.  She has been a writer and editor for over 30 years, and she has an MA and BA in English Composition/Literature from the University of Akron in Akron, OH. She lives in Ohio with her fiance; 2 tiny dogs, Selena Brigid Sophia and Doctor Danger Dog; and a big black cat, Freya. She loves reading, writing, gardening, and spending time with her loved ones.

CDC overhauls COVID-19 guidelines (Adobe Stock) 

Centers for Disease Control and Prevention (CDC) announced it no longer recommends that someone quarantine if they come into close contact with an infected individual. The CDC also announced individuals no longer need to stay at least 6 feet away from others in public spaces.

While these changes are significant with the school year getting underway, one other change affects schools even more meaningfully. In the statement, CDC shelves the recommendation that schools do routine daily testing, unless, in certain situations, the testing is needed, such as during a surge in infections, officials said.

Many experts approve of the change, including Monica Gandhi, MD, MH, director of UCSF—Bay Area Center for AIDS Research (CFAR), professor of medicine and associate chief of division of HIV, Infectious Diseases, and Global Medicine, and medical director of the “Ward 86” HIV Clinic, San Francisco General Hospital, and a member of 

"I applaud the revised CDC guidelines which embrace that our advances in vaccines and treatment have significantly lowered the risk of severe disease, hospitalization and death," Gandhi told 

. “The guidelines still recommend isolation and masking after a positive test but, otherwise, acknowledges advances in our COVID-19 tools in mid-2022, as well as balances other needs of society including that of keeping children in school."

Two and a half years after the beginning of the pandemic, an estimated 95% of Americans 16 and older have acquired some level of immunity, either from being vaccinated or infected, agency officials said, and that is the basis for the change.

However, not all experts agree with the CDC’s guideline changes. Ambassador Deborah Birx, MD, who once served as the director of CDC’s Division of Global HIV/AIDS, part of the agency's Center for Global Health,  says the CDC’s guideline changes are too soon.

“Saying you are following the science and data requires agencies to collect population-based science and data and transparently provide that data to support guidance to the American people,” Birx said told 

 “I remain disappointed that CDC continues to provide guidance without full population data in support of the changes. Mitigation practices should absolutely evolve with additional tools to combat the virus from vaccination to antivirals and long-acting monoclonal. But without treating every COVID-19 severe disease that results in hospitalization and death as a failure of programming, we will continue to have an unacceptable rate of fatalities compared to all other high-income countries.”

The guidelines are only a part of the whole issue with mitigating the effects of COVID-19. Birx also said, “We are not addressing the critical gaps in access to primary health care in rural America and among our Tribal Nations. We need to understand and address these gaps at the community level to move this virus to an endemic status for all Americans. We must acknowledge the limitations in science and data in our understanding of long COVID-19 as well as persistent severe disease among specific Americans.”

CDC’s announcement on the COVID-19 guidelines is not enough explanation to the American public, Birx explained. “CDC must show the data supporting their shifts both in increasing and decreasing mitigation so every American can be empowered to make the decisions for themselves and their family so every American can not only survive but thrive despite persistent COVID-19 infections.“

One point from CDC stayed the same: the responsibility to stay safe remains on the individual. “To prevent medically significant COVID-19 illness and death, persons must understand their risk, take steps to protect themselves and others with vaccines, therapeutics, and nonpharmaceutical interventions when needed, receive testing and wear masks when exposed, receive testing if symptomatic, and isolate for equal to or more than 5 days if infected,” the announcement said.

Articles

Ambassador Deborah Birx, MD, infectious disease expert, and a former director at the Centers for Disease Control and Prevention, and Monica Gandhi, MD, MPH, weigh in on that agency's significantly changed quarantine and distancing guidelines.

CDC Radically Cuts COVID-19 Guidelines Right as School Year Begins: Not All Experts Approve 

Ultrasound transducer with gel (Adobe Stock)

Inconsistency in ultrasound transducers leads to health care-associated infections (HAIs), and many HAIs are because the health care workers are not following strict protocol of using probes that are covered, proper thorough disinfection of surfaces, and using demonstrated safe decontamination procedures.

