COVID-19

The CDC released new guidance regarding recommendations for post-exposure COVID-19 testing. Here’s what this means for infection preventionists and public health.

Sharon Ward-Fore, MS, MT(ASCP), CIC: “Practices drift. You can become complacent and maybe your level of awareness has decreased…. So, infection preventionists need to be really aware of what’s happening in the areas they cover as far as PPE usage is concerned.”

Will it be a severe flu season? Will SARS-CoV-2/coronavirus disease 2019 (COVID-19) surges occur this winter? How will this compound the stresses of COVID-19?

If you see something, say something. Let coworkers know when they may have breached infection control practices such as forgetting to wash their hands, not wearing PPE properly, or missed opportunities to clean a high-touch surfaces.

Sharon Ward-Fore, MS, MT(ASCP), CIC: “Although EVS is in charge of the cleaning process infection preventionists work carefully with them to make sure the process is followed by auditing it frequently. And both sides provide feedback to each other just to make sure everything follows best practices.”

Investigators in Hong Kong report they have observed a reinfection of SARS-CoV-2 in a 33-year-old man nearly 5 months after his first positive test.

Knowing the needs of patients, how can we safely allow visitors again? When will universal masking not be required? A piece to this is that there is no hard rule. These are conversations that require considerable collaboration and plans to scale up and scale down.

Especially in healthcare settings, when infection preventionists need to explain protocols and guidelines to their fellow healthcare workers and patients, something can always be lost in translation if much of the face remains hidden.

Kevin Kavanagh, MD: “Getting this message out is something which we need to do. Infection preventionists can be very, very much instrumental in getting out the correct message and counteracting the false messaging, which we are hearing on both social media and also, unfortunately, from our elected officials.”

Linda Spaulding: “We [infection preventionists] have listening sessions with staff and we talked to them about proper mask wearing 24/7. We can do a listening session and we still have people sitting there with a mask under their nose, while we’re telling them not to. You have to continuously stress this among healthcare workers, be it whatever department.”

Experts discuss the pros and cons of reopening schools.

This year we have to do more than just rely on the flu vaccine. Avoiding the flu plus COVID-19 catastrophe is contingent on the US widely embracing public health guidance of wearing masks, meticulous hand hygiene and social distancing.

Neck gaiters weren’t the only face coverings tested: in all 14 were analyzed, from N95s (unsurprisingly judged to be the most effective in containing COVID-19 spread) to bandanas (not much more effective then neck gaiters, according to the study).

Dalilah Restrepo, MD: “I think now infection preventionists should be part of a school board, should be part of any executive board, of any corporate area, because there is no way that you can expect this expertise to just come about for other folks that aren’t trained in infection prevention.”

One example of a way that IPs can collaborate with other departments to implement a vaccination program is to work with occupational health and emergency response departments to have a mass vaccination drill.

Much of the care for the spread-out and isolated patient population is home care. The hospital has a 3-person HIV team and about 6 public health nurses who visit patients in their homes. They all speak Navajo. (COVID-19 is Diko Ntsaaígíí-Náhást’éíts’áadah.)

Linda Spaulding, RN, BC, CIC, CHEC, CHOP: “Infection control people really have to monitor closely all respiratory viruses that are out there and be sure that you’re working actively with management to help put in place whatever needs to be put in place.”

Film healthcare workers as they don and doff N95s, show that video to participants (explaining where they got it right, and where they got it wrong), and then have the participants don and doff again with more input from trainers.

As the COVID-19 pandemic continues to surge, it is unlikely that contact tracing within healthcare will become anything less than critical.

Mary Ellen Beliveau: “If I’m an OB/GYN and all of a sudden I’m in the ICU, I don’t know how to run a ventilator. I’ve never run a ventilator before. I could be the best OB/GYN in the country. But suddenly, being put in a different area of practice and then to be expected to be at the top of my license is almost impossible.”

Investigators found SARS-CoV-2 "on various hospital objects, and these surfaces can be sources of nosocomial transmission via direct contact. Therefore, our findings provide an important basis for justification of strict contact precaution.”

Infection preventionists are of utmost importance to work with school systems and provide the safest strategies and environmental modifications which can suppress the transmission of the SARS-CoV-2 virus.

Maya Gossman, RN: “I tell people, I put tubes in veins, that’s what I do for a living. Anytime you break the skin and you place a tube into the bloodstream, that’s a huge risk for infection.”

The resources used to study hydroxychloroquine (HCQ) would have been better spent on more promising treatment modalities, such as studying Camostat mesilate or nafamostat mesylate therapy for COVID-19, a compound which has been shown to block TMPRSS2.

Northwell Health officials point out that their data showing the benefit of free testing and adequate supply of personal protective equipment come from healthcare workers who were on the frontlines of the COVID-19 pandemic in New York City.