How to protect healthcare workforce during an epidemic outbreak: Modelling a desynchronization strategy from the COVID-19 pandemic

During worldwide pandemics, protecting caregivers and thereby maintaining the medical workforce is a crucial and challenging task. Under such extraordinary situations, the sustainability of the healthcare providers is threatened by several factors including: 1) infected patients, 2) infected co-workers and 3) the infected community. Unlike most other professions, social distancing is extremely difficult in medical teams where healthcare workers are required to work in close contact with patients and colleagues. Currently, little is known about which work organizational strategy in hospitals is most suitable to protect the healthcare workforce. Therefore, the current project aims to identify if organizational measures installed during the COVID-19 outbreak were effective in protecting caregivers. This is of high relevance as during the course of an epidemic the healthcare workforce may become a scarce resource during later phases of the epidemic.The proposed project is designed to analyze data from the current COVID-19 outbreak to understand how organizational approaches may protect the healthcare workforce in a large university hospital. The obtained data will be used for the simulation and refinement of mathematical modelling to develop strategies that can be adapted for new regions affected by this, recurrent and future epidemic outbreaks. Aim 1. Determine the difference in risks of infection between healthcare and non-healthcare workers in a hospital environment The design of the study allows to determine the different roles on infection of hospital employees being 1) patient contact 2) no patient contact, working place in the hospital 3) home office. The model will determine to what extent these different roles impact of infection rates of workers and patients.Aim 2.Determine the impact of early testing on healthcare personnelAn intensive strategy of testing twice weekly for SARS-CoV-2 was established locally in one clinical unit. By assessing health status and productivity of the workforce compared to other departments allows to determine the relevance of frequent testing of asymptomatic healthcare workers for the protection of workers and patients. Aim 3.Determine the effectiveness of a desynchronization strategy to protect healthcare workersA desynchronization strategy was installed in one large unit in which the entire staff was dichotomized. Each of the two teams is working alternating for one week with the goal to reduce contact between the teams and decrease infection rates of the workforce. By comparing health status and productivity of the workforce to other departments will determine the relevance of such organizational distancing in healthcare workers. With the empirical data collected in Aims 1, 2 and 3, mathematical models will be developed, tested and simulated for impact evaluation. Modelling approaches address parametric as well as stochastic effects and extend the existing models that were developed for larger populations. Furthermore, the studies are designed to measure and model the productivity of the workforce resulting from the different organizational strategies. SignificanceWithin this project, the consequence of the COVID-19 outbreak on the workforce of a large university hospital will be analyzed and used to design new models for new regions affected, recurrent and future epidemic outbreaks. The results of this project will help to define the best strategy to organize the healthcare workforce of a hospital. The final goal is to be able to care for both infected and non-infected patients, while minimizing the risk to staff a thus maintaining a healthy caregiver workforce. Given the fact that data are available for many non-healthcare workers the results will also be modeled for non-healthcare institution. Therefore, these studies allow to determine the relevance of home office and desynchronization strategies to protect workers in their environment during and epidemic outbreak.