Reducing the Risk of Healthcare Worker Infection and Service Interruption by Rostering for 'Isolated Teams' During the COVID-19 Pandemic

Background: Effective workforce planning during a pandemic has the dual aims of protecting healthcare workers (HCW) and preserving the capacity for service provision in the face of increased demand and/or workforce depletion. This requires a considered approach to workforce structuring aiming to minimise service disruption caused by illness and quarantine. Case: Division of the available workforce into multiple small teams, and keeping these teams physically isolated from each other, mitigates risk of mass exposure given an undiagnosed or prodromal COVID-19. This has greatly changed the daily routine;each team meets separately for electronic handover each morning. Ideally, each team will avoid any physical proximity with other teams, continuing duties and communicating by phone as needed;this includes the tea room. Outpatient clinics including antenatal clinic are conducted by phone where possible. Discussion: Although research is currently ongoing as no vaccine exists. Without a vaccine or effective medical treatment and in the absence of herd immunity, COVID-19 remains a persistent threat to the community and healthcare system. Every opportunity should be taken to minimise HCW exposure including the structure of the workforce. Alternative strategies have been proposed such as a 'Hot and Cold' team model the rationale and limitations of this are discussed. Contingencies for depleted workforce have been developed and are outlined.