Hot Topics in Infection Prevention: Thank You, My Fellow Infection Preventionists

Earlier this week I was talking to a colleague in infection prevention. Exhausted to our core and with that languishing feeling we’ve all been reading about, we both shared the same sentiment—no one seems to know what infection preventionists (IPs) have gone through this year.

This got me thinking. COVID-19 has put a light on so much that we’ve been neglecting for so long – the hard work of essential workers, social and racial inequities, underserved areas and understaffed hospitals, underfunded public health, etc. There’s been much written on the role of health care workers during COVID-19 and the goal of this article isn’t to diminish that, but rather to honor a group that I’ve seen routinely neglected during public health emergencies. I may be biased as an infection preventionist and epidemiologist, but frankly, I worry that after Ebola in 2014 and now COVID-19, the field of infection prevention will see an exodus due to the continued neglect.

I’ve spent a lot of time writing and researching (and talking) about how neglected infection prevention and control (IPC) is and what that means for health care, but also biodefense. This was pre-COVID, but as I hear the heartbreak of so many IP friends and colleagues, I think it’s important to write this. Before the first cases were even identified in the United States, IPs were worriedly watching and the moment the first case was announced in Washington, we began preparing. For many of us, the 24/7 on-call work began around this time.

We operationalize new guidance, relayed travel-related alerts, and prepared staff for what may come. When the surges hit, we were there—rounding on the units and doing training on all the units. From being trained to do N95 fit-testing to jumping into the count to partake in patient care, IPs took on many roles.

We had to navigate the changing guidance, establish overflow areas, ensure reporting to the health department was occurring, and do contact-tracing to make sure exposed staff were quarantined. We had to navigate PPE shortages and decontamination of masks. We faced politicization of masks and hesitancy around vaccines.

We’ve been attacked by people who didn’t understand our approach to isolation precautions. In the non-surging times, we were expected to go back to normal. To go back to the health care-associated infections (HAIs) that were being neglected but also to maintain readiness. Coming down from that exhausted panic of “just keep going” is not easy.

For most IPs, we work five days a week in under-staff programs and are frequently on call. Readiness for an infectious disease tends to fall on us and it’s our job to coordinate with all the internal partners—like clinical, lab, and environmental services—to ensure we’re prepared.

As COVID-19 began to surge across the world and the United States in 2020, IPs went into overtime, working continuously … and we haven’t stopped. Like public health, we’ve worked long weeks, weekends on call, and have been expected to manage our day-to-day duties. For many of us, it’s isolating, and few understand this. Few even know what IPs are, let alone acknowledge our role in this.

In the wake of all of this and the often-frustrating isolation we feel as the U.S. seems to go back to “normal,” I want to acknowledge IPs. You all inspire me daily and I’m eternally grateful to work among you. We work to protect our health care personnel and patients fiercely and often to the point where we are burned out. Now is a hard time for so many and ultimately, it’s important to know that it’s not a light switch. That feeling of exhaustion and inability to just recover from it all is not instant. Our roles have been the underdogs and will likely continue so.

Many may not know the dedication we put in during this all but please know, our patients and staff are safer due to the work you do daily. Now is the time we try to pick up the pieces—care for the caregiver, right? Working through this challenging time won’t be quick but know that you’re not alone. Infection prevention is a critical field and like public health, it often is neglected until it’s necessary. Just know that you played (and continue to do so) a vital role in the COVID-19 response and as we work to raise awareness for our field, this is the time to revitalize and shape the future of infection prevention. This means we need new ideas, innovative approaches, but most importantly—we need you to recover and heal. We still have a long road ahead but surrounded by some of the best people one could hope for, I know infection prevention will be OK.