Determining the source of transmission of SARS-CoV-2 infection in a healthcare worker

BackgroundHealthcare workers (HCWs) are at the frontlines of the COVID-19 pandemic and are at risk of exposure to SARS-CoV-2 infection from their interactions with patients and in the community (1, 2). Limited availability of recommended personal protective equipment (PPE), in particular N95 respirators, has fueled concerns about whether HCWs are adequately protected from exposure while caring for patients. Understanding the source of SARS-CoV-2 infection in a HCW – the community or the healthcare system – is critical for understanding the effectiveness of hospital infection control and PPE practices. In Dane County, Wisconsin, community prevalence of SARS-CoV-2 is relatively low (cumulative prevalence of ~0.06% – positive cases / total population in Dane county as of April 17). Although SARS-CoV-2 infections in HCWs are often presumed to be acquired during the course of patient care, there are few reports unambiguously identifying the source of acquisition.ObjectiveTo determine the source of transmission of SARS-CoV-2 in a healthcare worker.

Download Full-text

Deactivation of SARS-CoV-2 with pulsed-xenon ultraviolet light: Implications for environmental COVID-19 control

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2020.399 ◽

2020 ◽

pp. 1-4 ◽

Cited By ~ 7

Author(s):

Sarah E. Simmons ◽

Ricardo Carrion ◽

Kendra J. Alfson ◽

Hilary M. Staples ◽

Chetan Jinadatha ◽

...

Keyword(s):

Patient Safety ◽

Viral Load ◽

Severe Acute Respiratory Syndrome ◽

Healthcare Worker ◽

Personal Protective Equipment ◽

Uv Disinfection ◽

Protective Equipment ◽

Environmental Surfaces ◽

Risk Of Exposure ◽

N95 Respirators

Abstract Objectives: Prolonged survival of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on environmental surfaces and personal protective equipment may lead to these surfaces transmitting this pathogen to others. We sought to determine the effectiveness of a pulsed-xenon ultraviolet (PX-UV) disinfection system in reducing the load of SARS-CoV-2 on hard surfaces and N95 respirators. Methods: Chamber slides and N95 respirator material were directly inoculated with SARS-CoV-2 and were exposed to different durations of PX-UV. Results: For hard surfaces, disinfection for 1, 2, and 5 minutes resulted in 3.53 log10, >4.54 log10, and >4.12 log10 reductions in viral load, respectively. For N95 respirators, disinfection for 5 minutes resulted in >4.79 log10 reduction in viral load. PX-UV significantly reduced SARS-CoV-2 on hard surfaces and N95 respirators. Conclusion: With the potential to rapidly disinfectant environmental surfaces and N95 respirators, PX-UV devices are a promising technology to reduce environmental and personal protective equipment bioburden and to enhance both healthcare worker and patient safety by reducing the risk of exposure to SARS-CoV-2.

Download Full-text

Decontamination methods of personal protective equipment for repeated utilization in medical/surgical settings

The Southwest Respiratory and Critical Care Chronicles ◽

10.12746/swrccc.v8i34.677 ◽

2020 ◽

Vol 8 (34) ◽

pp. 27-39

Author(s):

Abdurrahman Kharbat ◽

Adin Mizer ◽

Mimi Zumwalt

Keyword(s):

Personal Protective Equipment ◽

Healthcare Workers ◽

Protective Equipment ◽

Pilot Studies ◽

Medical Supplies ◽

Policy Statements ◽

Repeated Use ◽

Meta Analyses ◽

N95 Respirators ◽

Made In

The COVID-19 pandemic has affected citizens and healthcare workers worldwide due to a number of important factors. The transmission of the SARS CoV-2 microorganism, the pathogen that causes COVID-19 infection, occurs through droplet and aerosol spread due to coughs and sneezes from infected patients. A panicked public began hoarding medical supplies and personal protective equipment (PPE), leaving healthcare workers to care for patients without adequate protection. A literature review was conducted to better understand the options available to hospital and healthcare system administrators as they develop necessary protocols for the conservation and possible reuse of PPE. This review is based upon the peer-reviewed studies of various scientific investigators, biotechnology researchers, governmental agency health officials, including meta-analyses, preliminary/pilot studies, and policy statements. Current findings indicate that extended usage of N95 respirators is practical since there are methods available for the decontamination/repeated use of N95 respirators. In evaluating the efficacy of such methods, the safety of healthcare workers is important in deciding which method to recommend. Available evidence supports the use of the Bioquell Hydrogen Peroxide Vapor (HPV) system for decontaminating N95 respirators. Information on other PPE will also be discussed about more specific items. Informed decisions regarding the policies of hospitals and healthcare systems must be considered, and with the safety of healthcare workers in mind, both factors influenced the recommendations made in this comprehensive review.

