Prevention

Daniel Burnett, MD, MBA: “The aerosols, the things that are the true danger and that can hang in the air for hours, depending on their size, are still released around the edges and around the nose of cloth masks. A cloth mask does very little to protect you.”

How will the COVID vaccine be handled at each facility? Wil it be mandatory? Will it be given annually? Will it be a condition of employment? These are all questions that will need to be addressed.

An “exponential” outbreak of COVID-19 occurred among health care workers most likely because they let their guard down during social interaction with colleagues.

Infection preventionists can coordinate with physicians and other subject matter experts on common areas of vaccine hesitancy among staff, and work with key stakeholders to address them.

As all resources and attention were focused on COVID-19 for the past year, many other infectious diseases were neglected. Here’s what we need to monitor.

In its push to get as many Americans vaccinated as soon as possible, the government is also pushing to get as many people qualified to administer the COVID-19 vaccinations as soon as possible.

Rebecca Leach, RN, BSN, MPH, CIC: “The flu vaccine is mandated where I work. I do see a day where the COVID-19 vaccine will be mandated as well in health care facilities especially if—as we expect—COVID is not going away.”

As infection and hospitalization rates from COVID-19 plummet across America, medical experts worry about the variants and vaccine hesitancy.

Frequent, (three times a week) screening of our athletes has been key to the opening of professional sports. Our students deserve the same safety precautions as professional athletes.

Kevin Kavanagh, MD: “Throughout the history of evolution, and even through the history of mankind, you’ve seen species get wiped out. You’ve seen civilizations of man fall because of infections. And the thing that differentiates us from a tadpole is our science and our knowledge. And if we don’t take advantage of that….”

The Association for Professionals in Infection Control and Epidemiology (APIC) argues that nursing homes in New York should have a fulltime IP on staff.

We need to have mandatory reporting of worker and patient acquisition of SARS-CoV-2 and the development of COVID-19 with metrics to provide us the most accurate estimate of cases so we can effectively plan and allocate resources.

Linda Spaulding RN, BC, CIC, CHEC, CHOP: “Now the new challenge is going to be will we get definitive answers that the COVID tests that we’re currently doing will pick this variant up?”

Hospitalizations for COVID-19 dropped by a statistically significant 5.5 percentage points for adults from 18 to 64, compared to the hospitalization rates in the 4 weeks preceding the implementation of the mask mandates.

Double-masking can prove more cumbersome for many. If the goal is to protect the mask underneath, perhaps consider a face shield or a strategy for cleaning the mask more frequently.

The good news? The fact that 3 different viruses with 3 different lineages came up with the same mutation to evade natural immunity and the vaccines. And initial reports are that it only partially evades the vaccines.

Contact tracing is reactive—the goal is to avoid these close contact exposures in which people are interacting without masks and indoors. Practice makes permanence after all.

“Infection control measures, including surveillance, education, cleaning/disinfection, patient cohorting, isolation, and hand hygiene, effectively contained the outbreak; it was declared over within 2 months.”

Beware the loophole. Many clinics are often classified as office space, not health care buildings, so they do not have adhered to ventilation standards.

Caitlin Stowe MPH, CPH, CIC: “There’s still a lot we don’t know about SARS-CoV-2 and the direct mechanisms of transmission…. It can be aerosolized. However, there is evidence of indirect transmission from surfaces to people.”

Concerning the possibility of a B.1.1.7 COVID-19 surge, Michael Osterholm, PhD, and a member of President Joe Biden’s transition team, does not mince words: “That hurricane’s coming.”

Kevin Kavanagh, MD: “If we keep spreading this virus around, it’s going to slowly devastate both our population and our economy.”

Stethoscope diaphragms are contaminated with the same pathogens as the hands and they are capable of transmitting pathogens from patient to patient. The CDC should readdress its published guidelines.

Mary Jean Ricci MSN, RNBC: “[Infection preventionists] really need to think about how we’re getting people from the assessment area to the vaccination area to the evaluation area in a unidirectional flow so that we don’t have the spread of the virus at the time of inoculation.”

Aside from being more contagious and deadlier, the B.1.1.7 strain of COVID-19 seems to pose a greater threat to children, some experts believe.

The topic of in-person school has been a heated one as the epidemiology around children has been something that’s taken a while to understand.

Sharon Ward-Fore, MS, MT(ASCP), CIC: “Infection preventionists need to remind people to be vigilant both in health care and outside of health care. Because we’re not done with this yet. We have a long way to go before we’re fully protected.”

Whether to make getting the COVID vaccine mandatory for health care workers is something that needs to be worked out against a backdrop that sees the recent surge subsiding and states starting to reopen.

British Prime Minister Boris Johnson said that the B.1.1.7 variant of COVID-19 which was said to be 50% to 70% more contagious, has now been discovered to also be 30% deadlier. The CDC warns it could become the dominant strain in the US by March.

Infection preventionists can coordinate with physicians and other subject matter experts on common areas of vaccine hesitancy among staff, and work with key stakeholders to address them. As vaccine rollouts begin, IPs can also partner with occupational health teams to track and trend compliance with vaccination.