Infection Preventionists Take on Omicron

Heather Saunders, MPH, RN, CIC: “We really need to make sure that we’re taking care of our teams. Infection preventionists are burned out. This has been a long 22 months. There are likely some rough months ahead of us.”

Like most other health care professionals, infection preventionists are sick of it. COVID-19 keeps coming back again and again like some horror movie monster that just refuses to either die or go away. But this monster is all too real, as is the horror that it spreads. (About 814,000 Americans have died from COVID-19, according the Centers for Disease Control and Prevention.) Now comes Omicron (though Delta is far from through with us). Once again, infection preventionists will need to educate and inspire frontline health care workers to, as Heather Saunders, MPH, RN, CIC, to “not let up.” Saunders, a member of Infection Control Today®’s Editorial Advisory Board, previously worked as the lead infection preventionists at the Maryland Department of Health, and the director of infection control at the Johns Hopkins Office of Population Health. She is currently working as the nurse manager for that institution’s infectious disease department. About Omicron, Saunders tells ICT® that “we’re learning more every day. But the same tools apply. And I think that’s really important for us to remember as we mount our response to this current surge.”

Infection Control Today®: During the first wave of COVID-19, back in March of 2020, infection preventionists were almost like rock stars. Every professional in the hospital went to them for advice about how to protect themselves and their patients against this new deadly pathogen. Is it safe to assume that that’s not the case now? That IPs and others know what they need to do to deal with new variants?

Heather Saunders, MPH, RN, CIC: First of all, I just want to say we are still rock stars. So, shout out to all of my fellow infection preventionists. It has been a long, long, 22 months. I think we have some rough couple months ahead of us as well. And a lot of us are feeling that burnout. But I think one of the messages that we should be sending to our infection prevention colleagues is that they do have the tools in their toolbox to fight this current surge, and to fight off this Omicron variants. I think they should be at the table for

all of these meetings within their health care institutions and leading and guiding the way in how do we prevent and control this current surge and all that comes with that. But we have the tools. And we have the knowledge, whereas in March of 2020, we really didn’t. We were flying blind. But now we really have the knowledge and the tools for how we combat SARS-CoV-2. And regardless of what the variant is. Now there are definitely some differences with this variant, which we can talk about. There’s literature on it right now. We’re learning more every day. But the same tools apply. And I think that’s really important for us to remember as we mount our response to this current surge.

ICT®: I know you can only depend on anecdotal evidence, but do you see infection preventionists getting a seat at the decision making table along with the hospital administrators, and the head of nursing, and the head of surgery?

Saunders: I think more so now than ever before. I think that our health care institutions, our administrators, have recognized us where maybe they did not before. The importance that infection prevention plays in the decision making around the response to this pandemic. I hope that they continue to value their infection prevention colleagues and have them at the table for those decisions. But I think more than ever before they are recognizing that they need them there. And they need them as a part of their incident command team so that they can guide how to prevent and control the spread of COVID-19 in their institutions regardless of what the variant is. I think that they’re going to become more of a valued position, more of a prominent position. More funding, hopefully, is going to go to these departments; should go to these departments. More staffing to these departments. As you mentioned before, long-term care facilities; really it wasn’t mandated for them to have full-time infection preventionist in every nursing home, and I think that that is something that is going to change. I think that following this pandemic in the years to come, we are really going to see some shifts in the infection prevention profession. And one of the shifts that I see is actually the shift into the business sector. So, recognizing that infection preventionists have a role in preventing and controlling infections, not just in health care, but outside of health care and businesses and areas that don’t really have that expertise. There’s going to be a lot of shifts, including in the health care sector in increasing staffing, increasing funding, hopefully, in many institutions. There’s going to be that recognition for the need for more infection prevention and control.

ICT®: You’re an infection prevention consultant. Are businesses starting to reach out to infection preventionists? Do you see that in your private business?

Saunders: Yes, they are. I have the opportunity to work with some health care institutions, but predominantly, I’m actually working with businesses. Businesses are very interested in making sure that they are keeping their customers, and they are keeping their employees safe, from COVID-19. I have the opportunity to work with an accrediting agency and making sure that we are giving them the information that they need to do that. And I have businesses that are needing the people in infection prevention and control that are, again, concerned with making sure that their employees are staying safe. That they’re able to do business and continue to keep the economy going while we have this pandemic and doing it safely. Which really requires a trained eye. It requires infection preventionists to be at the table to help them make those decisions, guide those decisions, and help implement those decisions. It’s a very interesting transition as we see infection preventionist starting to work with businesses, sometimes major businesses, on those decisions.