Download Full-text

Examining the cost-effectiveness of personal protective equipment for formal healthcare workers in Kenya during the COVID-19 pandemic

BMC Health Services Research ◽

10.1186/s12913-021-07015-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jacob Kazungu ◽

Kenneth Munge ◽

Kalin Werner ◽

Nicholas Risko ◽

Andres I. Vecino-Ortiz ◽

...

Keyword(s):

Cost Effectiveness ◽

Incremental Cost ◽

Healthcare Worker ◽

Personal Protective Equipment ◽

Return On Investment ◽

Healthcare Workers ◽

Health Economic Evaluation ◽

Response Strategy ◽

Decision Analytic Model ◽

Protective Equipment

Abstract Background Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the incremental cost per healthcare worker death averted, and 2) the incremental cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results Kenya would need to invest $3.12 million (95% CI: 2.65–3.59) to adequately protect healthcare workers against COVID-19. This investment would avert 416 (IQR: 330–517) and 30,041 (IQR: 7243 – 102,480) healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a healthcare system ROI of $170.64 million (IQR: 138–209) – equivalent to an 11.04 times return. Conclusion Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

Download Full-text

The Feasibility of an Infection Control “Safe Zone” in a Spinal Cord Injury Unit

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2016.37 ◽

2016 ◽

Vol 37 (6) ◽

pp. 714-716 ◽

Cited By ~ 1

Author(s):

Keshonna Lones ◽

Swetha Ramanathan ◽

Margaret Fitzpatrick ◽

Jennifer N. Hill ◽

Marylou Guihan ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Infection Control ◽

Healthcare Worker ◽

Personal Protective Equipment ◽

Safe Zone ◽

Infect Control Hosp ◽

Protective Equipment ◽

Cord Injury

We report on healthcare worker use of a safe zone (outside a 3-foot perimeter around the patient’s bed) and personal protective equipment in 2 inpatient spinal cord injury/disorder units. Workers remained within the safe zone during 22% of observations but were less compliant with personal protective equipment inside the zone.Infect Control Hosp Epidemiol 2016;37:714–716

Download Full-text

Infection Control Practices among Laboratory Healthcare Workers in an Urban Local Government Area of Lagos State, Nigeria

Babcock University Medical Journal (BUMJ) ◽

10.38029/bumj.v4i2.82 ◽

2021 ◽

Vol 4 (2) ◽

pp. 86-96

Author(s):

Omobola Ojo ◽

Adeyinka Adeniran ◽

Olayinka Goodman ◽

Bisola Adebayo ◽

Esther Oluwole ◽

...

Keyword(s):

Local Government ◽

Infection Control ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Local Government Area ◽

Good Knowledge ◽

Protective Equipment ◽

Major Barrier ◽

Limited Availability ◽

Wide Range

Background: Laboratory healthcare workers do handle a wide range of potentially dangerous materials which exposes them to numerous hazards. This study aimed to assess the practices of laboratory health care workers towards safety, infection control and the associated factors to its practices. Case Presentation: A cross-sectional study was conducted among 181 laboratory healthcare workers in all registered 33 laboratory facilities in Ikeja Local Government Area in 2017. Data were collected with pre-tested, structured self-administered questionnaires. Data analysed with SPSS version 20 and p-value of < 0.05. The mean age of respondents was 35.0 ± 2.45 years, most of whom were females (57.7%) and married (61.1%). The majority (98.9%) demonstrated good knowledge of infection control. A total of 62.3% identified hand washing as the most important infection control practice while HIV and Tuberculosis were diseases respondents majorly considered as high risk of contracting. A total of 84.6% of the respondents showed good practices. Limited availability of personal protective equipment in the laboratories was a major barrier identified by 98.1% of respondents. Respondents displayed good knowledge, attitude and practice of infection control. Discussion and Conclusion: Barrier to infection control was the limited availability of personal protective equipment. Therefore, concerted efforts should be mustered to ensure continuous training and retraining with the provision of personal protective equipment.

