Severe acute respiratory syndrome (SARS) in intensive care units (ICUs): limiting the risk to healthcare workers

Abstract

The global epidemic of severe acute respiratory syndrome (SARS) during the first half of 2003 resulted in over 8000 cases with more than 800 deaths. Many of those who eventually died, did so in the critical (intensive) care units of various hospitals around the world, and many secondary cases of SARS arose in healthcare workers looking after such patients in these units. Research on SARS coronavirus (SARS CoV) demonstrated that this virus belongs to the same family of viruses, the Coronaviridae that causes the common cold, with some important differences. Properties of this virus have been discovered which can be used to develop important infection control policies within hospitals to limit the number of secondary cases. These properties include environmental survival, transmissibility, viral load in various organs and fluids and periods of symptomatic illness during which infectivity is greatest. Various barrier methods were used throughout the epidemic to protect healthcare workers from SARS, with varying degrees of success. Treatment of SARS patients has mainly involved steroid therapy, with or without ribavirin, but there is no consensus on the best treatment protocol, as yet. This review focuses on the implications of SARS for healthcare workers and patients on critical care units.

A framework for open tracheostomy in COVID‐19 patients

“…1 Full personal protective equipment must be used, as failure to comply is a risk factor for infection in healthcare workers. 2,3 We have developed guidance and cognitive aids to help departments prepare for tracheostomies in COVID-19 patients ( Figure 1A Therefore, without being prescriptive, this guide is aimed at outlining the steps that can be taken by surgeons to best protect themselves and minimise aerosol generation when called on to perform open surgical tracheostomies on COVID-19 patients.…”

SARS: clinical presentation, transmission, pathogenesis and treatment options

“…This superspreading event is thought to be related to the administration of a nebulized bronchodilator to the index case, together with overcrowding and poor ventilation in the hospital ward. Many cases of nosocomial SARS-CoV transmission between healthcare workers and patients occurred in intensive care units, where there is particularly close contact between healthcare workers and patients [52][53][54][55][56].…”