Does the CDC COVID-19 Exposure Assessment Criteria for Healthcare Personnel Work in a Healthcare Setting in Pakistan?

Imran Hassan, Unab Inayat Khan, Shehreen Ali, Asif Hakim, Asad Ali

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Objective: To evaluate the real-world performance of the CDC's “Interim US guidance for risk assessment and work restriction for healthcare personnel with exposure to COVID-19” at a private healthcare system in Pakistan. Study Design: Retrospective observational study. Place and Duration of Study: The Aga khan University Hospital, Karachi, and its associated healthcare facilities in all four provinces of Pakistan, from February to September 2020. Methodology: Healthcare personnel (HCPs) assessed and tested for exposures to COVID-19 were included in the study. An exposure category was assigned to each HCP presenting with exposure to COVID-19 based on the CDC criteria. Percentage positivity was recorded and compared among the different exposure categories. Logistic regression analysis was used to identify variables significantly associated with COVID-19 infection. Results: Three thousand Six hundred and forty-seven HCPs were assessed for exposure to COVID-19 of whom 603 (16.5%) tested positive. Percent positivity was highest in high-risk symptomatic HCPs (18.2%), 15.6% in low-risk symptomatic HCPs, and 11% in high-risk asymptomatic HCPs. After controlling for age, gender, area of work, and source of exposure, compared to low-risk asymptomatic HCPs, the odds of a positive SARS-CoV-2 PCR were 2.13 (95%CI: 1.49-3.04) for high-risk symptomatic, 1.66 (95% CI: 1.12-2.46) for low-risk symptomatic, and 1.18 (95% CI: 0.83-1.68) for high-risk asymptomatic HCPs. Conclusion: Regardless of exposure category, HCPs with symptoms consistent with COVID-19 have the highest likelihood of testing positive. The CDC exposure risk assessment criteria work best for symptomatic HCPs. Testing asymptomatic HCPs with high-risk exposures may not be necessary in low-resource settings with a limited healthcare workforce.

Original languageEnglish
Pages (from-to)53-58
Number of pages6
JournalJournal of the College of Physicians and Surgeons--Pakistan : JCPSP
Issue number1
Publication statusPublished - Jan 2023


  • COVID-19
  • Employee health
  • Medical surveillance/screening
  • Occupational health and safety programs
  • Return to work


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