Lessons Learnt from an Epidemioloical Investigation of COVID-19 Outbreak amongst Health Care workers in a Major Specialist Hospital in Malaysia
Abstract
Introduction: Healthcare staff, particularly front liners, have been reported to be exposed to emerging diseases due to inadequate measures to control infection during overwhelming or unexpected initial encounters with infected patients. We report on the experience of a major specialist hospital in Malaysia in the face of a COVID-19 outbreak in which our healthcare workers were exposed while close contacts between staff were quarantined. Service delivery has been challenged and new measures have been in place to mitigate the spread in healthcare settings.
Problem (Rationale): The first positive COVID-19 case in Malaysia was reported on 24 January 2020, while the first local healthcare worker (HCW) death occurred on 22 March 2020. The trend of infected HCWs increased over the next several weeks, burdening the healthcare system.
Approach (Methodology): We identified that the major possible cause of spread was secondary to close contact with colleagues when managing Patient Under Investigation (PUI) or Severe Acute Respiratory Illness (SARI) patients. Following this, healthcare workers and the public are encouraged to avoid '3C' areas, namely crowded places, confined spaces, and close conservation and to, practice '3W' which is frequently washing hands with water and soap, wearing a face mask in public places or when encountering those with fever and flu, practice caution by avoiding handshakes, staying at home, and seeking treatment if developing symptoms related to COVID-19. Symptomatic staff suspected and confirmed cases were identified and quarantined.
Relevant Changes (Result/Findings): Within four weeks, (11 HCWs were COVID-19 positive with 550 close contacts quarantined). The flattening of curve was seen after the quarantine order was released on 9 April 2020. No new cases were recorded after 1 April and recovery was observed by 2 April. All cases were recovered by 24 April with no additional new cases.
Lesson Learnt (Conclusion): Identifying and managing HCWs at risk of infection, timely sharing of information, organizing personnel, promoting sanitizing, and restricted gatherings were critical for controlling COVID-19 spread.
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