Staff-to-staff transmission of SARS-CoV-2 poses a significant risk to the Emergency Department (ED) workforce. We measured close (<6 ft), prolonged (>10 min) staff interactions in a busy pediatric Emergency Department in common work areas over time as the pandemic unfolded, measuring the effectiveness of interventions meant to discourage such close contact.

We used a Real-Time Locating System to measure staff groupings in crowded common work areas lasting ten or more minutes. We compared the number of these interactions pre-pandemic with those occurring early and then later in the pandemic, as distancing interventions were suggested and then formalized. Nearly all healthcare workers in the ED were included, and the duration of interactions over time were evaluated as well.

This study included a total of 12,386 pairs of staff-to-staff encounters over three time periods including just prior to the pandemic, early in the pandemic response, and later in the steady-state pandemic response. Pairs of staff averaged 0.89 high-risk interactions hourly prior to the pandemic, and this continued early in the pandemic with informal recommendations (0.80 high-risk pairs hourly). High-risk staff encounters fell significantly to 0.47 interactions per hour in the steady-state pandemic with formal distancing guidelines in place and decreased patient and staffing volumes. The duration of these encounters remained stable, near 16 min. Close contact between healthcare staff workers did significantly decrease with formal distancing guidelines, though some high-risk interactions remained, warranting additive protective measures such as universal masking.