State-wide Genomic Epidemiology Investigations of COVID-19 Infections in Healthcare Workers: Insights for Future Pandemic Preparedness

Background COVID-19 has resulted in many infections in healthcare workers (HCWs) globally. We performed state-wide SARS-CoV-2 genomic epidemiological investigations to identify HCW transmission dynamics and provide recommendations to optimise healthcare system preparedness for future outbreaks. Methods Genome sequencing was attempted on all COVID-19 cases in Victoria, Australia. We combined genomic and epidemiologic data to investigate the source of HCW infections across multiple healthcare facilities (HCFs) in the state. Phylogenetic analysis and fine-scale hierarchical clustering were performed for the entire Victorian dataset including community and healthcare cases. Facilities provided standardised epidemiological data and putative transmission links. Findings Between March and October 2020, approximately 1,240 HCW COVID-19 infection cases were identified; 765 are included here. Genomic sequencing was successful for 612 (80%) cases. Thirty-six investigations were undertaken across 12 HCFs. Genomic analysis revealed that multiple introductions of COVID-19 into facilities (31/36) were more common than single introductions (5/36). Major contributors to HCW acquisitions included mobility of staff and patients between wards and facilities, and characteristics and behaviours of individual patients including super-spreading events. Key limitations at the HCF level were identified. Interpretation Genomic epidemiological analyses enhanced understanding of HCW infections, revealing unsuspected clusters and transmission networks. Combined analysis of all HCWs and patients in a HCF should be conducted, supported by high rates of sequencing coverage for all cases in the population. Established systems for integrated genomic epidemiological investigations in healthcare settings will improve HCW safety in future pandemics.

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Facing the Challenge of Patient Transfers: Using Ceiling Lifts in Healthcare Facilities

HERD Health Environments Research & Design Journal ◽

10.1177/193758670800200102 ◽

2008 ◽

Vol 2 (1) ◽

pp. 6-16 ◽

Cited By ~ 9

Author(s):

Edgar Ramos Vieira ◽

Linda Miller

Keyword(s):

Web Sites ◽

Healthcare Workers ◽

New Technology ◽

Musculoskeletal Injuries ◽

Key Words And Phrases ◽

Patient Transfers ◽

Healthcare Facilities ◽

Healthcare Settings ◽

Risk Of Injury ◽

Magazine Articles

Objective: The objective was to review the literature on the use of ceiling lifts to perform patient transfers in healthcare settings. Background: Manual patient transfers present a high risk of injury. Ceiling lifts are increasingly used in healthcare facilities. Despite this, little is known about the effects of this new technology. Methods: Research and review articles were searched on five databases using specific key words and phrases. Literature citations in the articles and gray literature (e.g., technical reports, conference proceedings, magazine articles, Web sites) were also evaluated when relevant for this review. Experts in this area were contacted regarding information on the topic, potential literature, and for their suggestions. Results: Few studies evaluated the use of ceiling lifts in healthcare. The studies available and the experiences of the experts contacted support the use of ceiling lifts. The musculoskeletal safety of healthcare workers and patients can be improved by the use of ceiling lifts. Having lifts available, organizing the workflow, and reducing the steps required during transfers and handling tasks can significantly lessen the risk of musculoskeletal injuries. Conclusions: Evidence supports the installation of ceiling lifts in patient rooms and recommends their use in bathrooms. However, additional studies are needed because the use of ceiling lifts in healthcare is relatively new.

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COVID-19: The Importance of Adequate Personal Protective Equipment in Healthcare Medical Staff

Journal of Regenerative Biology and Medicine ◽

10.37191/mapsci-2582-385x-2(2)-021 ◽

2020 ◽

Cited By ~ 1

Author(s):

Anne Weissenstein

Keyword(s):

Health Care ◽

Personal Protective Equipment ◽

Health Care Services ◽

Infection Prevention And Control ◽

Protective Equipment ◽

Emotional Resilience ◽

Healthcare Facilities ◽

Care Services ◽

Healthcare Settings ◽

And Control

We present an update on infection prevention and control for COVID-19 in healthcare settings. This update focuses on measures to be applied in settings with increasing community transmission, growing demand for concern about COVID-19 patients, and subsequent staffing issues in the event of shortages of personal protective equipment for healthcare facilities worldwide. The comfort and emotional resilience of health care workers are key components in maintaining essential health care services during the COVID-19 virus (coronavirus) outbreak.

