Rapid Expert Consultation on Understanding Causes of Health Care Worker Deaths Due to the COVID-19 Pandemic (December 10, 2020) (2020) / Chapter Skim
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Rapid Expert Consultation on Understanding Causes of Health Care Worker Deaths Due to the COVID-19 Pandemic (December 10, 2020)
Rapid Expert Consultation on Understanding Causes of Health Care Worker Deaths Due to the COVID-19 Pandemic (December 10, 2020)
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morbidity and mortality due to COVID-19 that was prepared by Sue Anne Bell, and Matthew Wynia, with input from John Hick, and conducted under the auspices of the National Academies of Sciences, Engineering, and Medicine's Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats. This rapid expert consultation describes what we know about the extent of deaths and mental health impairments among HCWs due to COVID-19.
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Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response, this rapid expert consultation reviews current resources and methods for tracking and evaluating HCW deaths related to COVID-19 in the health care setting. As outlined in the Statement of Task in Box 1, deaths related to COVID-19 among HCWs include deaths due to occupational exposure directly to COVID-19 and deaths that could reasonably be attributed to conditions exacerbated by COVID-19, such as HCW suicides due to fatigue, stress, or burnout.
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At the request of the Office of the Assistant Secretary for Preparedness and Response at the U.S. Department of Health and Human Services, the National Academies of Sciences, Engineering, and Medicine's Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats will provide a rapid expert consultation addressing potential methods to better track and understand the causes of HCW deaths due to COVID-19, and assess the impact of the SARS-CoV-2 pandemic on the physical and mental health of HCWs.
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5 As of November 3, 2020, the CDC COVID Data Tracker webpage reported 786 HCW deaths attributable to infection with COVID-19. 6 CDC's mechanism for collecting information about HCW infections currently relies on coronavirus case report forms, typically completed by local health departments.
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The earlier estimate of 12,348 nursing home health care worker deaths was a calculation error made by summing cumulative data instead of weekly data retrieved from the raw CMS COVID-19 nursing home dataset available at https://data.cms.gov/Special-Programs-InitiativesCOVID-19-Nursing-Home/COVID-19-Nursing-Home-Dataset/s2uc-8wxp (accessed December 16, 2020)
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20 While some mitigation strategies are necessary at the organizational level, the NAM Action Collaborative called for several immediate actions at the national level to lay the groundwork for a clear and accountable strategy to safeguard the health and well-being of the health care workforce. These include the implementation of a national epidemiologic tracking program to measure HCW well-being, assess the acute and long-term effects of COVID-19 on HCWs, and report on the outcomes of interventions.
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In March 2020, MGB implemented an infection reduction strategy involving testing of symptomatic HCWs and universal masking of health care staff and patients. Before the intervention, the positivity rate increased exponentially from 0 percent to 21.32 percent; implementation of universal masking was followed by a significantly lower rate of COVID-19 positivity among HCWs.
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A comprehensive, integrated national data tracking and reporting system coupled with well-designed, focused epidemiological assessments such as those described here, could help identify more effective measures to protect the health and well-being of the health care workforce. APPENDIX A Previous National Academies Report Relevant to Mortality Tracking During Disasters In September 2020, the National Academies published a report that reviewed and assessed the current state of the field and best practices in assessing and quantifying mortality and significant morbidity following large-scale disasters, which included pandemics.
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Senators Schatz and Cassidy introduced bipartisan legislation "to create a new permanent and independent board, the National Disaster Safety Board, to study the underlying causes of disaster related fatalities and property damage nationwide." 27 National-level solutions specific to HCWs could be extrapolated and tailored further to mitigate some of the challenges unique to pandemics, in particular to the COVID-19 crisis. For example, included in the adoption of a uniform framework for collecting, recording, and reporting HCW COVID-19 mortality and morbidity data and the promulgation of national standards for tracking and reporting mortality data could be the inclusion or flagging of specific fields in various reporting systems (including death certificates, hospital data reporting systems, and others)
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We extend gratitude to the staff of the National Academies, in particular to Scott Wollek, Aurelia Attal-Juncqua, Lisa Brown, and Andy Pope, who contributed research, editing, and writing assistance. Harvey Fineberg, chair of the Standing Committee, approved this document.
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