) spoke with Nancy Moureau, RN, PhD, CRNI, CPUI, VA-BC, expert in the field of vascular access practice, owner and CEO of PICC Excellence, and a member of 

’s editorial board about concerns of contamination and what can—and does—happen when the proper procedures are not followed. Finally, Moureau covers what it means when a health care worker says he or she does not have time to do proper hand hygiene.

): What are the principal contamination concerns associated with transducers used in point-of-care ultrasound procedures?

Basically, our concerns associated with ultrasound and the types of transducers used for percutaneous procedures go along the lines of blood exposure and exposure to other types of bacteria that can be transmitted from patient to patient. We have contamination concerns when naked probes or naked transducers are used, and there’s no disinfection of the surfaces before and after, which is the standard recommendation.

Contamination of transducers occurs through skin contact, through contact with unsterile or contaminated gloves, or through contact with hands that are not covered by gloves. We also have environmental contaminants where the transducer may be sitting in the air and have contaminants that attach to the surface. There are a number of contamination concerns associated with transducers that require us to have very consistent use of disinfection before and after a procedure.

: Those procedures are required, and if they’re not performed correctly, health care-associated infections (HAIs) and other situations can arise.

Hand hygiene is required too, but we all know that there is great variability and inconsistency in the way hand hygiene is practiced. If blood is detected on a transducer after an ultrasound procedure, someone didn’t do something they were supposed to do. Unfortunately, that’s truly not uncommon.

A problem associated with ultrasound use in emergency departments or intensive care units is that ultrasound units are used for a variety of applications. Some of those applications may be more invasive than others, involving the use of a probe rather than a transducer. In the field of vascular access, which is my primary focus, we are lucky to use only linear transducers that do not contact mucus membranes and do not enter the body. In that situation, the types of contaminants capable of attaching to the transducer are limited, but risk is certainly still present.

: You mentioned inconsistency in hand hygiene, but there’s also inconsistency in the use of supplies, including transducer barriers and covers. What do you think that inconsistency suggests about the safety of point-of-care ultrasound procedures?

When I see inconsistency, it suggests that there is a lack of standardization, and limited education and training in the protocols and procedures demonstrated to be safe in clinical practice.

My comments mostly apply to ultrasound-guided peripheral IV access or the use of ultrasound for central lines. We know that bloodstream infections can occur if the contaminants attach to the catheter or are pushed into the bloodstream. There’s certainly a higher level of risk associated with the placement of ultrasound-guided peripheral venous catheters when there are inconsistent practices of using nonsterile gel, not cleaning the transducer, or not protecting the transducer.

Clinicians often use the term “transducer” and “probe” interchangeably, but they are not equivalent. “Probe” refers to an ultrasound device that enters the body or is used in contact with mucus membranes, while “transducer” refers to a device used on intact skin or in guiding percutaneous procedures. However inaccurate, “probe” tends to be the most common term used for all.

Whichever device is in use, for whatever medical specialty and procedure, we see a huge amount of inconsistency from clinician to clinician, department to department, and site to site. The cause of such inconsistency often comes down to a lack of training.

: One thing that has come up in all the interviews I’ve done with clinicians is their lack of time. Do you think that time pressures have anything to do with causing inconsistencies in practice?

Oftentimes when people take the stance that they don’t have enough time, they’re saying that they don’t have enough time to provide a safe procedure for the patient.

In some cases, that’s true. When a patient comes in with a high trauma situation, the clinicians are just trying to save the patient’s life. There may not be time to grab a transducer cover or protective barrier. Nevertheless, the clinicians may use ultrasound to try to gain vascular access and administer lifesaving drugs in order to save the patient.

However, our job is to safeguard the patient and provide procedures using methods that are as safe as possible. So when we insert an intravenous device under less-than-sterile conditions, there should be policies that allow for tagging that device so that it can be removed and replaced as soon as possible, and for making sure that other clinicians are aware of what happened during the procedure.

Very often, I find that none of those things actually happen. The clinicians take care of what they can take care of, transfer the patient out of the emergency department (ED), and immediately go on to the next patient. Consequently, even patients in other departments may be put at risk. Meanwhile, the other departments are never made aware of the breaks in technique that were performed on the patient.