ICT®: Are schools reaching out to you or is it just too much red tape involved for schools to be doing that?

Saunders: The public school districts are really being guided more so by the states, the county health departments. But even there more infection preventionists at the public health level are really getting involved in those decisions with the schools and the training of the school nurses than really ever before. And we’re starting to see that there are some gaps in infection prevention in schools that we really need to address, and not just in the COVID-19 pandemic, but in other areas. There’s definitely more involvement there. Private schools, however.… I definitely know of some infection preventionists that have been working with private schools, on their policies on their protocols and making sure that they are responding to this pandemic in appropriate ways. Making good decisions to keep their students safe. And so definitely I’m seeing infection preventionists work with these schools to try and improve prevention and control. And I think that those are relationships that I believe are going to continue. I think we’re going to continue those relationships. I think we should continue those relationships. We are recognizing that there is a need for infection prevention and control outside of the health care industry. And I think that that’s a really exciting opportunity for infection prevention. Granted, it is a little overwhelming, because we already feel overwhelmed as infection preventionists just trying to manage the health care side of things. And now we have businesses that are reaching out to us for help as well. But I think it’s really an exciting thing, but it’s being recognized, even outside of the health care industry.

ICT®: Again, I’m asking for anecdotal evidence, but do you see younger people who are interested in going into health care—has there been a little bit of a spike of interest in becoming an infection preventionist?

Saunders: I think that there has, and I think one of the reasons for that is that we—my infection prevention colleagues and I—are reaching out to the schools and saying, “Hey. I want to talk about my job. I want to give a lecture on infection prevention and control and how I’m in this profession.” And whether it’s nursing, whether it’s your MPH … that this is a profession that you can go into and how exciting it is. I’ve heard of a lot of infection prevention colleagues that are doing that. And then I know that our national society, APIC [Association for Professionals in Infection Control and Epidemiology] is looking at various opportunities as well to be able to get involved with schools, maybe even creating programs for schools. These are really exciting things because we need some dedicated pathways for people to be able to choose infection prevention and control. Most of us we stumbled on to this profession. We didn’t know that it existed. We stumbled onto it. We loved it and ran with it. But I think what I’m seeing is that we’re trying to create some dedicated pathways. We’re trying to reach out and say, “Hey, this is this is a profession, and you can get into this and it’s really exciting.” Which I think is garnering some more interest in students and infection prevention and control could be their profession.

ICT®: Back to the hospitals. Is there anything that infection preventionists should be doing differently in light of the different variants or basically just keep doing what they’ve been doing since March 2020? And just not let up?

Saunders: I’m glad you said that: Not let up. The thing is that a lot of us did relax a little bit, and rightly so. This summer brought some lower case rates, as well as into the fall. We were able to relax just a little bit, relax some of our policies and protocols. There were some changes in various health care institutions. And I think, if we’re not already doing this, we need to be looking at what do we really need to now tighten up. What do we need to put back into place? Whether that is masked social distancing…. And maybe those policies and protocols are in place, but our health care workers have gotten relaxed. Making sure that we are sending out the reminders, sending out the messages, making sure that we are looking at compliance, to masking, looking at compliance to social distancing in the breakrooms. All those things that we were doing before that maybe we got a little bit relaxed about. We need to make sure that we’re doing those. I’m encouraging vaccination, again, continuing those campaigns. I’m making sure that we’re testing appropriately and looking at our testing policies, seeing what needs to change in light of the surge and the Omicron variant. I think we need to stay on top of the literature. And we’ve been doing that all along. But again, there is a lot of exhaustion in this profession. And we just need to make sure that we are on top of that literature again and looking at the current guidance and recommendations so that we can make sure that we’re communicating that to our institutions. We really need to make sure that we’re taking care of our teams. Infection preventionists are burned out. This has been a long 22 months. There are likely some rough months ahead of us. We need to make sure that our teams are doing well, focusing on well-being, and making sure that we’re taking care of each other.

ICT®: Is there anything that I neglected to ask you that you think is pertinent and that you want your fellow infection preventionists or health care professionals in general to know about the struggle ahead?

Saunders: I would just say, “Stay vigilant. Stay vigilant and continue to communicate well.” Communication is such an important key to prevention and control. We’ve seen that in the past 22 months. And I think that as we learn more about this variant, as things maybe change in the coming months, we are going to need to make sure that we have really strong communication, not just within our team, but within our incident command and within our institution. Making sure we stay vigilant. And say on top of that literature and guidance.

This interview has been edited for clarity and length.