Study: UK, US Health Care Workers Report Higher Rates of COVID-19 Compared with General Population Early in Pandemic


Study finds that health care systems need to develop additional strategies to protect workers from COVID-19.

New research has found that the risk of reporting a positive test for coronavirus disease 2019 (COVID-19) was greater among front-line health care workers in the United Kingdom and United States, according to a study published by The Lancet.

The objective of the study was to assess the risk of COVID-19 among front-line health care workers compared with the general community and the effect of personal protective equipment (PPE) on that risk.

The researchers conducted an observational cohort study in the UK and the US of the general community, including front-line health care workers, using self-reported data from the COVID Symptom Study smartphone application from March 24 (UK) and March 29 (USA) to April 23, 2020, according to the press release.

Participants were voluntary users of the app who provided information during their first use of the app on demographic factors, including age, sex, race or ethnic background, height and weight, occupation, and medical history. Further, the participants subsequently reported any COVID-19 symptoms.

The researchers used Cox proportional hazards modeling to estimate multivariate-adjusted hazard ratios (HRs) of the primary outcome, which was a positive COVID-19 test, according to the study.

Among the 2,035,395 community individuals and 99,795 front-line health care workers, the researchers recorded 5545 incident reports of a positive COVID-19 test over 34,435,272 person-days. Front-line health care workers were at an increased risk for reporting a positive COVID-19 test compared with the general community.

An inverse probability-weighted model was used to adjust for the likelihood of receiving a COVID-19 test to account for differences in testing frequency between front-line health care workers and the general community, according to the study. In addition, secondary and post-hoc analyses suggested adequacy of PPE, clinical setting, and ethnic background were also important factors.

The study concluded that health care systems should ensure adequate PPE and develop additional strategies to protect health care workers from COVID-19, particularly those from black, Asian, and minority ethnic backgrounds. The researchers noted that additional follow-up of these observational findings is needed.


Nguyen LH, Drew DA, Graham MS, et al. Risk of COVID-19 among front-line health care workers and the general community: a prospective cohort study. The Lancet Public Health. DOI:

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