospitals

  • Ian G Goodfellow

NHS Blood and Transplant (WPA15-02)

  • Nicholas J Matheson

National Institute for Health Research

  • Gordon Dougan

National Institute for Health Research

  • John R Bradley

National Institute for Health Research

  • Afzal Chaudhry

Cancer Research UK (C38317/A24043)

  • Jamie Young

Wellcome (215515/Z/19/Z)

  • Stephen Baker

Wellcome (207498?Z/17/Z)

  • Ian G Goodfellow

Wellcome (206298/B/17/Z)

  • Ian G Goodfellow

Wellcome (210688/Z/18/Z)

  • Paul J Lehner

Wellcome (200871/Z/16/Z)

  • Kenneth G C Smith

Medical Research Council (MR/P008801/1)

  • Nicholas J Matheson

Addenbrooke's Charitable Trust, Cambridge University Hospitals

  • Michael P Weekes

Addenbrooke's Charitable Trust, Cambridge University Hospitals

  • Stephen Baker

The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.

Ethics

Human subjects: As a study of healthcare-associated infections, this investigation is exempt from requiring ethical approval under Section 251 of the NHS Act 2006 (see also the NHS Health Research Authority algorithm, available at http://www.hra-decisiontools.org.uk/research/, which concludes that no formal ethical approval is required). Our study was performed as a service evaluation of the Cambridge Universith Hospitals NHS Foundation Trust screening programme. The service provided was not changed in any way in order to undertake this evaluation.

Reviewing Editor

  1. Jos WM van der Meer, Radboud University Medical Centre, Netherlands

Publication history

  1. Received: May 28, 2020
  2. Accepted: June 19, 2020
  3. Accepted Manuscript published: June 19, 2020 (version 1)
  4. Version of Record published: June 30, 2020 (version 2)
  5. Version of Record updated: September 21, 2020 (version 3)

Copyright

© 2020, Jones et al.

This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.

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Further reading

    1. Epidemiology and Global Health
    2. Medicine
    3. Microbiology and Infectious Disease
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