Protecting Brazil’s Healthcare Workers from A Dangerous COVID Variant

Around the world, coronavirus variants continue to complicate the fight against COVID-19. In Brazil, healthcare workers are struggling with the P.1 variant of the virus, which spread rapidly around the country in early 2021 and caused a spike in hospitalizations.

To help protect Brazil’s frontline healthcare workers, the CDC Foundation is funding a research project to gather data on infection rates among hospital workers.

“One of the objectives is to look at the attack rate of this variant against those workers who got one dose or no doses versus those who are fully vaccinated,” said Fernanda Lessa, lead of the prevention team with the Centers for Disease Control and Prevention’s (CDC) International Infection Prevention and Control Program. “The second objective is to better understand what activities in the healthcare setting placed them at risk."

Fernanda Lessa (left), lead of the prevention team with CDC’s International Infection Prevention and Control Program, interviews a health care worker in Manaus as part of the project funded by the CDC Foundation. (Photo by Roberto Freire)

To accommodate the surge in COVID-19 patients, “we had to break hospital walls to make space,” said Aida Cristina Tapajós, director of Hospital Platão Araújo, who took this photo.

A health care worker in Brazil provides a nasal swab to CDC researchers as part of the project to sample 730 health care workers in two hospitals for asymptomatic COVID-19 infection. (Photo by Fernanda Lessa, Courtesy of CDC)

Implemented by the University of São Paulo School of Nursing, the research project lies within a larger project aimed at preventing the spread of COVID-19 at 10 hospitals in São Paulo and Manaus, epicenters of the P.1 variant. Through that project, healthcare workers learn proper handwashing techniques, safe patient triage techniques and how to use personal protective equipment. The project is also funding alcohol hand rub dispensers for staff in critical areas of each hospital. These efforts are a vital step in shoring up Brazil’s frontline hospitals, particularly in Manaus, according to Dr. Maria Clara Padoveze, World Health Organization infection prevention and control consultant, School of Nursing, University of São Paulo.

“We already have a shortage of health workers, so anyone who is infected is one less person to take care of patients,” Padoveze said. “That is why we are focused on training personnel to identify the signs and symptoms of COVID-19.”

Through the new project, CDC is training 16 fellows to collect weekly blood samples and nasal swabs from a target sample of 730 workers in two of those 10 hospitals. Those samples are then tested to identify cases of asymptomatic infection among healthcare workers who might unknowingly be exposing others to the virus. Because vaccination rates among Brazil’s healthcare workers are extremely high, the collected samples will provide other key data as well.

“The other objective is to look at vaccine breakthrough—infected healthcare personnel who contracted COVID-19 despite having had two doses of the vaccine,” Lessa said.

With CDC Foundation support, CDC sent a team to Brazil to provide training and technical support for the fellows carrying out the research project. By sampling each participating healthcare worker weekly, researchers hope not only to detect asymptomatic COVID-19 cases and uncover cases of vaccine breakthrough, but also understand how long infected healthcare workers remain contagious, critical to checking the spread of the virus.

Fernanda Lessa, lead of the prevention team with the CDC’s International Infection Prevention and Control Program

The CDC team arrives in Brazil with supplies provided by the CDC Foundation to launch their research study. (Photo from Fernanda Lessa)

Dr. Maria Clara Padoveze, World Health Organization infection prevention and control consultant, School of Nursing, University of São Paulo

Once the research study was launched, Lessa says, support from the CDC Foundation allowed the team to mobilize quickly.

“Before our deployment, the CDC Foundation helped us procure supplies to take to Brazil,” Lessa said. “Those supplies are not available in Brazil, so being able to take them with us was critical to the investigation.”

Having seen first-hand the impact of the P.1 variant during a month-long deployment in Brazil, Lessa says many healthcare workers are dealing with COVID-19 infections in their own families, compounding the stress they face at work. The variant is also highly infectious, resulting in more young people requiring hospitalization and straining the healthcare system.

From the samples collected by the project fellows, researchers can use information about the P.1 variant to develop new protocols to keep workers and patients safer from the virus and save lives. This project, Lessa says, was made possible through the quick support of the CDC Foundation.

“The commitment that the people at the CDC Foundation have shown has been outstanding,” Lessa said. “We were working with them in a very short timeframe, and they were always very responsive to our requests.”

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