Infection Prevention Needs to Broaden Its Scope

For years I’ve been writing, speaking, and researching the role of infection prevention efforts in biopreparedness and global health security. The issue is complex and truth be told, not many realize that infection prevention programs exist, let alone the robust nature of our work. Infection prevention is of course the daily work of preventing healthcare-associated infections, but that also includes the prevention of healthcare-associated novel and emerging pathogens. Nosocomial infections are not unique to invasive medical devices or antimicrobial resistance, but also should be considered in the context of those more unusual pathogens, like Coronavirus disease 2019 (COVID-19)/SARS-CoV-2.

Infection prevention efforts are about reducing the spread of infections in healthcare and the problem is that too often that concept, like our roles, is only thought of in the context of those more common infections. Thinking of infection prevention efforts only in the frame of the day-to-day issues, like central line-associated bloodstream infections (CLABSIs), misses the true spectrum of our work. Simply put, we have a problem in infection prevention—for too long the role has been narrowed and limited in ways that have neglected the true spectrum of the work, but also the diversity of the people within it.

Saskia v. Popescu, PhD, MPH, MA, CIC

Outbreaks like SARS-CoV-1, MERS-CoV, Ebola, and now COVID-19 have all taught us that hospitals are inherently vulnerable to emerging infectious diseases. This is precisely where infection prevention efforts rest and should be reinforced. If practice makes permanence, then how can we create a culture of prevention? The issue is that it’s not just the world of health security or biodefense, or biopreparedness that needs to evolve to really include infection prevention. The profession and industry of infection control needs to inherently change as well. I think we can all safely say that there’s been a shift in the industry, to be more inclusive, expand the scope, and grow the diversity within our partners. It’s also important that we expand the expectation and scope of our roles to include emerging infectious diseases and pandemic preparedness more.

This doesn’t mean just developing another policy or set of plans we set aside and forget about, but really infusing these topics into our own skills and training, as well as building more robust programs so we’re not racing to catch up when these events occur. Initially this might feel like we’re adding more to an already full platter, but we already have a lot of these resources. From the documents and information made available during the 2014/2016 Ebola outbreak to this year’s COVID-19 pandemic, we have the resources to build more robust biopreparedness programs and skills within ourselves.

Part of this is investing in ourselves and expanding our skillset outside of the age-old focus on healthcare-associated infections. At this point, since 2014, we all have improved our ability to respond to and prevent emerging infectious diseases, so why not make this practice a permanent part of infection control and not just one that comes up ad hoc? Infection prevention is about leaning into the newest literature, practices, and enhancing patient and healthcare safety. Now is the time to evolve our field to be more proactive and inclusive of the work we really do.