COVID-19 Healthcare Worker Exposure Response & Outcomes (HERO) Trial

Importance: Healthcare workers are on the front-lines of the COVID-19 pandemic and may be disproportionately affected by it.
Objective: To assess the effects of the pandemic on the health and lives of US healthcare workers.
Design: Survey of US healthcare workers who joined the HERO registry from April 10 to May 22, 2020.
Setting: All types of healthcare organizations nationwide.
Participants: 11,982 healthcare workers 18 years and older.
Main Outcomes: COVID-19 exposure, viral and antibody testing, diagnosis of COVID-19, access to personal protective equipment (PPE), work hours, physical and emotional symptoms, and job burnout.
Results: Mean age was 42.9 years, 76.3% were female, 79.3% White, 77.3% worked in hospitals, 33.3% were nurses, 19.4% were physicians, and 31.0% worked in high risk settings. Overall, 43.2% reported a COVID-19 exposure and 91.3% were exposed at work. Just 3.7% had a positive viral or antibody test or a physician diagnosis of COVID-19. The adjusted odds of COVID-19 illness were 2.1 times (95% CI 1.6-2.9) higher for Hispanic/Latinos and 2.2 times higher (95% CI 1.5-3.3) for Black/African-Americans than White counterparts. Access to N95 respiratory masks was problematic for 35.7% and reuse of masks was common (51.5%). Staff who worked in high risk settings (e.g., ICUs, EDs, COVID-19 units) experienced more physical and emotional symptoms than those in low risk settings and were more likely to report job burnout (43.1% vs 38.1%, p<0.01). Conclusions and Relevance: Healthcare workers are at high risk for COVID-19 exposure, but rates of COVID-19 illness remain low. Attention should be given to addressing staff well-being, particularly the needs of women who comprise three-fourths of the healthcare workforce. The greater risk of COVID-19 infection among race/ethnicity minorities reported in the general population is also seen in healthcare workers, which calls for a better understanding of the origins of these disturbing disparities.

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