I believe in using a standardized procedure with materials and devices that are efficient, timesaving, and capable of being used in trauma situations or in a very high volume, high-speed ED or intensive care unit. Separating the transducer from the insertion device by using a barrier dressing can help to save time, while eliminating gel from the risk equation. A barrier dressing can enable a clinician to save time by using any kind of gel that is within easy reach, while still safeguarding the patient. Teaching everyone about these timesaving methods and devices is part of how we need to standardize care for safeguarding our patients.

Using ultrasound transducers is often necessary in the emergency department, but too often the proper procedures to protect against health care associated infections are not followed, and clinicians are worried. 

Contamination of Point-of-Care Ultrasound Transducers Alarms Key Clinician 

At least 35 patients across 2 Chinese provinces have been infected with the phylogenetically distinct Langya henipavirus (LayV), according to a 

The investigators reported that they could not find evidence that the virus transmitted between people, suggesting it is spreading 

. Though the sample size is small, they suspect Langya virus was hosted by shrews before infecting humans.

During routine surveillance of fever patients in eastern China with a recent history of animal exposure, a team of investigators isolated acute LayV infection after metagenomic analysis of 1 patient’s throat swab sample.

Subsequently, 35 patients with LayV infection were identified in the Shandong and Henan provinces of China, 26 of whom were infected with LayV alone, meaning no other pathogens were present.

Of these 26 patients, 100% presented with fever, 54% with fatigue, 50% with cough, 50% with anorexia, 46% with myalgia, 38% with nausea, 35% with headache, and 35% with vomiting. Additionally, 35% had abnormalities of thrombocytopenia, 54% leukopenia, 35% impaired liver function, and 8% impaired kidney function. The investigators noted that none of the Langya patients have died of the infection.

A serosurvey of domesticated animals revealed LayV seropositivity in 2% of goats (3 of 168) and 5% of dogs (4 of 79). The investigators also surveyed 25 species of small wild animals, finding LayV RNA in 27% of shrews (71 of 262), suggesting shrews may be a natural reservoir of Langya henipavirus.

The Langya virus is comprised of 18402 nucleotides with genomic organization identical to other henipaviruses. LayV was first detected in 2018 via a sample from a farmer living in the Shandong province who presented with fever. Over the next 2 years, 34 other people, most of them farmers, were infected with the virus in the Shandong and Henan provinces.

Langya henipavirus belongs to the genus henipavirus and family Paramyxoviridae, home to the Hendra and Nipah viruses, which are known to infect and cause fatal disease in humans. LayV is most closely phylogenetically related to Mojiang henipavirus, a virus with a genome length of 18404 nt originally discovered in southern China.

Zoonotic virus spillover is nothing new and not necessarily cause for concern, but the 

likely caused by zoonotic viral transfer at a market in Wuhan, China

, has escalated the level of concern associated with zoonotic events.

Contact tracing of 9 infected patients with 15 close-contact family members revealed no transmission of LayV. The investigators reiterated the limitations of the small sample size, but hypothesized that unlike COVID-19, human-to-human transfer of Langya henipavirus is fairly unlikely: “There was no close contact or common exposure history among the patients, which suggests that the infection in the human population may be sporadic.”

Identified in at least 35 people in eastern China, a new type of henipavirus, Langya virus, is suspected to have infected shrews before jumping to humans.

Déjà vu? Langya Virus, New Novel Virus, Identified in China

With a new paralytic case of polio in New York State, both infection preventionists and the public have questions about what they should know and what to tell those they serve.

) spoke with Matt Pullen, MD, who is a clinical researcher for the medical school at the University of Minnesota, where he is also an assistant professor of infectious disease and international medicine. He is also employed at the Fairview Hospital System.

Pullen discusses what polio is, whether polio is underdiagnosed, and vaccination details for older adults. “Having 3 doses of vaccine by your second birthday confers about 95% protection,” Pullen explains. “There are catch up schedules for people who are older than 2 years old who haven't received all those doses that doctors can use to help someone quickly get immunity they need for protection. But the main people who should be concerned are the ones who are unvaccinated. Some of that's by choice, in which case, I would urge them to reconsider that choice and get vaccinated. Some of [the unvaccination] is in people who have immune deficiencies, specifically B cell depleting syndromes, that make it difficult to mount any kind of vaccine-related immunity, so they should definitely be protected.”

