COVID-19: our current priority
The following titles are, given the ongoing COVID-19 pandemic, the current priorities of our group:
- Workplace interventions to reduce exposure to SARS-CoV-2 Protocol phase
- Interventions to improve return to work in people diagnosed with COVID-19 Protocol phase
- Experiences and needs of people after COVID-19 that impact return to work (qualitative evidence synthesis review) Protocol phase
- Interventions to prevent exposure to SARS-CoV-2 aerosols in healthcare workers due to aerosol generating procedures Protocol phase
Review 1: Workplace interventions to reduce exposure to SARS-CoV-2
Interventions to prevent healthcare workers and dentists from infection with SARS-CoV-2 are covered in other Cochrane reviews. Interventions for other workers are not systematically assessed, yet:
- workers in close contact with potential infectious clients, such as taxi-drivers and cashiers in shops, and
- workers without close contact to clients, but who can be infected by colleagues.
The focus of this Cochrane review are interventions for those types of workers. Interventions you can think of, are for example (Barned and Sax, NEJM 2020): personal hygiene such as hand disinfection, workspace cleaning, employee screening by the employer, redesigning workspaces such as greater distance and improved ventilation, telework or working from home for segments of workers, etc.
This Cochrane review will include any controlled study aimed at reducing infection conducted at workplaces (other than health care) among workers exposed to SARS-CoV-2 or comparable upper airway viruses.
Review 2: Interventions to improve return to work in people diagnosed with COVID-19
A large group of people experience ongoing psychological and physical health problems long after having the COVID-19 disease. This may impact their ability to participate in paid work. For example, fatigue has been reported as a long term complaint in many people with COVID-19. Workers that have suffered from COVID-19 will have to return to work and for some this will be challenging. They might experience long term effects and challenges in returning to work similar to other infectious diseases.
The focus of this Cochrane review are interventions that are aimed at return to work after COVID-19. For example interventions targeting the workers’ physical condition, working conditions or coping strategy.
This Cochrane review will include controlled intervention studies aimed at improving return to work in patients after COVID-19, or any other comparable upper airway infection.
Review 3: Qualitative review on the experiences and needs of people after COVID-19 that impact return to work
The aim of this review is to make an inventory of the reported health complaints and the challenges and barriers that are experienced that could impede the ability to return to work after COVID-19.
We plan to do a qualitative evidence synthesis, which would allow a deeper understanding of the problem of RTW during and after the COVID-19 pandemic. Using this methodology, we also explore what elements are essential to target in return-to-work support, advice and interventions (see https://epoc.cochrane.org/news/qualitative-evidence-synthesis-template). It focuses on:
- increasing understanding of a phenomenon of interest (e.g. workers conceptualization of what good work or RTW looks like during/after COVID-19 pandemic);
- identifying associations between the broader environment within which people live and the interventions that are implemented;
- increasing understanding of the values and attitudes toward, and experiences of, health conditions and interventions during COVID-19 by those who implement or receive them; and
- providing a detailed understanding of the complexity of experiences to inform the (future) development of interventions and their impacts and effects on different subgroups of people and within different contexts.
Review 4: Interventions to prevent exposure to SARS-CoV-2 aerosols in healthcare workers due to aerosol generating procedures
Aerosol generating procedures (AGPs) put health care workers at special risk of respiratory infection. This is further stressed by current experiences with COVID-19 patients. In guidelines, health care workers are required to put on more and more stringent PPE to protect themselves compared to other situations in which they care for infectious patients. The strategy of hierarchy of controls, as used in occupational hygiene, would require first considering elimination of the source of the exposure, then considering engineering controls and only as a last resort the use of PPE. Aerosol generating procedures are a longstanding problem in dental care and many interventions have been applied to either control the source of the aerosol in the patient or to extract the aerosol close to where it is generated. Similar interventions are possible in AGPs in health care in general. The objective of this review is to list and evaluate the effects of interventions that eliminate the source or use engineering controls to prevent infections arising from aerosols in health care workers.