Coronavirus disease 2019 (COVID-19) outbreak on an inpatient psychiatry unit: Mitigation and prevention

Abstract

and clinical practice, we suggest a framework for the investigation of suspected recurrence cases (Fig. 1). However, the challenge of this detailed investigation lies in the high resource load required to allow truly robust conclusions, especially considering complicating factors in a postvaccination setting.Nonetheless, we propose that studies that employ such techniques must be undertaken to appropriately answer the multitude of pressing questions that pertain to COVID-19 recurrence. These investigations are particularly significant considering recent reports of reinfection by novel SARS-CoV-2 variants, which may lead to a more severe second episode of disease. 8 Thus, only when we comprehend the complex interplay between COVID-19 recurrence and the other components of the pandemic will we be able to quantify and react to its impact on both the patient and population levels.

Use of serial testing to interrupt a severe acute respiratory coronavirus virus 2 (SARS-CoV-2) outbreak on a hospital medical floor—Minnesota, October–December 2020

“…28 Previous investigations have demonstrated transmission within healthcare facilities among HCP, patient to HCP, and HCP to patient, despite the recommended use of PPE supporting the need for higher levels of control. 5,29 Prompt identification of infectious patients and HCP through admission screening and serial testing (examples of administrative controls) can inform changes in PPE use given the situation, including use of N95 respirators for all patient care during facility-based outbreaks to allow for more effective PPE use. 30 As a part of these efforts, however, auditing of PPE compliance is essential.…”

“…SARS-CoV-2 outbreaks have been reported in skilled nursing facilities 1,2 and hospitals. [3][4][5][6] To prevent infection of vulnerable individuals, the Center for Medicare and Medicaid Services (CMS) has required federally certified nursing homes to conduct daily symptom screening and routine screening tests for staff based on county test-positivity rates. 7,8 Testing a group of people at a single point in time is called a point-prevalence survey.…”

Infection Prevention and Control of Severe Acute Respiratory Syndrome Coronavirus 2 in Health Care Settings

“…Despite symptom screening of patients and the use of testing to identify asymptomatic infection, patients who are incubating infection on admission and are missed by such strategies, or patients who acquire infection from another source (roommate, HCP, visitor) during the course of an admission while not isolated, can result in exposures to HCP and other patients. 75 , 78 , 79 , 80 , 81 In one outbreak in an acute care hospital tracing by epidemiology and genomic sequencing found late-onset infection following admission of the index patient who spread COVID-19 to both other patients and to HCP. 75 The initial exposure event was attributed to a symptomatic patient who tested negative for SARS-CoV-2 on two serial nasopharyngeal swabs upon admission with subsequent AGPs performed.…”

“…11 , 12 , 13 , 87 Infections among patients have also been observed in inpatient psychiatric units where it is difficult to promote mask wearing, distancing, and hand hygiene, and group activities are instrumental to treatment. 80 Strategies to reduce the risk of patient-to-patient transmission includes serial testing at regular intervals during hospitalization and rapid isolation with positive testing or development of symptoms.…”

COVID-19 pandemic in a mental health ward: inpatient admissions, use of mechanical restraint and aggressions

“…Additionally, agitation and aggressive behaviors could represent a challenge in following prevention and social distancing measures. This has led to the use of different measures to avoid contagion; for example, family visit restrictions, restriction of conditions for admission, previous isolation, conduction of tests, educational interventions, and mobility restrictions [7][8][9][10][11][12]. These measures have led to a reduction in the availability of care that could have signi cant long-term consequences [13,14]; however, an increase in the number of admissions has also been reported [9].…”