For adults over 50 years, who were vaccinated as children, if they completed the entire series, they are protected. However, Pullen said, “If an adult is unsure if they've had their full series, or if they had an incomplete primary series, you can, like I said before, there's a catch up schedule to get 3 doses of vaccine, and most guidelines recommend if you're unsure of your schedule, or if you know that you didn't complete it, to go ahead and do a 3 core series. Just to be sure that you have that full complete primary series, [the individual] would get 2 doses about 4 weeks apart, and then your third dose [would be] 6 to 12 months after that second one. So within the course of about a year to a year and a half, you could have a complete vaccine series and full protection.”

 facing the US–polio, COVID-19, and monkeypox.

Videos

Infection Control Today® asked Matt Pullen, MD, the questions from our readers about the NY polio patient.  


Is Polio Resurging? Readers’ Questions Answered by Infectious Disease Expert

Detective work and teamwork led to halt of a potentially deadly outbreak in a Louisiana hospital. The infection preventionists (IPs) in the hospital reached out to the state Department of Health, and the 2 teams coordinated and solved the situation before it grew worse. The report about this situation was published in the 

, and originally presented as a poster at the 

Association for Professionals in Infection Control and Epidemiology (APIC) 2022 Annual Conference

, held June 13-15, 2022, in Indianapolis, Indiana. The lead investigator, Erica Washington, MPH, CPH, CIC, CPHQ, FAPIC, and the health care-associated infection and antibiotic resistance program coordinator for the Louisiana Department of Health, spoke to 

):Please give a summary of the key findings and why they are important.

Erica Washington, MPH, CPH, CIC, CPHQ, FAPIC

: This poster [study] surrounded an investigation of carbapenem-resistant Acinetobacter 

 that was identified in a cluster of patients who were admitted to an acute care hospital. The infection preventionists at the hospital noticed that they were being admitted from the same ventilator skilled nursing facility (VSNF). So they alerted my team at the Louisiana Department of Health. We activated an investigation, first doing chart abstractions of the patients from the records at the acute care hospital and then working with the VSNF to do first an infection control assessment in person, then colonization screenings to identify additional cases, and make sure that transmission was not ongoing of this potentially deadly bug. The colonization screenings were done in coordination with the Centers of Disease Control and Prevention (CDC) antibiotic resistance laboratory network. The key findings were that 1 patient was admitted to the same room that a previous patient was discharged from. That [situation] led to some of our recommendations surrounding environmental cleaning hand hygiene, and additional infection control inclusive efforts of with environmental services and reupping on infection control competencies within that setting.

: What do you think the practical application is for the key findings for infection preventionists?

Practically, even beyond looking at the infection control recommendations, I think we can look a bit upstream. The IPs at the acute care hospital were skilled at cluster detection. I think that [detection] was commendable. All [the IPs] were certified. Their director of infection prevention [were] touting the fact that they all got certified in infection control…and they quickly coordinated with public health. And while we do receive reports of these infections, their detection was swift and very timely that activated a quick and coordinated approach. 

The second thing would be communications. [The IPs'] communications with us and then subsequently within the facility itself, so communications between infection control departments at an acute care hospital and a long-term care setting then became strengthened as well. We're always promoting that patients do go between setting types of facilities [and IPs] need to understand how to handle patients upon discharge or admission. I think that was a good outcome [of this study] as well. Then, also, understanding the fact that identifying additional cases through colonization screening can inform infection control, and whether the facilities need to promote or strengthen infection control efforts within a facility.

What results from the study surprised you?

The first thing that we looked at from the chart abstractions, and but when we did the chart abstractions, I first clued into the fact that the resistance patterns among the isolates. For cases 1 and 3, were the same. So I had a bit of information that those cases had some crossover on some level. It turns out the case 3 was admitted to the same room as case 1 after case 1 was discharged. On rounding, so I can't underestimate or speak more highly of doing infection control rounding during infection control assessments. Because when looking at the layout of the ventilator unit, I saw that the rooms were laid out right across from each other as well. So that also led to some recommendations around potentially [increasing] hand hygiene, aside from environmental cleaning, as well. I recommended that the facility have a policy against gel and acrylic nails because I did observe some personnel having gel and acrylic nails. After CDC did their workup for the isolates, they saw that those isolates for cases 1 and 3, were pan resistant, and carbapenem producing. I think that we get a lot of information out of contributing to the body of knowledge around resistance patterns in our own populations, how the resistance patterns are changing, as well. And just informing and making sure that the facilities understand that colonization versus infection as well. So making sure that antibiotic stewardship is working in concert with the colonization screenings, so that we're not inappropriately treating people who don't necessarily have infection. But I think that we had suspicions around cases 1 and 3, but then confirmed on rounding when looking at the room layouts. And then also looking at the confirmatory testing from CDC.

