COVID-19 Among U.S. Health Care Workers, February–July 2020

Summary

• Health care personnel are essential workers at risk of COVID-19 through exposure to patients or infectious materials.
• From February 12 to July 16, 2020, 100,570 health care workers with COVID-19 were reported to CDC, and 641 died — up tenfold in cases since CDC's first report in April 2020 (9,282 cases and 27 deaths).
• Those who died were more often older, male, Asian or Black, and nearly all had an underlying medical condition. Nurses were the most common single occupation, and nursing and residential care facilities the most common workplace.

By September 21, 2020, the pandemic had caused 6,786,352 cases and 199,024 deaths in the United States.

The data

Health departments report cases to CDC voluntarily on a standard form. Of 2,633,585 cases reported during the period, only 571,708 (22%) said whether the person was a health care worker; 100,481 (18%) were. Another 89 came from extra death surveillance in Michigan, New Jersey and New York City. Occupation and job setting were added to the form only in May.

Who got sick

• Median age 41; 79% women; 57% aged 16–44.
• Race and ethnicity (known for 69%): 47% White, 26% Black, 12% Hispanic, 9% Asian.
• 8% were hospitalized and 5% treated in intensive care.
• 44% had at least one of 10 listed underlying conditions — most often cardiovascular disease (18%), chronic lung disease (16%) and diabetes (13%).

Who died

Of those whose outcome was known, 641 (1%) died, in 22 jurisdictions.

Among those who died, more than half had cardiovascular disease (61%) or diabetes (52%), and 32% had both.

Jobs and workplaces

In six jurisdictions reporting these details:

• Health care support workers — nursing and medical assistants and aides — were the largest group (32%), and nurses the largest single occupation (30%) — although nurses are only about 15% of the health care and social assistance workforce.
• Two-thirds (67%) worked in nursing and residential care facilities.
• Cases also occurred among workers who don't treat patients, such as administrative and environmental services staff.

What it means

• Long-term care: large outbreaks in these facilities point to spread among residents and staff, amid short staffing, too little protective equipment and gaps in infection-control training.
• Inequities: long-standing inequities in the social determinants of health put some groups at greater risk, and must be addressed at work, at home and in the community. Making sure every worker has enough protective equipment is one way to reduce them.
• Higher-risk workers should stay in touch with their own doctors and occupational health services to manage their risk.
• Protection: access to protective equipment and training, masks for everyone at work and in the community, social distancing and hand hygiene remain critical — along with screening workers for illness before shifts and sick leave without penalty. Workers can catch the virus from coworkers, family or the community, and pass it to patients.
• The data can also inform decisions about vaccination, once vaccines are available.

Limits: most cases lacked health care worker status, and cases are surely undercounted, especially without symptoms; missing data varied by group; job details came from only six jurisdictions; testing differed by place; and the report doesn't say where workers were exposed.

Sources

Based on Michelle M. Hughes, Matthew R. Groenewold, Sarah E. Lessem and others, "Update: Characteristics of Health Care Personnel with COVID-19 — United States, February 12–July 16, 2020," MMWR, Centers for Disease Control and Prevention; a work of the United States government in the public domain.