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Explained: Why nurses are more at risk for Covid-19 among healthcare workers

One of the main reasons that individuals in nursing-related occupations are at higher risk is because of their frequent and close contacts with patients, which leads to an extended cumulative exposure time.

Nurses prepare for work in a Covid-19 intensive care unit (ICU) at the Ambroise Pare Clinic (Photographer: Nathan Laine/Bloomberg)

The US Centers for Disease Control and Prevention (CDC), in its recent Morbidity and Mortality Weekly Report (MMWR), analysed hospitalisation data from 13 sites in the US that indicated that six per cent of the adults hospitalised were health care personnel (HCP). Out of the infected HCP, 36 per cent of the individuals were in nursing-related occupations.

“HCP can have severe COVID-19–associated illness, highlighting the need for continued infection prevention and control in health care settings as well as community mitigation efforts to reduce SARS-CoV-2 transmission,” the analysis notes.

Why are nurses at high risk among HCP?

The study looked at 6,760 adult hospitalisations from March 1, 2020 to May 31, 2020. Out of the 36 percent of the infected HCP, 73 per cent had obesity and 28 per cent of them were admitted in intensive care units (ICUs) indicating severe disease. Further, 16 per cent required invasive mechanical ventilation, while four percent died.


Significantly, the median age of hospitalised HCP was 49 years and over 89 per cent of them had at least one underlying medical condition, out of which obesity was the most commonly reported. The authors of the analysis have referred to a recent study, which found that obesity was highly associated with the risk of death among COVID-19 patients.

One of the main reasons that individuals in nursing-related occupations are at higher risk is because of their frequent and close contacts with patients, which leads to an extended cumulative exposure time. Furthermore, in the US, nursing-related occupations account for a large proportion of the healthcare workforce. In 2019, registered nurses accounted for over one-third of the health care practitioners.

Even so, it is unclear if the HCP contracted the infection from healthcare facilities or from outside them.

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Health workers wearing protective masks speak with each other during a media tour of a temporary community treatment facility for Covid-19 patients at the AsiaWorld-Expo (AWE) in Hong Kong (Photographer: Paul Yeung/Bloomberg)

What steps do HCP take to protect themselves?

The analysis highlights that while HCPs take more precautions than other individuals, they are still susceptible to the disease.

CDC recommends that HCP use face masks, which include medical masks such as surgical or procedure masks at all times when they are in health care facilities. This includes patient-care areas, staff member rooms and areas where other HCP may be present. In areas that have reported moderate to substantial community transmission, the CDC recommends that HCP also wear eye protection when coming in contact with patients.

For aerosol-generating procedures, HCPs should ideally wear N95-equivalent or higher-level respirators.

Are the results of the analysis unique to the US?

The authors of the report note that the findings of their analysis are comparable to those that have reported among HCP in countries such as China, where nursing-related occupations accounted for the largest proportion of cases.

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