Do you have any plans on doing any further observations to gather more information?

So the way that colonization screenings work is that we ensure that transmission is stopped, by asking facilities to do 2 rounds of screenings. And if 2 rounds occur where no additional cases are identified, then we can be confident that transmission is stopped. So that's the prospective way that we can ensure patient safety. And then, we do the surveillance statewide, as well, as far as ensuring the quality side of best practices for infection control and the setting. We certainly confirm recommendations to the facility regarding environmental cleaning, hand hygiene, and the like, in education. But, [those recommendations are] something that are worth ongoing training. Those are also some things that our health department is working with APIC to do. We have in the past, I believe in 2018, contracted APIC to do long-term care trainings in Louisiana. And we're working, hopefully, in the next 6 to 12 months to contract them to do additional trainings in our state, around long-term care-focused trainings and infection control.

Do you have anything else that you would like to add?

Considering your audience consists of infection preventionist across the provider section, I want them to know that all health departments, or all state health departments and some local and city health departments, are staff with health care-associated infection coordinators like myself who work with the CDC on activities just like this. So working with the antibiotic resistance laboratory network, [I want to tell them] to make sure that we are detecting and containing and responding to antibiotic resistant threats. If we reach out to you to ask, for your help with colonization, screenings, understand that the materials, supplies, and shipping are free of cost. We know that the personal time is not free, but this goes far to contributing to the body of knowledge about changing resistance, but then also understanding how you can be informed about transmission-based precautions and protecting patient safety, and the health of your patients within health care states.

This article has been edited for length and clarity.

A carbapenem-resistant Acinetobacter baumannii (CRAB) cluster was identified and stopped because of due diligence of the infection preventionists at an acute care facility in Louisiana. 


Infection Preventionists’ Detective Work Stopped an Outbreak of CRAB

KEVIN KAVANAGH, MD, is the founder of the patient advocacy group Health Watch USA

Last week’s news regarding infectious disease was nothing short of depressing. There are fears of a significant polio outbreak, monkeypox has sustained exponential growth, and SARS-CoV-2 has a new emerging variant, BA.4.6.


Polio has reemerged after being absent almost a decade, with a Rockland County, New York, resident contracting the infection. For every case of paralytic polio, there are hundreds of other infections. According to the CDC, approximately 72% of individuals infected with the polio virus are asymptomatic. These individuals can shed the virus for days or weeks after infection, spreading it asymptomatically, so with 1 case, community spread in New York is likely.
 
About 25% of those infected with polio will have flu-like symptoms. About 1 in 200 develop paralysis (half of 1%). Between 2% to 10% of individuals with paralysis will die (1 in 2,000 to 1 in 10,000). The Associated Press reports that 7 different wastewater samples from Rockland and Orange Countries were positive for the virus, raising prospect of community spread.

Rapid and aggressive public health interventions are immediately needed. There is concern that the public resistance we have seen in attempts to stop SARS-CoV-2 will spill over to other pathogens, such as polio, and stopping polio will not be easy. Polio has an R naught of 5 to 7, meaning that between 80 to 86% of the population would need to be vaccinated before viral spread would stop. With the levels of vaccine hesitancy in rural New York counties, this goal will be difficult to achieve. Rockland County has a polio vaccination rate of 60.3%, and adjacent Orange County has a vaccination rate of only 58.7%.

Credit to Global.health team. github.com/globaldothealth/monkeypox

Monkeypox infections in the United States continue to undergo exponential growth. The CDC reported on August 5, 2022, that cases occur 

99% of the time in men, 94% of whom reported recent male-to-male sexual

 or close intimate contact. The US has more than 7,500 cases, more than any other country in the world. Worldwide, there is a 

, and changing the method of administration allowing for more doses to be administered per vial is under consideration.

