Multi-pronged infection control strategy to achieve zero nosocomial COVID-19 infection among Hong Kong healthcare workers in the first 300 days of combat

Abstract Background: Nosocomial outbreaks leading to healthcare workers (HCWs) infection and death have been increasingly reported during the coronavirus disease 2019 (COVID-19) pandemic. An effective intervention is urgently needed to reduce nosocomial acquisition. Methods: We summarized our experience of multi-pronged infection control (IC) strategy in the first 300 days (December 31, 2019 to October 25, 2020) of COVID-19 era under the governance of Hospital Authority in Hong Kong. Results: Of 5,296 COVID-19 patients, 4,808 (90.8%) were diagnosed in the first (142 cases), second (896 cases), and third wave (3,770 cases) of COVID-19 in Hong Kong. Except for one patient who died before admission, all COVID-19 patients were admitted to public healthcare system which culminated to 78,834 COVID-19 patient-days. The median length of stay was 13 days (ranged, 1-128). Of 81,955 HCWs, thirty-eight (0.05%) HCWs [13 professional (2 doctors, 11 nurses) and 25 non-professional staff], had COVID-19. Except for 5 of 38 (13.2%) infected by HCW-to-HCW transmission in the non-clinical settings, no HCW had documented transmission from COVID-19 patients in the hospitals. The incidence of COVID-19 among HCWs was significantly lower than that of our general population (0.46 per 1,000 HCWs vs 0.71 per 1,000 population, p=0.008). The incidence of COVID-19 among professional staff was significantly lower than that of non-professional staff (0.30 vs 0.66 per 1,000 FTE, p=0.022). Conclusion: Hospital-based approach spared our healthcare service from being overloaded. No nosocomial COVID-19 in HCWs was found in the first 300 days of COVID-19 era in Hong Kong with our multi-pronged IC strategy.

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Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2): A cohort study

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.1389 ◽

2020 ◽

pp. 1-4

Author(s):

Carla Benea ◽

Laura Rendon ◽

Jesse Papenburg ◽

Charles Frenette ◽

Ahmed Imacoudene ◽

...

Keyword(s):

High Risk ◽

Infection Control ◽

Control Strategy ◽

Healthcare Workers ◽

Control Strategies ◽

Risk Exposure ◽

Nasopharyngeal Swab ◽

Home Based ◽

Respiratory Coronavirus ◽

Second Wave

Abstract Objective: Evidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to severe acute respiratory coronavirus virus 2 (SARS-CoV-2). In this study, we evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy. Methods: HCWs advised by their infection control or occupational health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May and October 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0 to day 7 after exposure and standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for (1) clinical coronavirus disease 2019 (COVID-19) diagnosis from day 8–14 after exposure, and for (2) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9, 10, and 14 after exposure. Interim results are reported in the context of a second wave threatening this essential workforce. Results: Among 30 HCWs enrolled, the mean age was 31 years (SD, ±9), and 24 (80%) were female. Moreover, 3 were diagnosed with COVID-19 by day 14 after exposure (secondary attack rate, 10.0%), and all cases were detected using the 7-day infection control strategy: the NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95% CI, 93.1%–100.0%). Conclusions: Among HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. Ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, and here we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

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Integrated infection control strategy to minimize nosocomial infection of coronavirus disease 2019 among ENT healthcare workers

Journal of Hospital Infection ◽

10.1016/j.jhin.2020.02.018 ◽

2020 ◽

Vol 104 (4) ◽

pp. 454-455 ◽

Cited By ~ 50

Author(s):

D. Lu ◽

H. Wang ◽

R. Yu ◽

H. Yang ◽

Y. Zhao

Keyword(s):

Nosocomial Infection ◽

Infection Control ◽

Control Strategy ◽

Healthcare Workers

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Evaluation of a home-based 7-day infection control strategy for healthcare workers following high-risk exposure to SARS-CoV-2: a cohort study

10.1101/2020.11.05.20224618 ◽

2020 ◽

Author(s):

Carla Benea ◽

Laura Rendon ◽

Jesse Papenburg ◽

Charles Frenette ◽

Ahmed Imcaoudene ◽

...

Keyword(s):

High Risk ◽

Infection Control ◽

Control Strategy ◽

Healthcare Workers ◽

Control Strategies ◽

Risk Exposure ◽

Nasopharyngeal Swab ◽

Post Exposure ◽

Home Based ◽

Second Wave

ABSTRACTBackgroundEvidence-based infection control strategies are needed for healthcare workers (HCWs) following high-risk exposure to SARS-CoV-2. This study evaluated the negative predictive value (NPV) of a home-based 7-day infection control strategy.MethodsHCWs advised by their Infection Control or Occupational Health officer to self-isolate due to a high-risk SARS-CoV-2 exposure were enrolled between May-September 2020. The strategy consisted of symptom-triggered nasopharyngeal SARS-CoV-2 RNA testing from day 0-6 post exposure, followed by standardized home-based nasopharyngeal swab and saliva testing on day 7. The NPV of this strategy was calculated for i) clinical COVID-19 diagnosis from day 8-14 post exposure, and for ii) asymptomatic SARS-CoV-2 detected by standardized nasopharyngeal swab and saliva specimens collected at days 9-10 and 14 post exposure. Interim results are reported in the context of a second wave threatening this essential workforce.ResultsAmong 30 HCWs enrolled to date (age 31±9 years, 24 [80.0%] female), 3 were diagnosed with COVID-19 by day 14 post exposure (secondary attack rate 10.0%), with all cases detected by the 7-day infection control strategy: NPV for subsequent clinical COVID-19 or asymptomatic SARS-CoV-2 detection by day 14 was 100.0% (95%CI: 93.1-100.0%).InterpretationAmong HCWs with high-risk exposure to SARS-CoV-2, a home-based 7-day infection control strategy may have a high NPV for subsequent COVID-19 and asymptomatic SARS-CoV-2 detection. While ongoing data collection and data sharing are needed to improve the precision of the estimated NPV, we report interim results to inform infection control strategies in light of a second wave threatening this essential workforce.

