Avoid March Madness—Keep COVID Contained

A year ago, we were just starting to feel the weight coronavirus disease 2019 (COVID-19). The seriousness of a novel respiratory pathogen, the worry that we weren’t ready, and then the reality that this was getting worse, and it wasn’t going away anytime soon. March in particular was a grueling month and one that frankly seemed to be that moment where we all took pause.

The images of New York City struggling against rising cases and overwhelmed hospitals, still sits with us and bears a continued reminder of the early signs that COVID-19 was going to be devastating. It was March 2020 that New York City initiated a full lockdown and for many of us, served as a warning of things to come. The stressed hospitals, extremely ill patients, and challenges of responding to a novel disease, were all something we were witnessing before us and in many ways, felt helpless to stop. I remember at this time thinking that what was happening in New York City was the warning we needed to listen to and one that told us to prepare for not only the hurdles ahead, but the longevity of a pandemic.

It seems like March is a month for reflection. While many thought a year out we would be done dealing with COVID-19, I think so many of us working in infection prevention and public health knew that it would take longer. I wonder, though, what has changed and will this be a different March or are we set to relive the same issues like a COVID-19 version of Groundhog Day?

Now, it seems as if we have a more clear-cut goal and less of a divisive approach to pandemic response for the United States as a whole. Two (almost 3!) effective vaccines are being distributed across the US and we’re working to address vaccine hesitancy and equity. While there have been some discussions around a potential plateau of cases in an otherwise downward trend, it’s likely too early to tell. Moreover, there’s increasing guidance from a Centers for Disease Control and Prevention (CDC) that is now much more communicative and involved in response.

When we look at where we’ve come in the past year, it seems as if we’re settled in response—we know the drill. From personal protective equipment (PPE) to patient management and isolation precautions, the infection prevention piece to COVID-19 is pretty settled. Now is about sustainability, reducing health care-associated infections in those critically ill COVID-19 patients, and operational nuances to updated guidance, such as quarantine for those vaccinated or double-masking. More transmissible variants are a newer concept as well, testing our ability to stay vigilant in both health care and the community, but also reinforcing that continued efforts like genomic surveillance are necessary to stay limber in a pandemic.

One thing though, as we look to the past year and our efforts in infection prevention, is that it becomes apparent that we will likely be dealing with COVID-19 for longer than hoped. Moreover, as we have addressed many of the challenges in health care, our IPC efforts also must turn to the community level. The nuances of how to function in this partially vaccinated world, in the face of variants and questions about sterilizing immunity, are often confusing. Infection prevention isn’t unique to health care, but rather representative of a bigger role within the community – it’s where health care and public health meet. In the past year we’ve seen how critical infection prevention is and how these skills and pragmatic educational efforts are so vital to address transmission. I’m hopeful that our work in harm reduction, risk education, and infection prevention across multiple venues mean that this March is one focused on vaccine distribution and continued downward trends instead of racing to catch up.