Further, the monkeypox virus is related to smallpox, and there are more lethal variants in Africa. The bottom line is that if we continue to spread the virus, it may enter the rodent population becoming endemic, or even worse, mutate and become more lethal.

Credit to Our World in Data. OurWorldInData.org/coronavirus

New hospitalizations during the BA.5 variant wave appears to have peaked. Currently, BA.5 comprises 85.5% of isolates. However, a new variant, BA.4.6, has emerged and is defined by the CDC as a “variant of concern”. This variant appears to be outcompeting BA.5. It is not known if this variant has more of an immune escape potential than BA.5. Currently, 

.
 
SARS-CoV-2 is at an unacceptably high level with 

. This level of disease and its associated long-term disability is not sustainable. It is estimated that 

 in the United Kingdom has long COVID-19. The 

. This decrease was attributed to the effects of long COVID-19. In the United States, it is estimated that 

 is no longer working due to long COVID-19. New SARS-CoV-2 variants are emerging at almost an alarming rate, making it more difficult for therapeutics, including vaccines, to keep pace.


The US is at substantial risk of having a reemergence of polio, the largest outbreak of monkeypox in the world and is enduring repeated surges of SARS-CoV-2 variants. Rapid and aggressive public health interventions are needed. If the resistance we have seen in attempting to stop SARS-CoV-2 becomes commonplace with other pathogens, we will be no better off dealing with disease than in the Middle Ages.
 
Ironically, if SARS-CoV-2’s public health interventions were widely adopted by the public, the large and expanding outbreak of monkeypox may not have taken place. Intimate contact with multiple strangers is not acceptable. It is apparent we cannot simply vaccinate our way back to normal. We must also encourage the public to adopt public health strategies, including the wearing of N95 masks, avoiding close contact with strangers, and improved indoor ventilation. Now, more than ever, infection preventionists are needed to do the work that needs done to turn this tide around. 

It is apparent we cannot simply vaccinate our way back to normal. We must also encourage the public to adopt public health strategies, including the wearing of N95 masks, avoiding close contact with strangers, and improved indoor ventilation. Now, more than ever, infection preventionists are needed to turn this tide around. 

A Call for Action: The Triple Threat of Polio, Monkeypox, and SARS-CoV-2

This article was originally published in 

US Health Secretary Xavier Becerra declared a national public health emergency for monkeypox.

“In light of evolving circumstances on the ground, I am declaring a public health emergency on #monkeypox. We are prepared to take our response to the next level in addressing this virus. We urge every American to take monkeypox seriously," Becerra, tweeted on August 4.

The declaration mobilizes the response and opens up federal funding to address the virus.

As of yesterday, there has been 6617 confirmed cases with California and New York having the most cases. Earlier this week, 

declared a state of emergency with regards to the monkeypox outbreak. This came on the heels of 

San Francisco and New York City declaring states of emergency 

along with New York State’s declaration that monkeypox is an "imminent threat to public health," over the last week. Shortly before that, World Health Organization declared monkeypox a 

The US federal agencies are making vaccines and treatment available. For example, CDC and FDA have developed a process to help clinicians secure an antiviral therapy, tecovirimat (Tpoxx), for treatment for patients with monkeypox. This falls under the expanded access investigational new drug (EA-IND). Clinicians can begin the process to secure tecovirimat by going here.

Tecovirimat is manufactured by SIGA Technologies, and is approved for smallpox and is being studied for monkeypox treatment. 

spoke with SIGA Technologies Chief Scientific Officer Dennis Hruby, PhD,

 recently about the therapy.

The federal government has also been sending out vaccines to prevent the spread of monkeypox. At this point in time, it has been reported that only people who are close personal contacts of people who have contracted the virus are eligible to get access to the vaccines.

 gives details about monkeypox, what it is and how it is spread, 

The declaration will allow more funds for control of and resources for the disease. 

US Follows WHO: Monkeypox Is a Public Health Emergency

 wide-ranging coverage of the infection prevention and control world. Everything from interviews with known opinion leaders, to the news that infection preventionists and other health care professionals can use on their jobs.