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Author Correction: Genomic epidemiology reveals multiple introductions of SARS-CoV-2 from mainland Europe into Scotland

Nature Microbiology ◽

10.1038/s41564-021-00869-0 ◽

2021 ◽

Vol 6 (3) ◽

pp. 414-414

Author(s):

Ana da Silva Filipe ◽

◽

James G. Shepherd ◽

Thomas Williams ◽

Joseph Hughes ◽

...

Keyword(s):

Multiple Introductions ◽

Genomic Epidemiology

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“Just So You Know, It Has Been Hard”: Food Retailers’ Perspectives of Implementing a Food and Nutrition Policy in Public Healthcare Settings

Nutrients ◽

10.3390/nu13062053 ◽

2021 ◽

Vol 13 (6) ◽

pp. 2053

Author(s):

Kristy Karying. Law ◽

Claire Elizabeth. Pulker ◽

Janelle Diann. Healy ◽

Christina Mary. Pollard

Keyword(s):

Nutrition Policy ◽

Public Healthcare ◽

Healthcare Facilities ◽

Voluntary Standards ◽

Policy Success ◽

Healthcare Settings ◽

Food Retailers ◽

Food And Nutrition ◽

The Cost ◽

Public Health Practitioners

Mandated policies to improve food environments in public settings are an important strategy for governments. Most Australian governments have mandated policies or voluntary standards for healthy food procurement in healthcare facilities, however, implementation and compliance are poor. A better understanding of the support required to successfully implement such policies is needed. This research explored food retailers’ experiences in implementing a mandated food and nutrition policy (the Policy) in healthcare settings to identify barriers, enablers, and impacts of compliance. Three 90-min workshops facilitated by two public health practitioners were undertaken with 12 food retailers responsible for operating 44 outlets across four hospitals in Perth, Western Australia. Workshop discussions were transcribed non-verbatim and inductive thematic content was analyzed. Three main themes were identified: (1) food retailers had come to accept their role in implementing the Policy; (2) the Policy made it difficult for food retailers to operate successfully, and; (3) food retailers needed help and support to implement the Policy. Findings indicate the cost of implementation is borne by food retailers. Communications campaigns, centralized databases of classified products, reporting frameworks, recognition of achievements, and dedicated technical expertise would support achieving policy compliance. Feasibility assessments prior to policy implementation are recommended for policy success.

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Symptom and Age Homophilies in SARS-CoV-2 Transmission Networks during the Early Phase of the Pandemic in Japan

Biology ◽

10.3390/biology10060499 ◽

2021 ◽

Vol 10 (6) ◽

pp. 499

Author(s):

Ali Andalibi ◽

Naoru Koizumi ◽

Meng-Hao Li ◽

Abu Bakkar Siddique

Keyword(s):

Early Stage ◽

Graph Model ◽

Initial Response ◽

Contact Tracing ◽

Pcr Analysis ◽

Exponential Random Graph Model ◽

Transmission Networks ◽

Random Graph Model ◽

Healthcare Settings ◽

Exponential Random Graph

Kanagawa and Hokkaido were affected by COVID-19 in the early stage of the pandemic. Japan’s initial response included contact tracing and PCR analysis on anyone who was suspected of having been exposed to SARS-CoV-2. In this retrospective study, we analyzed publicly available COVID-19 registry data from Kanagawa and Hokkaido (n = 4392). Exponential random graph model (ERGM) network analysis was performed to examine demographic and symptomological homophilies. Age, symptomatic, and asymptomatic status homophilies were seen in both prefectures. Symptom homophilies suggest that nuanced genetic differences in the virus may affect its epithelial cell type range and can result in the diversity of symptoms seen in individuals infected by SARS-CoV-2. Environmental variables such as temperature and humidity may also play a role in the overall pathogenesis of the virus. A higher level of asymptomatic transmission was observed in Kanagawa. Moreover, patients who contracted the virus through secondary or tertiary contacts were shown to be asymptomatic more frequently than those who contracted it from primary cases. Additionally, most of the transmissions stopped at the primary and secondary levels. As expected, significant viral transmission was seen in healthcare settings.

