Corona infections
Inoculated staff pose risk in hospital, yet allowed to continue working with symptoms
The Outbreak Management Team is concerned about the possible spread of the corona-virus by vaccinated healthcare workers. However, vaccinated hospital staff may continue to work with symptoms.
Johan van Heerde - 29 July 2021, 23:11
People who work in health care, have long been fully vaccinated and yet are now receiving Covid-19. Do they pose a danger at work? Infections with high contagiousness are found among vaccinated healthcare workers in the Netherlands and so there is a chance of transmission of this virus to vulnerable patients, the Outbreak Management Team reported this week.
In Israel, a forerunner when it comes to vaccination, the corona-virus broke through the vaccine in half a percent of vaccinated healthcare workers, according to the first hard data on this,
published in the scientific journal
The New England Journal of Medicine. The tests were conducted at the beginning of the year, when the alpha variant of the corona-virus dominated. Now the more contagious delta variant of the virus is dominant, which other Israeli research says breaks through vaccinations more easily.
Stuffy noses and airways
Most "breakthrough infections" among healthcare workers are accompanied by mild or even no symptoms, but sometimes there are persistent symptoms, such as a stuffy nose or respiratory distress.
This poses a problem. In the Dutch healthcare sector, too, (young) healthcare workers get infected with corona after their full vaccination. In the last three weeks, 7051 healthcare workers in the Netherlands tested positive, compared to 724 in the previous three weeks. It is not known how many of those care workers had already been vaccinated. However, it is known that the vaccination willingness among health care workers is very high, often above 90 percent.
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corona infections among healthcare workers
number of infections per week
Those people work in nursing homes, among other places. In that care sector there is suddenly a sharp increase in infections visible. Yesterday the RIVM reported that in 133 nursing home locations over the past 28 days at least one infection has been reported. Ten days earlier that figure stood at 56 nursing homes.
According to Verenso, the association of specialists in geriatric medicine, it is also possible that a vaccinated employee brought the virus with him/her. However, introduction of the virus can also have happened by non-vaccinated employees, or family, or visitors of residents, we do not know, Verenso emphasizes.
Cees Hertogh, professor of geriatrics and member of the OMT, thinks the same. "The idea is that those infections were caused by, among other things, introduction via care staff. We know that the vaccine does not work one hundred percent against infection and certainly not against transmission."
Always a propagation risk
The clinical profile of those residents, who are often also vaccinated, is usually mild. Nevertheless, the nursing home sector is vigilant. Hertogh: "The infections show that we cannot let go of infection prevention measures; there is always a risk of propagation.
Funnily enough, a new guideline for healthcare workers has just come into effect. This states that healthcare workers with complaints indicating the presence of the corona-virus may still work, provided they are fully vaccinated. This goes against the RIVM's classic credo that people with complaints should stay at home.
The Federation of Medical Specialists is responsible for this guideline, which was published before the OMT expressed its concerns about infections among vaccinated healthcare workers. When asked, the FMS states that there is no reason to revise the guideline again. The document states that a mouth mask must always be worn in case of direct patient contact. Tests are also carried out immediately.
Alertness is necessary, acknowledges clinical microbiologist Heiman Wertheim, one of the fourteen compilers of the guideline. "We are constantly weighing up the risks. In that sense, discussions in the OMT and at the FMS are not always synchronous," says Wertheim. "The fact is that in healthcare you work with vulnerable people and the guideline is a minimum requirement. A hospital can as well say: just stay home for a day. That also depends on how high the need is, whether all hands are needed at the bedside."
Translated with
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Sadly she is pro vaccination in a big way. 
