SARS-COV-2 Screening of Health Care Workers in Brunei Darussalam

Abstract

Background: Health care workers (HCWs) are at high risk of COVID-19 infection; therefore, screening is recommended for early detection and management to break the chain of transmission. Globally, multiple strategies have been utilized for the screening of HCWs. This article reports and evaluates an active surveillance and screening strategy for severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) among HCWs following work or nonwork exposures in Brunei Darussalam to prevent health care–associated COVID-19 transmission. Methods: In March 2020, the Ministry of Health through the Occupational Health Division adopted an active screening strategy for symptomatic and asymptomatic HCWs, which involved symptom screening, risk assessment, SARS-COV-2 testing, and management following work/nonwork exposure and recent overseas travel, and those with influenza-like illness (ILI) symptoms. Screening frequency was based on the HCWs’ symptoms and exposure, with the intent to evaluate all possible sources of exposure. Findings: As of December 31, 2020, 821 HCWs were screened, of which 632 (77%) had ILI symptoms and 14 (1.7%) had high-risk occupational exposure. Reverse transcription polymerase chain reaction (RT-PCR) swab testing was carried out on 577 (70.3%) HCWs, with the highest proportion of swabs done on doctors (85.1%; p < .01) due to their workplace exposure (34.3%) and overseas travel (38.7%). Conclusion: By July 2021, Brunei Darussalam had recorded zero cases of COVID-19 among HCWs from occupational exposure. Our strategy of active screening for SARS-COV-2 RT-PCR testing since early in the outbreak has proven to be successful, in combination with infection control practices and public health measures, in the prevention of occupational transmission, thereby facilitating early return to work for HCWs with low-risk exposure and without symptoms.