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Using an integrated infection control strategy during outbreak control to minimize nosocomial infection of severe acute respiratory syndrome among healthcare workers

Journal of Hospital Infection ◽

10.1016/j.jhin.2005.02.011 ◽

2006 ◽

Vol 62 (2) ◽

pp. 195-199 ◽

Cited By ~ 31

Author(s):

M.-Y. Yen ◽

Y.E. Lin ◽

I.-J. Su ◽

F.-Y. Huang ◽

...

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Nosocomial Infection ◽

Infection Control ◽

Control Strategy ◽

Healthcare Workers ◽

Outbreak Control

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Hong Kong healthcare workers’ coronavirus disease 2019 (COVID-19) concerns: infection control, recognition and staff wellbeing, duty arrangements

Journal of Hospital Management and Health Policy ◽

10.21037/jhmhp-20-142 ◽

2021 ◽

Vol 0 ◽

pp. 0-0

Author(s):

Alastair P. Mah ◽

Kelvin C. Tong ◽

Linda L. Chan ◽

Peter D. Hibbert ◽

Fei-Chau Pang

Keyword(s):

Hong Kong ◽

Infection Control ◽

Healthcare Workers ◽

Staff Wellbeing

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An Integrated Strategy for the Prevention of SARS-CoV-2 Infection in Healthcare Workers: A Prospective Observational Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17165785 ◽

2020 ◽

Vol 17 (16) ◽

pp. 5785 ◽

Cited By ~ 2

Author(s):

Anna Maria Cattelan ◽

Lolita Sasset ◽

Eugenia Di Meco ◽

Silvia Cocchio ◽

Francesco Barbaro ◽

...

Keyword(s):

Observational Study ◽

Infection Control ◽

Control Strategy ◽

Healthcare Workers ◽

Prospective Observational Study ◽

Secondary Endpoint ◽

University Hospital ◽

Healthcare Personnel ◽

North East ◽

Hospital Infection Control

Background: Since the beginning of SARS-CoV-2 outbreak, a large number of infections have been reported among healthcare workers (HCWs). The aim of this study was to investigate the occurrence of SARS-CoV-2 infection among HCWs involved in the first management of infected patients and to describe the measures adopted to prevent the transmission in the hospital. Methods: This prospective observational study was conducted between February 21 and April 16, 2020, in the Padua University Hospital (north-east Italy). The infection control policy adopted consisted of the following: the creation of the “Advanced Triage” area for the evaluation of SARS-CoV-2 cases, and the implementation of an integrated infection control surveillance system directed to all the healthcare personnel involved in the Advance Triage area. HCWs were regularly tested with nasopharyngeal swabs for SARS-CoV-2; body temperature and suggestive symptoms were evaluated at each duty. Demographic and clinical data of both patients and HCWs were collected and analyzed; HCWs’ personal protective equipment (PPE) consumption was also recorded. The efficiency of the control strategy among HCWs was evaluated identifying symptomatic infection (primary endpoint) and asymptomatic infection (secondary endpoint) with confirmed detection of SARS-CoV-2. Results: 7595 patients were evaluated in the Advanced Triage area: 5.2% resulted positive and 72.4% was symptomatic. The HCW team was composed of 60 members. A total of 361 nasopharyngeal swabs were performed on HCWs. All the swabs resulted negative and none of the HCWs reached the primary or the secondary endpoint. Conclusions: An integrated hospital infection control strategy, consisting of dedicated areas for infected patients, strict measures for PPE use and mass surveillance, is successful to prevent infection among HCWs.

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Knowledge of COVID-19 infection control among healthcare workers in radiology departments in Saudi Arabia

Journal of Radiation Research and Applied Sciences ◽

10.1080/16878507.2020.1856587 ◽

2020 ◽

pp. 1-10

Author(s):

Rowa Aljondi ◽

Salem Saeed Alghamdi ◽

Ikhlas Abdelaziz ◽

Lubna Bushara ◽

Somayah Alghamdi ◽

...

Keyword(s):

Saudi Arabia ◽

Infection Control ◽

Healthcare Workers

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‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa

BMJ Global Health ◽

10.1136/bmjgh-2020-004360 ◽

2021 ◽

Vol 6 (4) ◽

pp. e004360

Author(s):

Dumisani MacDonald Hompashe ◽

Ulf-G Gerdtham ◽

Carmen S Christian ◽

Anja Smith ◽

Ronelle Burger

Keyword(s):

Health Systems ◽

Primary Healthcare ◽

Healthcare Workers ◽

Quality Care ◽

Public Healthcare ◽

Health Coverage ◽

Access To Health Services ◽

Healthcare Provision ◽

Healthcare Facilities ◽

Patients Experience

Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

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