Validation of the All Wales Covid-19 Risk Assessment tool in Practice

Background: The All-Wales Covid-19 Risk Assessment tool (WRA) was developed to support managers in undertaking individual risk assessments for employees in public facing work settings, and put in place appropriate mitigation. Although a tool for all employees, it’s development was prompted in part by the observation that Covid-19 was disproportionately affecting Black, Asian and Minority Ethnic (BAME) employees, particularly those in health and social care settings.  This simple, self-administered tool estimates an individual’s risk of severe Covid-19 disease by scoring  personal risk factors, based on those previously identified in the emerging literature. The aim of this study was to assess the performance of this tool, by measuring concordance between an individual respondants self perceived risk and the risk indicated by the tool in a sample of healthcare professionals. Methods: The WRA was distributed amongst BAME healthcare professionals around Wales, UK with additional questions  to understand participant concordance with the risk stratification from the tool. Statistical analyses were applied to establish the degree of concordance. The initial survey was followed by a more widespread survey across Wales where the sample size of the respondents was 3728 Results: A total of 136 participants responses were included in the analyses. The majority of participants were below 50 years of age (median age, range), male,  and of BAME ethnicity. The weighted kappa coefficient indicated significant concordance between the tool outcome and respondent’s self perceived risk (k=) . Younger respondents considered themselves at lower risk, which was correctly predicted by the tool. The association between risk tool outcome and self-perceived risk was not affected by participant characteristic. Of the larger Welsh cohort of 3728 respondents, 93.8% felt that the tool correctly identified their risk and was in concordance with their own risk perception.      Conclusions: There was a high level of concordance between the tool user's self-perceived risk and risk assessment tool outcome.  Where there was disagreement, self-perception of risk was lower than that of the tool, indicating a more precautionary approach taken by the tool. The high concordance provides user confidence that the All Wales Covid-19 risk assessment tool is likely to provide a correct risk stratification and mitigation strategies in this occupational group.