This is a summary, written by members of the CITF Secretariat, of:

Galarneau J-M, Labrèche F, Durand-Moreau Q, Ruzycki S, Adisesh A, Burstyn I, Zadunayski T, Cherry N. Excess risk of COVID-19 infection and mental distress in healthcare workers during successive pandemic waves: Analysis of matched cohorts of healthcare workers and community referents in Alberta, Canada. Can J Public Health. 2024 Jan 16. doi: 10.17269/s41997-023-00848-4.

The results and/or conclusions contained in the research do not necessarily reflect the views of all CITF members.

A CITF-funded study, published in the Canadian Journal of Public Health, found that healthcare workers (HCWs) in Alberta had a higher incidence of SARS-CoV-2 infection and of mental health distress compared to community members seen in physician consultations. They were matched by gender, age, and geographic location. Excess infection among healthcare workers was most notable early in the pandemic and during the fifth (Omicron) wave. Based on administrative health data, the excess incidence of mental health conditions, including stress/adjustment reaction or depressive disorder, was seen with each wave of the pandemic, increasing to a peak in the fourth wave in Alberta. This study was led by Dr. Nicola Cherry (University of Alberta).

Key findings:

  • HCWs had a greater risk of SARS-CoV-2 infection compared to matched community members (referents). A higher percentage of HCWs tested positive for SARS-CoV-2 by PCR (20% versus 12%) or their infections were reported in medical records (33% versus 26%) than matched community referents.
  • When compared to referents in analyses adjusted for confounding, risk of SARS-CoV-2 infection among HCWs was higher than for community referents both early in the pandemic and during the fifth (Omicron) wave of the pandemic.
  • HCWs were at an increased risk of anxiety, stress/adjustment reactions, and depressive disorders, compared to community members.
  • Anxiety was the mental health condition most often recorded in physician records but the excess became less evident as the pandemic progressed.
  • The incidence of mental health conditions including stress/adjustment reactions or depressive disorders increased with each wave of the pandemic, peaking in the fourth wave.

These findings emphasize the ongoing challenges faced by HCWs during the pandemic, not only in terms of occupational infection risk but also mental well-being. Administrative data provided an opportunity to analyze the evolution of these risks over the course of the pandemic.

This study recruited healthcare workers from Alberta, British Columbia, Ontario, and Quebec from early 2020 to summer 2022. Participants in Alberta consented to match individual records on COVID-19 immunization and SARS-CoV-2 polymerase chain reaction (PCR) testing to Alberta’s administrative health database (AHDB). HCWs were matched with community members by gender, age, location, and physician consultations between April 2019 and March 2020. Of 3,812 Alberta HCWs who consented to join the cohort, 80% (3,050/3,812) agreed to be matched to the Alberta AHDB. Among the HCWs, 476 (16.1%) were physicians, 2,353 (79.5%) were registered nurses, 58 (2.0%) were licensed practical nurses, and 72 (2.4%) were healthcare aides. Most were female (87.5%, 2,590/2,959). The median age at recruitment was 44 years.