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Ann Med . The impact of government pandemic policies on the vulnerability of healthcare workers to SARS-CoV-2 infection and mortality in Jakarta Pr

tetano

Editor, Senior Moderator
Ann Med


. 2023;55(2):2293306.
doi: 10.1080/07853890.2023.2293306. Epub 2024 Jan 11. The impact of government pandemic policies on the vulnerability of healthcare workers to SARS-CoV-2 infection and mortality in Jakarta Province, Indonesia

Rina Agustina[SUP] 1 2 [/SUP], Davrina Rianda[SUP] 2 3 [/SUP], Aly Lamuri[SUP] 4 [/SUP], Karina Rahmadia Ekawidyani[SUP] 1 5 [/SUP], Deviana Ayushinta Sani Siregar[SUP] 2 [/SUP], Dyana Santika Sari[SUP] 2 [/SUP], Prashti Mutia Wulan[SUP] 2 [/SUP], Natasha Dianasari Devana[SUP] 1 [/SUP], Ari Fahrial Syam[SUP] 6 [/SUP], Ahmad Jabir Rahyussalim[SUP] 7 [/SUP], Dwi Oktavia Handayani[SUP] 8 [/SUP], Widyastuti Widyastuti[SUP] 8 [/SUP], Anuraj Harish Shankar[SUP] 9 10 [/SUP], Ngabila Salama[SUP] 8 [/SUP]



Affiliations
Abstract

Introduction: Healthcare workers (HCWs) are on the frontlines of the COVID-19 pandemic, putting them at a higher risk of infection and disease than non-HCWs. We analysed the effects of government policies for the public and for HCWs on the likelihood of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and mortality among HCWs during the first 8 months of the pandemic in Jakarta province, the capital city and COVID-19 hotspot in Indonesia.
Methods: We conducted a retrospective cohort study using secondary data from the Jakarta provincial government from March to October 2020, which included sociodemographic characteristics, symptoms, comorbidities and COVID-19 diagnosis history for all cases. A generalized linear mixed-effect regression model was used to determine the effect of each month on the odds ratio (OR) of COVID-19 cases and deaths for HCW compared with non-HCW, assuming that monthly trends were influenced by varying government policies.
Results: A total of 894,487 suspected and confirmed COVID-19 cases in health facilities in Jakarta province were analysed. The OR of confirmed cases for HCW was 2.04 (95% CI 2.00-2.08; p < .001) compared to non-HCW. Despite this higher OR for infection, the case fatality rate (2.32 per 100) and OR (1.02, 95% CI 0.93-1.11; p = .65) of COVID-19 deaths for HCW were similar to those of non-HCW. We observed a trend towards a lower number of COVID-19 patients in hospitals and lower odds of COVID-19 cases among HCWs during the April-to-July 2020 phase compared to the August-to-October phase. This chronologically aligned with more extensive policies to support hospital-based, community-based and well-being-related actions to protect HCW.
Conclusions: HCW had higher odds of having SARS-CoV-2 infection, yet similar odds of death from COVID-19, as compared to non-HCW. Government policies with collective efforts to prevent hospital overcapacity during high transmission and burden periods of the pandemic should be prioritized.

Keywords: COVID-19; Indonesia; SARS-CoV-2; healthcare worker; policy.

 
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