COVID-19

The means of transmission of SARS-CoV-2 and the age group most likely to transmit the virus—people in their 20s—garnered headlines this week, as well as controversy for the CDC.

The Japanese company Ushio says that it will sell the Care 222 UV lamp to medical facilities first for about $2,800 a piece. The company also foresees the lamps being used on buses, trains, elevators, and offices.

Cedric Steiner: “We had to address the ability to say good-bye to loved ones. A big guy, with tears in his eyes. He was so thankful that they had a place to go for their mother, because at the hospital they couldn’t see her. He wanted to give me a bear hug, but we did the ‘elbow thing’ instead.”

Sylvia Garcia-Houchins, MBA, RN, CIC: “I think initially, everybody said: ‘Oh, my gosh, we have a pandemic happening.’ It’s sort of a dead stop everywhere. And we’ve got to get ready. We’ve got to be prepared…. In many organizations at that point, the infection preventionist was really put into a position: Put my resources here? Put my resources there? I need to get a plan.”

Most hospitals have implemented stringent visitor restrictions that don’t allow anyone to visit, even during end of life. While an understandable public health and infection prevention measure, it has generated some concern.

Patients afflicted with COVID-19 have an increased susceptibility to antibiotic resistant infections both from prolonged hospitalizations and the use of immunocompromising agents such as dexamethasone.

Kevin Kavanagh, MD: “I think you’ll find that infection preventionists in this type of climate are just not healthcare employed personnel. They need to be everywhere. They need to be in business. They need to be in schools. And, of course, they need to be in our healthcare system. But it is crucial to be in schools…”

Infection preventionists should know that these technologies are available to add to their toolboxes of best cleaning and disinfection practices when they need them, but be aware of the caveats for their use.

Peter Walter, PhD: “We think of AeroNabs as a molecular form of PPE that could serve as an important stopgap until vaccines provide a more permanent solution to COVID-19.”

Jonathan Iralu, MD: “We’ve dealt with small outbreaks, not a pandemic, but we were, in a sense, prepped to deal with the pandemic because we have had experience working with outbreaks…. We were used to collaborating with the state and the tribe on these other conditions. For COVID-19, we didn’t have to reinvent the wheel….”

As these healthcare worker serology studies are designed and performed, we need more insight beyond just PPE use and symptoms, but also internal and external exposures.

Jason Tetro: “There are going to be COVID-19 waves every year. What we hope is that that vaccine is going to be able to help us to be able to have that protection whenever those waves are hitting us.”

It is imperative that infection preventionists engage and combat this messaging on social media and wherever it occurs. To not do so, allows misinformation to fan the pandemic, placing all of our lives at risk.

Infection preventionists need to be able to articulate to those who feel that the young are safe just because their fatality rate is extremely low, that even in this age group there are major concerns regarding long-term consequences of this virus.

J. Hudson Garrett Jr., PhD, MSN, MPH: “I think the role of the infection preventionist has always been of the most critical importance. Every time we have an outbreak or, now, a pandemic, it highlights that further.”

Anthony Harris, MD, MBA, MPH: “Really now it’s all about testing. How do we test? What scale do we test with? And, you know, what are the steps toward getting that access to the testing levels that we need necessary to mitigate risk?”

The case involves a 25-year-old Reno man who’d gotten mild symptoms of the disease in April but developed more severe symptoms when he got reinfected in mid-May.

Rebecca Leach, RN, BSN, MPH, CIC: “I’m a very strong vaccine proponent. I do believe in them, and I think they should be mandatory if you’re working in healthcare.”

The CDC released new guidance regarding recommendations for post-exposure COVID-19 testing. Here’s what this means for infection preventionists and public health.

Sharon Ward-Fore, MS, MT(ASCP), CIC: “Practices drift. You can become complacent and maybe your level of awareness has decreased…. So, infection preventionists need to be really aware of what’s happening in the areas they cover as far as PPE usage is concerned.”

Will it be a severe flu season? Will SARS-CoV-2/coronavirus disease 2019 (COVID-19) surges occur this winter? How will this compound the stresses of COVID-19?

If you see something, say something. Let coworkers know when they may have breached infection control practices such as forgetting to wash their hands, not wearing PPE properly, or missed opportunities to clean a high-touch surfaces.

Sharon Ward-Fore, MS, MT(ASCP), CIC: “Although EVS is in charge of the cleaning process infection preventionists work carefully with them to make sure the process is followed by auditing it frequently. And both sides provide feedback to each other just to make sure everything follows best practices.”

Investigators in Hong Kong report they have observed a reinfection of SARS-CoV-2 in a 33-year-old man nearly 5 months after his first positive test.

Knowing the needs of patients, how can we safely allow visitors again? When will universal masking not be required? A piece to this is that there is no hard rule. These are conversations that require considerable collaboration and plans to scale up and scale down.