New York City COVID-19 resident physician exposure during exponential phase of pandemic

Abstract

BACKGROUNDFrom March 2, 2020, to April 12, 2020, New York City (NYC) experienced exponential growth of the COVID-19 pandemic due to novel coronavirus (SARS-CoV-2). Little is known regarding how physicians have been affected. We aimed to characterize the COVID-19 impact on NYC resident physicians.METHODSIRB-exempt and expedited cross-sectional analysis through survey to NYC residency program directors April 3-12, 2020, encompassing events from March 2, 2020, to April 12, 2020.RESULTSFrom an estimated 340 residency programs around NYC, recruitment yielded 91 responses, representing 24 specialties and 2306 residents. In 45.1% of programs, at least 1 resident with confirmed COVID-19 was reported. One hundred one resident physicians were confirmed COVID-19-positive, with an additional 163 residents presumed positive for COVID-19 based on symptoms but awaiting or unable to obtain testing. Two COVID-19-positive residents were hospitalized, with 1 in intensive care. Among specialties with more than 100 residents represented, negative binomial regression indicated that infection risk differed by specialty (P = 0.039). In 80% of programs, quarantining a resident was reported. Ninety of 91 programs reported reuse or extended mask use, and 43 programs reported that personal protective equipment (PPE) was suboptimal. Sixty-five programs (74.7%) redeployed residents elsewhere to support COVID-19 efforts.CONCLUSIONMany resident physicians around NYC have been affected by COVID-19 through direct infection, quarantine, or redeployment. Lack of access to testing and concern regarding suboptimal PPE are common among residency programs. Infection risk may differ by specialty.FUNDINGNational Eye Institute Core Grant P30EY019007; Research to Prevent Blindness Unrestricted Grant; Parker Family Chair; University of Pennsylvania.

Keywords: COVID-19; Epidemiology.

Figure 1. Flow chart of survey recruitment and responses among greater NYC training programs.

The flow chart includes represented specialties and number of residents. ACGME, Accreditation Council for Graduate Medical Education; PDs, training program directors.

Figure 2. Residents with known COVID-19 testing status, stratified by symptoms.

Of 2088 total residents with known COVID-19 testing status, 101 residents were confirmed (positive), 163 were presumed (untested), 76 were suspected (negative), and 1748 neither had symptoms nor were tested.

Figure 3. Number of residents with new COVID-19 symptoms and number of programs enforcing mask policy, by week.

Most confirmed COVID-19 cases (n = 35) were reported during the week of 3/23–3/29. Most presumed COVID-19 cases (n = 53) and suspected COVID-19 cases (n = 29) were reported a week earlier than the peak of confirmed cases during 3/16–3/22. Total number of confirmed, presumed, and suspected COVID-19 cases started to drop after the week of 3/23–3/29. The bottom graph shows the number of programs enforcing mask policy by week. Most programs started to enforce universal mask policy during the week of 3/23–3/29.