Prevention

The coming months will be telling in terms of how we approach quarantine and the implications of shortened quarantine periods. While it might be easier for people to adhere to, there is still concern for disease transmission.

For vaccines: Delivery doesn’t mean distribution. For variants: Their appearance underscores the importance of infection prevention methods.

Kevin Kavanagh, MD: “One of the things that’s really frustrated me with this epidemic and pandemic is that people are totally focused on dying…. But in actuality, the disabilities are much, much more concerning because that is even affecting the young people.”

Yesterday, 3775 people died from COVID-19; that’s the highest single-day death total since the pandemic began, according to Johns Hopkins University. According to the COVID Tracking Project, 131,135 people were hospitalized yesterday for COVID-19, another single-day record.

The US and the world must appreciate the role of the pharmaceutical industry—the investigators, physicians and business leaders—who are rescuing the world from COVID-19. It’s the medical breakthrough of our lifetime.

Infection preventionists need to spread the message and articulate the uncertainties of this new variant of COVID-19. They need to emphasize that it is just not the old who are at risk and employ stricter containment measures.

Just how much more serious of a threat South Africa’s 501Y.V2 COVID variant represents has yet to be definitively answered, but British health officials argue that it’s much worse than the UK’s B117.

2021 will likely mean a mixture of things for infection preventionists (IPs). First, a focused effort on vaccine education. While this is a larger effort, IPs have always played a significant role in education and answering questions while rounding on the units and clinics.

Maureen Vowles: “I think that the relationship between infection preventionists and public health is key to the success of preventing CRAB and other multi-drug resistant organisms.”

Kristy Warren: “We need to do everything we can to help protect our providers when performing these aerosol generating procedures. And subsequently those providers that enter the room or exit the room after these procedures have occurred.”

Paula J. Olsiewski, PhD: “Healthcare workers at hospitals are always concerned about the air because historically, we know many disease agents are transmitted through the air, whether it’s measles or tuberculosis. Those appear on the scene long before COVID-19.”

Ravi Starzl, PhD: “If you’re constantly focused on trying to escalate the war of destruction, I think that the bacteria will always win that war. They just have too many countermeasures available to them and our rate of developing new antibiotics is far slower than their rate of developing countermeasures.”

Though tough months lie ahead for infection preventionists and other healthcare professionals, hope remains that at some point in 2021 things will begin to settle down. In the end, it comes down to a simple formula: We win, COVID-19 loses.

We must treat this strain with the respect it deserves, but we must not panic. There is no doubt that increased infectivity equates with increases in deaths, but it does not mean the vaccines will not work.

When it comes to COVID-19 vaccinations, it’s important to consider ancillary staff. Employees in environmental services, lab, respiratory therapy, physical therapy, and food services who have been working in high-risk areas.

Healthcare experts around the world worry that the COVID-19 mutation—called VUI–202012/01—might be 70% more infectious than the standard SARS-CoV-2 strain. There are no indications yet that it may also be more lethal or that vaccines can’t neutralize it.

Unlike traditional forms, Moderna’s mRNA-1273 vaccine does not put weakened or inactivated germs inside the body. Rather, it teaches cells to make proteins that will trigger an immune response by injecting ribonucleic acid into cells which gives them instructions.

Officials at the Children’s Hospital of Philadelphia have the ability to convert several floors into airborne infection isolation rooms (AII), or more commonly termed negative pressure rooms, with the flip of a switch.

A panel of experts advising the FDA voted 20-1 (with 1 abstention) to tell the FDA that it should grant an emergency use authorization to Moderna's COVID-19 vaccine.

Bruce Y. Lee, MD, MBA: “We have to remember that infection control and prevention is not just dealing with the pathogen itself but dealing with the consequences and the downstream effects of what happens when you are dealing with the pathogen.”

Moderna’s phase 3 trial data about its messenger RNA (mRNA) vaccine will be presented tomorrow to the FDA’s advisory panel of experts who could then grant an emergency use authorization.

This non-prescription test allows users to perform and get results themselves without a medical provider or laboratory needed.

In essence, infection prevention and control isn’t just one measure, like personal protective equipment (PPE), but all of these layers. Each layer is imperfect but plays a critical role in reducing risk.

V-Safe and VAERS are 2 monitoring systems for patients who are given a COVID-19 vaccine. Infection preventionists can play a vital role in educating about the strengths and drawbacks of each.

Angela Rasmussen, PhD: “Even if you are in the first group to get the vaccine, even if the vaccine becomes available widely beyond the first groups that are going to get it, we still need to be wearing masks, social distancing, thinking about ventilation, and avoiding large gatherings for some time to come.”

Infection preventionists can work with environmental services (EVS) leadership to implement a routine practice for quality assurance checks that EVS leadership can follow. These metrics can then be reviewed as an aggregate with the IP department to target whether further education may be beneficial.

An advisory panel to the FDA voted 17-4, with 1 abstention, to tell the FDA to approve the Pfizer/BioNTech COVID-19 vaccine. US Health and Human Services secretary Alex Azar says that approval may come in days.

Infection preventionists are an important component of fostering trust in the healthcare system and need to actively articulate to both patients and on social media the need to be vaccinated and to follow public health advice.

Sharon Ward-Fore, MS, MT(ASCP), CIC: “If it were my institution, I would make sure that infection preventionists are educated on everything they need to know about the COVID vaccine, as well as the flu vaccine side effects.”

Public acceptance of a COVID-19 vaccine is far from a lock. A nurse who participated in a trial for one of the vaccines up for FDA approval worries that side-effects will diminish uptake.