The Impact of a Changing Public Health Approach to Preventing COVID-19 in Inpatient Psychiatric SettingMangal, Krishnendu (2023) The Impact of a Changing Public Health Approach to Preventing COVID-19 in Inpatient Psychiatric Setting. Master Essay, University of Pittsburgh.
AbstractBackground: SARS-CoV-2, the virus that causes COVID-19, is challenging to control. This research project seeks to assess the effectiveness of PA HAN 627, an updated SARS-CoV-2 control strategy that used vaccination status to eliminate isolation precautions, by quantifying the COVID-19 attack rate among vaccinated non-cohorted and unvaccinated cohorted patients at UPMC Western Psychiatric Hospital. Methods: We analyzed patient admissions to 10 inpatient units at WPH from May 1st to September 30th, 2022, including all admissions with at least one inpatient day. The study population and their locations were obtained from TheraDoc. Patient vaccination status was obtained from PA SIIS, and SARS-CoV-2 exposure and acquisition data were obtained from IP&C contact tracing databases. The COVID-19 conversion rate was calculated as the ratio of the number of patient admissions with at least one exposure leading to a positive COVID-19 test, and as the number of cases per patient day at risk. The attack rate was calculated among exposed unvaccinated cohorted patients and exposed vaccinated non-cohorted patients. Epidemiologic curves were drawn to compare study case patients with Allegheny County COVID-19 cases from Western Pennsylvania Regional Data Center. Results: At UPMC WPH, 1,844 patients were admitted, resulting in 27,030 inpatient days. After excluding patients not at risk for COVID-19, there were 25,012 patient days. Of these, 928 were male, 915 were female, and one unknown. The mean age was 35.8 years, with a standard deviation of 19 years. There were 76 indexes and 452 exposures, with 44 resulting in conversion. The conversion rate was 2% per admission, with 17.59 conversions per 10,000 patient days. The attack rate was 11% for the unvaccinated cohorted group and 9% for the vaccinated non-cohorted group. Conclusions: The observation of attack rates suggests that the advantages of vaccination may be outweighed by the increased risk of exposure and conversion in the absence of cohorting. Public Health Significance: Behavioral health facilities serve a distinct population, so it's important to assess if government guidelines effectively protect them in congregate settings. Research like this is crucial to evaluate the risks and benefits of changing public health approaches for COVID-19 and other diseases. Share
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