CMS Proposed Minimum Staffing Requirements Could Cost $10B Annually

Adding staff is not the cure-all the CMS hopes it is. Higher wages and better government financial assistance would help, but fixing the system is not going to be easy.

How to Choose the Best Disinfectant Wipe for a Facility

Standardizing disinfectant wipes across multiple facilities requires comparing active ingredients, kill claims, and dwell times.

Leading with Heart: Kindness in Infection Control

With stress and burnout from staff shortages and the COVID-19 pandemic, infection prevention auditors need to remember kindness and compassion.

The 2022 Health Watch USA Conference Will Examine Frontline Work Safety During COVID-19

The 16th annual conference will highlight speakers from around the globe, offer continuing education credits, and will be held as a webinar on September 14, 2022.

What’s in Your Hospital’s Kitchen? The Basics of Food Service Hygiene

Foodborne illnesses can be prevented by breaking the chain of infection and eliminating elements of the kitchen from becoming reservoirs for pathogens to flourish.

Take 5 minutes to catch up on Infection Control Today’s highlights for the week ending August 5.

Weekly Rounds: The Best Disinfectant Wipe for Facilities, Minimum Staffing Requirements, and More

Bernadette “Priya” Pandya-Orozco, MSN, RN, PHN, CIC, is the manager for infection prevention at O'Connor Hospital, which is part of the County of Santa Clara Hospital and Health System. She has served in several critical leadership roles in the field of infection prevention and communicable disease over the last 25 years. Most recently, in 2019, she became the manager of O' Connor Hospital infection prevention, where she serves as a subject matter expert to hospital staff and leaders for infection prevention and control. She has worked for highly reliable organizations to reduce hospital-acquired infection rates. She encourages the use of creative performance improvement projects which utilize evidence-based practices to engage frontline champions and leaders. Priya attributes her successes to her ability to understand and value every member of a health care system, recognizing how each person in a hospital can affect infection prevention efforts and contribute to performance improvement.

Priya has spent her career working in Bay Area hospitals and also precepted nursing students from local schools, in both Public Health Nursing and Communicable Disease. She graduated with a Bachelor of Science in Nursing from California State University Hayward, in 1998, she went on to receive her Masters of Science in Nursing from Holy Names University, in 2007, and is currently enrolled in her Doctoral of Nursing Practice at San Jose State University. 

From all of her collective experiences, Priya has learned the importance of waking up every day, ready to share her love and passion for infection prevention. Her drive for excellence is deeply rooted in her desire to provide a safe environment for every patient who crosses through her hospital’s doors.

Let’s chat about why kindness matters in infection control and why it needs to be a part of every conversation. As a manager in infection prevention and control in a hospital system in central California, I have always striven to lead with my heart when I take on any task. Time is a precious commodity, but time is also what we need to ensure we comprehend the issues faced by our teams and build sustainable solutions.

When my team or I are auditing on the floors, it is important for us to remember kindness first when we see opportunities for missed hand hygiene. Performing “Speak Up” through shaming and guilting creates an environment of discomfort and defensiveness and can lead to fear in the HCW, which cannot build strong teams.

Let’s consider the scenario when a HCW who has their hands full of supplies and is unable to perform hand hygiene before entering the patient’s room. Now an infection control auditor who is not leading with heart may abruptly prompt or even scold the HCW to perform hand hygiene then move on to another task. However, an auditor who keeps kindness in mind will listen to the HCW’s rationale for why they didn’t or couldn’t use the hand sanitizer. Listening to their reasoning leads to a barrier being identified and solutions being found, such as having a surface to place items on prior to entering the room, so the HCW can perform hand hygiene. Understanding when and why a HCW is noncompliant with hand hygiene, for example, is not only important for strengthening the team, but also can identify barriers, so solutions can be offered.

We, as infection control auditors, need to recognize the humanity of our frontline staff and respect their perspective. This involves listening, understanding, and explaining the various aspects of infection control. When we offer an ear to listen and explain “the ‘why’ behind the ‘do it,’” the HCWs are not only better equipped with knowledge, but we also show we see them as a individual and not just someone to direct orders to.