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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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Genomic Epidemiology of Invasive Methicillin-Resistant Staphylococcus aureus Infections Among Hospitalized Individuals in Ontario, Canada

The Journal of Infectious Diseases ◽

10.1093/infdis/jiaa147 ◽

2020 ◽

Vol 222 (12) ◽

pp. 2071-2081 ◽

Cited By ~ 2

Author(s):

Jennifer L Guthrie ◽

Sarah Teatero ◽

Sotaro Hirai ◽

Alex Fortuna ◽

Daniel Rosen ◽

...

Keyword(s):

Staphylococcus Aureus ◽

Methicillin Resistant Staphylococcus Aureus ◽

Demographic Data ◽

Public Health Practice ◽

Acid Resistance ◽

Fold Increase ◽

High Genetic Diversity ◽

Methicillin Resistant ◽

Genomic Epidemiology ◽

Healthcare Settings

Abstract Background Prevention and control of methicillin-resistant Staphylococcus aureus (MRSA) infections remain challenging. In-depth surveillance integrating patient and isolate data can provide evidence to better inform infection control and public health practice. Methods We analyzed MRSA cases diagnosed in 2010 (n = 212) and 2016 (n = 214) by hospitals in Ontario, Canada. Case-level clinical and demographic data were integrated with isolate characteristics, including antimicrobial resistance (AMR), classic genotyping, and whole-genome sequencing results. Results Community-associated MRSA (epidemiologically defined) increased significantly from 23.6% in 2010 to 43.0% in 2016 (P < .001). The MRSA population structure changed over time, with a 1.5× increase in clonal complex (CC)8 strains and a concomitant decrease in CC5. The clonal shift was reflected in AMR patterns, with a decrease in erythromycin (86.7% to 78.4%, P = .036) and clindamycin resistance (84.3% to 47.9%, P < .001) and a >2-fold increase in fusidic acid resistance (9.0% to 22.5%, P < .001). Isolates within both CC5 and CC8 were relatively genetically diverse. We identified 6 small genomic clusters—3 potentially related to transmission in healthcare settings. Conclusions Community-associated MRSA is increasing among hospitalized individuals in Ontario. Clonal shifting from CC5 to CC8 has impacted AMR. We identified a relatively high genetic diversity and limited genomic clustering within these dominant CCs.

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Genomic Analysis of Avian Infectious Bronchitis Viruses Recently Isolated in South Korea Reveals Multiple Introductions of GI-19 Lineage (QX Genotype)

Viruses ◽

10.3390/v13061045 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1045

Author(s):

Hyuk-Chae Lee ◽

Sol Jeong ◽

Andrew Y. Cho ◽

Kyu-Jik Kim ◽

Jun-Young Kim ◽

...

Keyword(s):

Phylogenetic Analysis ◽

South Korea ◽

Infectious Bronchitis Virus ◽

Economic Burden ◽

Genomic Analysis ◽

Multiple Introductions ◽

Infectious Bronchitis ◽

South Korean ◽

Phylogeographic Analysis ◽

The Past

Infectious bronchitis virus (IBV) was first identified in the 1930s and it imposes a major economic burden on the poultry industry. In particular, GI-19 lineage has spread globally and has evolved constantly since it was first detected in China. In this study, we analyzed S1 gene sequences from 60 IBVs isolated in South Korea. Two IBV lineages, GI-15 and GI-19, were identified in South Korea. Phylogenetic analysis suggested that there were six distinct subgroups (KM91-like, K40/09-like, and QX-like I to IV) of the South Korean GI-19 IBVs. Among them, QX-type III and IV subgroups, which are phylogenetically different from those reported in South Korea in the past, accounted for more than half of the total. Moreover, the phylogeographic analysis of the QX-like subgroups indicated at least four distinct introductions of GI-19 IBVs into South Korea during 2001–2020. The efficacy of commercialized vaccines against the recently introduced QX-like subgroups should be verified, and continuous international surveillance efforts and quarantine procedures should be enhanced to prevent the incursion of viruses.

