Implementation of infection control measures to prevent healthcare-associated transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2)

Abstract

Care of SARS-CoV-2-positive patients in healthcare institutions is challenging because of potential risk of transmission to other vulnerable patients. We describe infection control measures which were associated with no instances of hospital transmission. Adoption of the infection control bundle described may be helpful to prevent SARS-CoV-2 spread within healthcare institutions.

Viral sequencing reveals US healthcare personnel rarely become infected with SARS-CoV-2 through patient contact

“…Our results suggest that the infection control measures and PPE in place at the institution where we conducted this case series 13 can protect against symptomatic SARS-CoV-2 infection, even in settings where the density of individuals infected with SARS-CoV-2 is relatively high. This provides some confidence that PPE and similar infection control measures, when used consistently and correctly, will provide adequate protection in other congregate settings, like schools.…”

“…The center where we conducted this case series implemented a number of changes to their institutional infection control guidelines based on these sequencing results 13 . The recommendations for extended reuse of medical grade face masks were clarified and now instruct HCP to consider barrier mask replacement after three days of wear, to inspect the barrier mask prior to each use and to replace if soiled or damaged, and to always ask for PPE when needed.…”

“…Detailed descriptions of all infection control measures implemented to prevent transmission of SARS-CoV-2 at the medical institution evaluated here can be found in a recent report by Lepak et al 13 . Briefly, these guidelines include a universal testing policy for all patients admitted to the hospital, negative air pressure in all locations where SARS-CoV-2 patients are treated, a limit of one visitor or primary support person per patient per day (required to undergo screening prior to entry), establishment of an employee testing site with required employee self-monitoring for signs and symptoms of infection, maintenance of a log of persons entering the room of a confirmed or suspected COVID-19 patient for contact tracing purposes, and establishment of a designated respiratory care unit in the emergency department, among others.…”

“…These guidelines include recommendations for the proper use of PPE, hand hygiene, precautions to be taken during aerosol-generating procedures, collection of diagnostic respiratory specimens, environmental infection control practices and many others. These guidelines in addition to institution-specific infection control measures – described in detail in Lepak et al 13 – were in place at the institution evaluated here. We posit that these guidelines are generally successful in protecting HCP from SARS-CoV-2 infection in a healthcare setting.…”

Elevated secondary infection rates in patients with coronavirus disease 2019 (COVID-19) requiring extracorporeal membrane oxygenation

“…To prevent in-hospital outbreaks, contact and airborne precautions have been implemented for patients with COVID-19 with demonstrated success in preventing severe acute respiratory coronavirus virus 2 (SARS-CoV-2) transmission. 1 Data on the rates of secondary infections in patients hospitalized with COVID-19 are limited. 2 Although early studies showed low rates of secondary infections in patients with COVID-19, 3 more recent studies in both larger and sicker populations have shown elevated rates of secondary infection.…”