Infection Control During Re-Opening Efforts—Beyond the Walls of the Hospital

May 5, 2020

For many in infection prevention and control (IPC), it’s been weeks and months of just trying to keep your head above water. Daily mask counts, rounding on COVID-19 units, education and training, and a continued stress of “is everyone being safe?” The de-scaling of these efforts will be slow and, in many ways, getting back to “normalcy” is not going to be easy. We won’t be the same but as the country works to get businesses re-opened and hospitals open to elective surgeries, how can we still be prepared for COVID-19?

Many in public health and healthcare worry that as things go back to being open and “normal”, there will be spikes in cases. Drafted reports have predicted a surge to roughly 200,000 deaths per day by June 1. As states re-open, there is deep concern that this will lead to significant surges in cases. As Missouri opened up, it reported the largest single-day jump in COVID-19 cases. While we are all ready to get back to life without COVID-19 and the closure of businesses only emphasize this, this will be a challenging time for public health and healthcare. We will likely see spikes in cases and COVID-19 response efforts are still strained. There are a few things to consider during this time.

First, now is the time to continue rounding on COVID-19 units and frontline areas to discuss personal protective equipment (PPE). Re-opening of businesses and relaxation of social distancing efforts doesn’t mean there are no more COVID-19 cases, but rather that it’s decreased by enough and continues to. We are still seeing cases and have to maintain vigilance in efforts to ensure public health and health care efforts aren’t overwhelmed. 

That’s painfully obvious for us in infection prevention, but after we leave the hospital or healthcare facility, we need to become role models for social infection prevention efforts. It’s easy make lapses in hand hygiene or use of masks in crowded areas because they seem less risky than the healthcare facilities we work in. I say, be a role model and show the best times for hand hygiene, how to properly wear a mask, or use of disinfecting wipes. Just your friendly neighborhood infection preventionist spreading the good word, eh?

In truth though, this is the time for continued vigilance. Identify sustainable efforts to ensure healthcare facilities are prepared for second waves of COVID-19 cases. If your state or city re-opens, remind staff that it doesn’t mean the disease has vanished and we still need to be good stewards of our resources and steadfast in our identification, isolation, and communication of cases. Sustainability isn’t easy and everyone is exhausted, but now is the time that practice makes permanent. 

In the midst of trying to get back to “normal” IPC efforts, but still with one foot in the world of COVID-19, it’s a hard thing to consider that this might be the new normal for a while. COVID-19 cases might be a more common occurrence in the future and sustainable approaches to management are critical. Perhaps this looks like reusable filtering facepiece respiratorsor long-term efforts to increase internal PPE supply stockpiles. Now is the time to regroup and apply the lessons learned so that if there is a secondary wave, we can be more prepared, more confident, and more successful.