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COVID-19 Pandemic: An Inhibitor of Universal Health Coverage Programme: A ViewPoint

African Journal of Health, Nursing and Midwifery ◽

10.52589/ajhnm-p2ax15ul ◽

2021 ◽

Vol 4 (5) ◽

pp. 1-13

Author(s):

Helen Idubamo Wankasi

Keyword(s):

Universal Health Coverage ◽

Healthcare Workers ◽

Sustainable Development Goals ◽

Health Coverage ◽

The Sustainable Development ◽

Healthcare Facilities ◽

Effective Governance ◽

Development Goals ◽

Frontline Healthcare Workers ◽

Universal Health

Ever since the re-emergence of Covid-19 as a pandemic, healthcare facilities (human and materials) have been overstressed, evidenced by the rate at which frontline healthcare workers fall sick and die in the course. In some healthcare institutions, the narrative has changed with regards to the number of days to access physicians for treatment, but selected and booked only on specific days and periods, except in extreme emergencies are able to access physicians un-booked. This is inconsistent with the intent of Universal Health Coverage and the Sustainable Development Goals. This paper, therefore, highlighted the objectives, covering a brief overview of COVID-19 and Universal Health Coverage; identified countries developed (Germany 1883) and emerging (South Africa/Nigeria) that have adopted Universal Health Coverage as well described how COVID-19 stands as an inhibitor to the achievement of Universal Health Coverage. At the tail end, recommendations are made on the way forward on the need for effective governance, manpower sourcing and general strengthening of the healthcare system.

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Risk Factors for Occupational Transmission of Tuberculosis among Healthcare Workers in Zambia

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i1130335 ◽

2020 ◽

pp. 59-65

Author(s):

Namaunga Kasumu Chisompola ◽

Kapambwe Mwape Kamanga ◽

Pipina Vlahakis Matafwali

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Healthcare Workers ◽

Critical Role ◽

Nosocomial Transmission ◽

Infection Prevention And Control ◽

Original Research ◽

Healthcare Facilities ◽

Prolonged Contact ◽

And Control

Healthcare workers (HCWs) play a critical role in the management and control of nosocomial transmission of tuberculosis (TB). At the same time, working in TB healthcare facilities such as hospital wards, diagnostic and treatment facilities increases the risk of acquiring TB due to occupational exposure in HCWs. The risk is further heightened in high TB prevalence populations, such as Zambia, as HCWs are exposed both occupationally and in the community. This review aims to provide a better understanding of the risk factors associated with occupational transmission of TB in HCWs in Zambia, by synthesising available data on TB in HCWs in Zambia and the surrounding region. A search of peer reviewed original research on the transmission of TB among HCWs in Zambia was conducted in PubMed and Google Scholar. Studies were eligible for inclusion in the analysis if they described TB amongst HCWs in Zambia, risk factors for TB in HCWs, and nosocomial transmission of TB in Zambia and the surrounding region. The prevalence of TB in HCWs has been demonstrated to be higher than that of the general population. Transmission of TB in healthcare facilities is driven by several factors centred on the lack of adherence to TB infection prevention and control (IPC) practices. Nosocomial transmission of TB in HCWs is further driven by the HIV epidemic and the rise in lifestyle diseases such as diabetes mellitus. However, there is very scarce data on the association of diabetes mellitus and TB among HCWs in Zambia. Prolonged contact with TB patients on wards has been demonstrated to play a vital role in occupational transmission of TB amongst nurses in Zambia. To curb the transmission of TB in HCWs several measures will require implementation such as; administrative support, IPC training and annual TB and HIV screening for all HCWs.

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