Download Full-text

Examining the Cost-effectiveness of Personal Protective Equipment for Formal Healthcare Workers in Kenya during the COVID-19 Pandemic

10.21203/rs.3.rs-479486/v1 ◽

2021 ◽

Author(s):

Jacob Kazungu ◽

Kenneth Munge ◽

Kalin Werner ◽

Nicholas Risko ◽

Andres Vecino Ortiz ◽

...

Keyword(s):

Cost Effectiveness ◽

Healthcare Worker ◽

Personal Protective Equipment ◽

Return On Investment ◽

Healthcare Workers ◽

Health Economic Evaluation ◽

Response Strategy ◽

Decision Analytic Model ◽

Protective Equipment ◽

The Cost

Abstract Background: Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods: We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the cost per healthcare worker death averted, and 2) the cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results: Kenya would need to invest $3.12 million to adequately protect healthcare workers against COVID-19. This investment would avert 416 and 30,041 healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a societal ROI of $170.64 million – equivalent to an 11.04 times return. Conclusion: Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.

Download Full-text

COVID-19 Guidelines to Protect Healthcare Workers at Hospitals and Dental Professionals at Dental Office

Ethiopian Journal of Health Sciences ◽

10.4314/ejhs.v30i6.23 ◽

2020 ◽

Vol 30 (6) ◽

Author(s):

Bassel Tarakji ◽

Mohammad Zakaria Nassani ◽

Faisal Mehsen Alali ◽

Abdulwahab A. Abuderman

Keyword(s):

Infection Control ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Dental Treatment ◽

Health Workers ◽

The Body ◽

Protective Equipment ◽

Dental Office ◽

Control Procedures ◽

Dental Professionals

BACKGROUND፡ Coronavirus disease 2019 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. This study aimed to address the preventive procedures to protect healthcare workers at hospital to avoid COVID-19, and infection control procedures to protect dental professionals in dental office.METHODS: We conducted a search of published articles from PubMed, google scholar databases using key words such as COVID-19, healthcare worker, infection control, and dental practice. Relevant articles were identified and reviewed. Most published papers were clinical reports and case studies. We have selected some of the current published papers written in English in 2020.RESULTS: Infection control procedures to protect health workers at hospitals, and dental professionals at dental office were summurised and presented. Infection control procedures for healthcare workers at hospitals include Personal protective equipment, Korea filter (KF)94 respirator, goggles, face protector,disposable waterproof long-arm gown, and gloves, and others. Extra-protection procedures should be taken with old and vulnerable healthcare workers. Dental professionals should evaluate patients in advance before starting dental treatment. Aerosols generating procedures should be avoided and personal protective equipment should be used. Dental treatment should be restricted to emergency cases only.CONCLUSION: Old medical staff should be in safer distance to avoid infection, but young physicians and nurses should work at frontline as their immunity is better than their colleagues at old age. Screening patients and measurement of the body temperature are essential measures before dental treatment.

Download Full-text

Protocols and safety measurements used in intubation of COVID-19 patients

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20220008 ◽

2022 ◽

Author(s):

Ahmed Fouad Bogari ◽

Nada Mohmmad Alharbi ◽

Mohammed Abdulrahman Alaqlan ◽

Turki Salem Aljaza ◽

Ali Ibrahim Alibrahim ◽

...

Keyword(s):

Literature Review ◽

Infection Control ◽

Operating Room ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Protective Equipment ◽

Critical Approach ◽

Research Papers ◽

Anesthesia Equipment ◽

Proper Disposal

The COVID-19 pandemic has forced many countries to pose an emergency to contain the contamination and prevent the further spread of the infection. In this context, many societies and research papers were published to optimize guidelines and protocols for patients undergoing surgery and subsequent intubation. Accordingly, infection control is a critical approach to reduce the rate of contamination and risk of catching infections for suspected and confirmed COVID-19 patients. As a result, various guidelines were discussed in the current literature review, including guidelines to the patient, healthcare workers, operating room, anesthesia equipment, and patient transportation. For instance, healthcare workers can protect themselves from catching infections by wearing personal protective equipment and conducting adequate disinfection measures following each operation, in addition to the proper disposal of the contaminated objects. Strictly following these protocols should be done to reduce the risk of contamination in the operating room and enhance the outcomes of the patients and healthcare workers.

Download Full-text

Potential application of novel technology developed for instant decontamination of personal protective equipment before the doffing step

PLoS ONE ◽

10.1371/journal.pone.0250854 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0250854

Author(s):

Luís Alberto Brêda Mascarenhas ◽

Bruna Aparecida Souza Machado ◽

Leticia de Alencar Pereira Rodrigues ◽

Katharine Valéria Saraiva Hodel ◽

Alex Álisson Bandeira Santos ◽

...

