A research program to provide a comparative contextualized analysis of occupational COVID-19 among health workers: Preliminary insights from a South African-Canadian Collaboration.

Objective The COVID-19 pandemic has demonstrated that healthcare workers (HCWs) in many settings are at high risk of occupational exposure to infectious diseases, especially where attention to occupational protection was lacking. In July 2020 our World Health Organization (WHO) collaborating centres in Canada and South Africa launched a joint Rapid Response Research program in partnership with local government health service delivery agencies in both countries to better understand how local contexts affect policies and practice; scrutinize their respective scientific and contextual rationales as well as outcome; grasp why and how these change over time; and understand organizational factors that enhance implementing resilient policies.

Methods The collaboration includes cohort studies, in the Vancouver Coastal Health (VCH) region in Canada, and Gauteng province in South Africa respectively, to assess risk factors for SARS-CoV-2 infection among HCWs as well as evaluate the effectiveness of SARS-CoV-2 infection prevention and control measures. It also includes a cross-sectional study in Gauteng to explore mental health of HCWs during the pandemic and identify areas for intervention; a quasi-experimental study of the role of information systems in strengthening occupational health services for healthcare workers; and global policy analyses including an analysis of a global survey of HCWs from 161 countries.

Results The global survey revealed considerable variations in the degree to which prevention and control measures were deemed adequate; the South African baseline audit of 42 hospitals also revealed considerable variations in implementing occupational health protection. We demonstrated the utility of information systems to assess risk by occupation and setting in VCH; preliminary results of the VCH case-control study demonstrated the feasibility of this design; and, importantly, we identified challenges in leveraging operational research to inform policy, practice and world-knowledge in both VCH and South Africa.

Conclusion Our research activities showed the impact of vaccine roll-out and new variants on rates of COVID-19 among HCWs within different healthcare settings and occupational groups and how policies to protect HCWs have evolved (e.g., masking policies and vaccine protocols for HCWs). We conclude that lessons regarding procedural barriers to data acquisition and sharing must be addressed with an ethical framework in mind.