Risk of nosocomial transmission of coronavirus disease 2019: an experience in a general ward setting in Hong Kong

Abstract

Background: Coronavirus disease 2019 was first reported in Wuhan in December 2019 and has rapidly spread across different cities within and outside China. Hong Kong started to prepare for COVID-19 on 31 st December 2019 and infection control measures in public hospitals were tightened to limit nosocomial transmission within healthcare facilities. However, the recommendations on the transmission-based precautions required for COVID-19 in hospital settings vary from droplet and contact precautions, to contact and airborne precautions with placement of patients in airborne infection isolation rooms. Aim: To describe an outbreak investigation of a patient with COVID-19 who was nursed in an open cubicle of a general ward before the diagnosis was made. Method: Contacts were identified and risk categorized as 'close' or 'casual' for decisions on quarantine and/or medical surveillance. Respiratory specimens were collected from contacts who developed fever, and/or respiratory symptoms during the surveillance period and were tested for SARS-CoV-2. Findings: A total of 71 staff and 49 patients were identified from contact tracing, seven staff and 10 patients fulfilled the criteria of 'close contact'. At the end of 28-day surveillance, 76 tests were performed on 52 contacts and all were negative, including all patient close contacts and six of the seven staff close contacts. The remaining contacts were asymptomatic throughout the surveillance period. Conclusion: Our findings suggest that SARS-CoV-2 is not spread by an airborne route, and nosocomial transmissions can be prevented through vigilant basic infection control measures, including wearing of surgical masks, hand and environmental hygiene.

Containment of COVID-19 cases among healthcare workers: The role of surveillance, early detection, and outbreak management

“…An exposed HCW was defined as having had contact within 2 m of the index case for a cumulative time of ≥15 minutes; unprotected exposure was defined as having used no PPE during exposure. 15 HCWs and patients deemed to have significant unprotected exposure based on our local ministry of health's guidelines were placed under a 14-day quarantine (home isolation), during which they were monitored for symptoms (eg, cough, dyspnea, and myalgia) and twice-daily temperature measurements were submitted via our institution's electronic surveillance system. If exposed patients or HCWs developed symptoms, swabs were sent for SARS-CoV-2 testing.…”

Serology surveillance of anti-SARS-CoV-2 antibodies among asymptomatic healthcare workers in Malaysian healthcare facilities designated for COVID-19 care

“…Numerous studies have stressed the critical importance of strict adherence to IPC measures to prevent patient-to-HCW infections, [21,23,[38][39][40] but few have investigated HCW compliance with IPC measures. Interestingly, Barrett et al did not nd any signi cant association between usage of PPE and COVID-19…”

Risk of COVID-19 Transmission During Gastrointestinal Endoscopy

“…1 Human-to-human transmission has been primarily attributed to direct contact or air droplets. 4,6,8 Respiratory tract infections can be transmitted through air droplets of varying sizes. The droplet particles > 5 to 10 μm in diameter are termed as respiratory droplets and droplets < 5 μm in diameter are termed as droplet nuclei.…”

“…1 The currently available evidence suggests that SARS-CoV-2 is primarily transmitted between people through respiratory droplets and contact routes. 1, 4,6,[8][9][10][11] It is important to understand the difference between respiratory droplets and droplet nuclei. The airborne transmission suggests transmission of infection by infected droplet nuclei.…”

“…2,[6][7][8] Minority of patients with COVID-19 develop acute respiratory distress syndrome (ARDS), and fatality rate of up to 3.5% has been reported consequent to septic shock, refractory metabolic acidosis, and coagulation dysfunction. 2,[6][7][8] Older people and patients with underlying comorbidities like cardiovascular disease, diabetes, chronic lung diseases, and malignancies are more likely to develop serious illness as well as fatality. 1 Currently, there is neither an effective treatment nor a vaccine for prevention of infection with SARS-CoV-2, although there are many ongoing clinical trials with potential drugs.…”