Fatigue during high workload shifts may result in an increased frequency of mistakes and hence the risk of exposure. Infection risk from self-contamination during doffing PPE is an important concern in healthcare settings, especially on a COVID-19 ward. The infection risk resulting from the exposure is challenging to estimate, as it will be influenced by the factors such as virus variant and vaccination rates. Dose correlates highly with surface contamination showing that this can be a determining factor for the exposure. The results simulate generally low viral exposures in most of the scenarios considered including on 100% COVID-19 positive wards, although this is where the highest self-inoculated dose is likely to occur with median 0.0305 viruses (95% CI =0–0.6 viruses). The driving factors for the exposure were surface contamination and the number of surface contacts. A parametric study was conducted to analyze the effect of: (1a) increasing patient numbers on the ward, (1b) the proportion of COVID-19 cases, (2) the length of a shift, and (3) the probability of touching contaminated PPE. In the simulation, the HCW then doffed PPE and contaminated themselves in a fraction of cases based on increasing caseload. Accretion of viral RNA on gloves during care was modeled using a stochastic recurrence relation. HCW surface contact sequences on a respiratory ward were modeled using a discrete-time Markov chain for: IV-drip care, blood pressure monitoring, and doctors’ rounds. Staff may subconsciously become contaminated through improper glove removal so, quantifying this exposure is critical for safe working procedures. Self-contamination during doffing of personal protective equipment (PPE) is a concern for healthcare workers (HCW) following SARS-CoV-2-positive patient care.
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