Now, I am not saying that it will take days or even weeks to find solutions to all the opportunities we identify, but if we start with kindness, the doors of communication swing open, and individuals are more apt to listen. Starting with scolding and accusations accomplishes nothing except bitterness and closed doors. Individuals inherently want to do the right things; they just may be unaware of how to do them, and we, as infection control auditors, may be unaware of the obstacles that prevent them from performing the necessary action, such as hand hygiene. Once we have open and transparent conversations with our frontline teams, they are more apt to listen and be motivated to come up with solutions. If they have input, they will be invested in the process and own the outcomes.

Another important aspect is to ensure we reach out to the respective leader and keep them informed of issues in their units and collaborate with them on the solutions offered by their teams. The leaders value this approach and appreciate the inclusion and respect for their position.

How we communicate matters. In the last 2 years especially, HCWs have all faced burnout, short staffing, and unimaginable stress, and individuals will gravitate to kindness. In my practice, I have seen the positive outcomes when my heart leads the conversation.

Leading with Heart: Kindness in Infection Control 

It is no secret that the COVID-19 pandemic has been devastating in many ways to the frontline worker, from the virus itself to threats of violence to the individuals who risk their lives to help others. This year’s Health Watch USA Conference titled 

Frontline Worker Safety in the Age of COVID-19: A Global Perspective

 will address these topics and many others.

The all-day seminar will have key speakers from several different countries such as Matthias Maiwald, MD, and Dale Fisher, FRACP, from Singapore; Imogen Mitchell, MBBS, PhD, and Lidia Morawska, PhD, MSc, from Australia; Nele Brusselaers, MD, PhD, from Belgium; Eike Steinmann, PhD, from Germany; and Laith Jamal Abu-Raddad, PhD, from Qatar.

In the afternoon, the seminar’s attendees will hear from many medical professionals from the United States also, including an introduction from past Surgeon General Joycelyn Elders, MD, MS; Ziyad Al-Aly, MD, FASN, Frazier B. Beatty, PhD, MPH, CHES; Mengyi "Zed" Zha, MD; United States Ambassador Deborah Birx, MD; Jeannie P. Cimiotti, PhD, RN; Christine Pontus, MS, RN,COHN-S/CCM; Elizabeth (Betty) Sparks, RN, CNOR, ADN; Omid Razmpour, BSN, RN, PHN; Janet Haas, PhD, RN, CIC, FSHEA, FAPIC; and Kevin T. Kavanagh, MD, MS.

“We are very pleased to have a number of world renown speakers ranging from Professor Lidia Morawska, one of Time Magazine's 100 most influential people in the world, regarding her work on the aerosolization of SARS-CoV-2; and Dr. Ziyad Al-Aly who had published a string of groundbreaking articles in 

regarding the long-term effects of long COVID,” Kevin Kavanagh, MD, MS, and the Board Chairman for Health Watch USA, told 

. “The conference also will not be without examining the impact of lessons learned and a critical look at the United States' response by Dr. Deborah Birx and Sweden’s response by Dr. Nele Brusselaers. Other topics will include an examination of personnel protective equipment, including masks, surface disinfection, vaccines, and natural immunity. The event will conclude with presentations regarding the increasing incidence of workplace violence and a panel discussion on the inertia and barriers encountered in our health care system to correct many of the problems.“

Other topics that the conference will cover include protecting staff and patients while staying practical, the experience Australia has had with workplace safety during COVID-19, evaluating science advice in Sweden during the pandemic, discussion of the COVID-19 vaccinations and natural infection immune protection, long COVID-19, and more.

Previous presentations with handouts and program resources are listed 

Outcomes and objectives of the seminar as listed on the flyer include “identify infection control strategies that prevent and mitigate the spread of COVID-19 disease among both frontline workers and patients,” “Identify infectious disease infrastructure deficiencies in the COVID-19 pandemic”; and “Explain the risks of disability and death from not only acute COVID-19, but also the disabling effects of long COVID-19,” among others.

Health care continuing education credits, free of charge, will be offered by Northeast Multistate Division. This year’s conference is sponsored by Health Watch USA, Massachusetts Nurses Association, Kentucky Rural Health Association, Southern Kentucky AHEC, and Northeast Multistate Division Gardner Consulting Group.