CDC underestimates COVID's toll on healthcare workers, experts say

Experts fear the Centers for Disease Control and Prevention's surveillance of COVID-19 cases and deaths among healthcare workers are under-counting the impact on the front lines, which could obscure the scope fo the pandemic as it hits the front lines.

According to CDC numbers, more than 63,000 healthcare workers have been infected with COVID-19 and 307 have died from the virus as of Friday.

But those figures are based on information received from a relatively small pool of test reports. The vast majority of the data collected lacks key information about the occupational status of those getting tested for the coronavirus.

That lack of detail obfuscates the toll COVID-19 is having on the approximaetly 18 million people in the national essential healthcare workforce.

"We don't know when healthcare workers are contracting COVID and even dying of COVID," said Dr. Alison Haddock, a member of the board of directors for the American College of Emergency Physicians.

The CDC's estimates were based on data collected from test reports from more than 1.3 million people. But only 288,000, or 21%, of the test reports included information about whether the person tested was a healthcare worker. Among cases involving healthcare personnel, death status information was only available for 57%, or approximately 36,000 cases.

That data make up a tiny fraction of the total number of COVID-19 cases and deaths that have occurred in the U.S. More than 101,000 people have died from COVID-19 as of Friday, according to the CDC, representing approximately 6% of the 1.7 million reported cases.

The numbers also indicate a significant spike in cases and deaths since early April. More than 9,200 healthcare workers had been infected with COVID-19 and 27 had died between Feb. 12 and April 9, according to CDC's Morbidity and Mortality Weekly Report on April 14.

Much like the latest figures, the April report estimates reflect only a fraction of the actual totals. Among the more than 315,000 COVID-19 cases reported to CDC at that time, 49,000, or 16%, of reports included data on whether the patient was a healthcare worker.

Haddock said there was a crucial need for states and federal health officials to collect more data on tested individuals so they can determine how underreported healthcare workers are in the current COVID-19 case and death totals.

That information would also be vital to helping public health leaders develop their pandemic response, she said.

"The more information and data we can be gathering in a consistent fashion across the board, the more we're going to be able to figure out how to combat the disease and how to make our country healthier," Haddock said.

Currently, just a handful of states and municipalities collect information on the number of COVID-19 cases and deaths involve healthcare workers, which prevents collecting more accurate numbers on a national scale.

In early May, a New York testing survey of 27,000 healthcare workers found 12% of New York City's healthcare workers tested positive for COVID-19 antibodies, compared to 20% of the city's general population.

Last month, Illinois health officials reported that 2,500 healthcare workers tested positive for COVID-19 and eight had died since the beginning of the outbreak.

Kendra McMillan, senior policy advisor for nursing practice and work environment for the American Nursing Association, said having more accurate incidence and mortality information on healthcare workers would provide a better understanding as to what's working and what as far as safety protocols and ensuring access to personal safety equipment.

That data will become increasingly important to help prepare healthcare workers for the possibility of a second wave of COVID-19 spreading throughout the country as states begin to re-open businesses to the public, she said.

"If we are still dealing with access related to PPE issues yet we're re-opening, then the question remains are we prepared for what's to come," McMillan said.