Implementation of a COVID-19 surveillance programme for healthcare workers in a teaching hospital in an upper-middle-income country

PLoS One. 2021 Apr 14;16(4):e0249394. doi: 10.1371/journal.pone.0249394. eCollection 2021.


Introduction: The reporting of Coronavirus Disease 19 (COVID-19) mortality among healthcare workers highlights their vulnerability in managing the COVID-19 pandemic. Some low- and middle-income countries have highlighted the challenges with COVID-19 testing, such as inadequate capacity, untrained laboratory personnel, and inadequate funding. This article describes the components and implementation of a healthcare worker surveillance programme in a designated COVID-19 teaching hospital in Malaysia. In addition, the distribution and characteristics of healthcare workers placed under surveillance are described.

Material and methods: A COVID-19 healthcare worker surveillance programme was implemented in University Malaya Medical Centre. The programme involved four teams: contact tracing, risk assessment, surveillance and outbreak investigation. Daily symptom surveillance was conducted over fourteen days for healthcare workers who were assessed to have low-, moderate- and high-risk of contracting COVID-19. A cross-sectional analysis was conducted for data collected over 24 weeks, from the 6th of March 2020 to the 20th of August 2020.

Results: A total of 1,174 healthcare workers were placed under surveillance. The majority were females (71.6%), aged between 25 and 34 years old (64.7%), were nursing staff (46.9%) and had no comorbidities (88.8%). A total of 70.9% were categorised as low-risk, 25.7% were moderate-risk, and 3.4% were at high risk of contracting COVID-19. One-third (35.2%) were symptomatic, with the sore throat (23.6%), cough (19.8%) and fever (5.0%) being the most commonly reported symptoms. A total of 17 healthcare workers tested positive for COVID-19, with a prevalence of 0.3% among all the healthcare workers. Risk category and presence of symptoms were associated with a positive COVID-19 test (p<0.001). Fever (p<0.001), cough (p = 0.003), shortness of breath (p = 0.015) and sore throat (p = 0.002) were associated with case positivity.

Conclusion: COVID-19 symptom surveillance and risk-based assessment have merits to be included in a healthcare worker surveillance programme to safeguard the health of the workforce.

MeSH terms

  • Adult
  • COVID-19 / diagnosis
  • COVID-19 / prevention & control*
  • COVID-19 Testing / methods*
  • COVID-19 Testing / trends
  • Comorbidity
  • Contact Tracing / methods
  • Cross-Sectional Studies
  • Disease Outbreaks / prevention & control*
  • Epidemiological Monitoring
  • Female
  • Health Personnel
  • Hospitals, Teaching
  • Humans
  • Malaysia / epidemiology
  • Male
  • Pandemics
  • SARS-CoV-2 / isolation & purification

Grant support

The authors received no specific funding for this work.