Keyword(s):

Infection Control ◽

Personal Protective Equipment ◽

Healthcare Workers ◽

Hospital Environment ◽

Protective Equipment ◽

Percentage Reduction ◽

Experimental Conditions ◽

Novel Technology ◽

Viable Cells ◽

Additional Barrier

The use of personal protective equipment (PPE) has been considered the most effective way to avoid the contamination of healthcare workers by different microorganisms, including SARS-CoV-2. A spray disinfection technology (chamber) was developed, and its efficacy in instant decontamination of previously contaminated surfaces was evaluated in two exposure times. Seven test microorganisms were prepared and inoculated on the surface of seven types of PPE (respirator mask, face shield, shoe, glove, cap, safety glasses and lab coat). The tests were performed on previously contaminated PPE using a manikin with a motion device for exposure to the chamber with biocidal agent (sodium hypochlorite) for 10 and 30s. In 96.93% of the experimental conditions analyzed, the percentage reduction was >99% (the number of viable cells found on the surface ranged from 4.3x106 to <10 CFU/mL). The samples of E. faecalis collected from the glove showed the lowest percentages reduction, with 86.000 and 86.500% for exposure times of 10 and 30 s, respectively. The log10 reduction values varied between 0.85 log10 (E. faecalis at 30 s in glove surface) and 9.69 log10 (E. coli at 10 and 30 s in lab coat surface). In general, E. coli, S. aureus, C. freundii, P. mirabilis, C. albicans and C. parapsilosis showed susceptibility to the biocidal agent under the tested conditions, with >99% reduction after 10 and 30s, while E. faecalis and P. aeruginosa showed a lower susceptibility. The 30s exposure time was more effective for the inactivation of the tested microorganisms. The results show that the spray disinfection technology has the potential for instant decontamination of PPE, which can contribute to an additional barrier for infection control of healthcare workers in the hospital environment.

Download Full-text

Sterilization and sanitizing of 3D-printed personal protective equipment using polypropylene and a Single Wall design

3D Printing in Medicine ◽

10.1186/s41205-021-00106-8 ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Karstan Luchini ◽

Shelly N. B. Sloan ◽

Ryan Mauro ◽

Aspram Sargsyan ◽

Aundrea Newman ◽

...

Keyword(s):

Bacterial Growth ◽

Personal Protective Equipment ◽

General Public ◽

Healthcare Workers ◽

Thermoplastic Polyurethane ◽

Protective Equipment ◽

E Coli ◽

3D Printed ◽

The Cost ◽

N95 Respirators

Abstract Background The emergence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic during the fall of 2019 and into the spring of 2020 has led to an increased demand of disposable N95 respirators and other types of personal protective equipment (PPE) as a way to prevent virus spread and help ensure the safety of healthcare workers. The sudden demand led to rapid modification, development, and dissemination of 3D printed PPE. The goal of this study was to determine the inherent sterility and re-sterilizing ability of 3D printed PPE in order to provide sterile equipment to the healthcare field and the general public. Methods Samples of polylactic acid (PLA), thermoplastic polyurethane (TPU) (infill-based designs) and polypropylene (single-wall hollow design) were 3D printed. Samples were inoculated with E. coli for 24 h and then sanitized using various chemical solutions or heat-based methods. The samples were then incubated for 24- or 72-h in sterile LB medium at 37°C, and bacterial growth was measured by optical density at 600nm. Statistical analysis was conducted using GraphPad Prism v8.2.1. Results Significant bacterial growth was observed in all PLA and TPU based samples following re-sterilization, regardless of the methods used when compared to controls (p < 0.05). The single-walled hollow polypropylene design was not only sterile following printing, but was also able to undergo re-sanitization following bacterial inoculation, with no significant bacterial growth (p > 0.05) observed regardless of sanitization method used. Conclusion The cost effectiveness, ease of sanitization, and reusability of 3D printed PPE, using our novel single-walled polypropylene design can help meet increased demands of PPE for healthcare workers and the general public that are needed to help decrease the viral transmission of the coronavirus disease of 2019 (COVID-19) pandemic. 3D printing also has the potential to lead to the creation and production of other sterile material items for the healthcare industry in the future. The ability to re-sterilize 3D printed PPE, as our design shows, would also contribute less to the increase in biomedical waste (BMW) being experienced by COVID-19.

Download Full-text