Impact of a Missed Diagnosed COVID-19 Patient on Healthcare Workers at a Private Hospital, Bangkok, Thailand, 2020

Abstract

On 23 Mar 2020, the Situation Awareness Team of the Emergency Operations Center, Department of Disease Control, was notified that a 44-year-old Thai male, who was infected with coronavirus disease 2019 (COVID-19), had died in a private hospital in Bangkok, and there was a suspicion that some healthcare workers were infected with SARS-CoV-2 following his death. A descriptive cross-sectional study was conducted. We reviewed medical records of the index case, interviewed relatives of the index case, and performed contact tracing using a standard questionnaire. We could identify 206 high-risk contacts. Twenty out of 206 high-risk contacts were then found to be infected with SARS-CoV-2. Fifteen of them were healthcare workers, two of them were current inpatients, and the other three were household contacts. The likely cause of disease spreading was the missed diagnosis of COVID-19 as the index case did not present with upper respiratory tract symptoms at the first visit to the hospital. Meal sharing among healthcare workers and sharing of a portable chest X-ray machine without proper protective equipment potentially served as other causes of COVID-19 spreading.