Health care provider absences and intervenable areas during a COVID-19 surge

Document Type

Conference Proceeding

Publication Date


Publication Title

Academic Emergency Medicine


Background and Objectives: Health care provider (HCP) absenteeism during the initial phase of an epidemic or pandemic can lead to significant understaffing during a critical time. There is a paucity of literature that describes the effect that the initial phases of a pandemic have on emergency department (ED) HCP absences, or possible interventions that may curb the number of absences. This lack of data places frontline departments at undue risk for inadequate HCP staffing at a time when patient care needs are greatest. This study aimed to quantify HCP absenteeism in the ED during the initial Coronavirus Disease 2019 (COVID-19) surge and to identify potential interventions that may mitigate absences.

Methods: This was a retrospective, descriptive record review that included 82 resident physicians, physician assistants, and staff physicians who were scheduled to work more than 3 clinical shifts during March 2020 in an urban, academic ED that received a high number of COVID-19 patients in March. The department created an external database during the pandemic to assist with staffing given the sudden increase in HCP absenteeism. This database included date of COVID-19 exposure, symptom onset, absence from and return to work, testing with result, age, gender, travel history, and admission history. Descriptive statistics and graphical representations superimposed with dated institutional policy changes were used in framing the progression of dependent variables.

Results: During March 2020, of 82 ED HCPs, 28 (34%) required an absence from clinical duties, totaling 152 absentee calendar days (n = 13 women [46%]; n = 15 men [54%]). Median age was 32 years (interquartile range 28-39). Median number of days absent was 4 (interquartile range 3-7). While 16 (57%) of the total absences were secondary to a known exposure, 12 (43%) were symptomatic without a known exposure. A total of 25 (89%) absent HCPs received COVID-19 testing (n = 5 positive [20%]; n = 20 negative [80%]) with test results returning in 1 to 10 days. Eleven (39%) symptomatic HCPs had traveled domestically or internationally in the past 30 days.

Conclusion: EDs should anticipate substantial HCP absenteeism during the initial surge of a pandemic. Possible interventions to mitigate absences include early and broad use of personal protective equipment, planning for many asymptomatic HCP absences secondary to exposures, prioritizing HCP testing, and mandating early travel restrictions.




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