scholarly journals Infection Control in Dental Anesthesiology: A Time for Preliminary Reconsideration of Current Practices

2020 ◽  
Vol 67 (2) ◽  
pp. 109-120
Author(s):  
James Tom

Relegated to clinical afterthought, the topic of infection control has never taken center stage in our modern dental sedation and anesthesiology practices. Surgical and procedural masks, gloves, gowns, protective eyewear, and appropriate surgical attire have remained de rigueur in both fashion and custom for decades. However, the emergence of certain seminal events throughout health care history has driven mandated changes when practitioners, staff, patients, and the surrounding communities were exposed or put at risk of exposure to infectious disease. Hepatitis, human immunodeficiency virus, and now the global COVID-19 pandemic involving the novel coronavirus SARS-CoV-2, have forced us into rethinking our current practices. This review article will contextualize previous epidemics and their influence on infection control in dental settings, and it will explore the rapid evolution of current modifications to personal protective equipment and infection mitigation practices specific to sedation and anesthesia in dentistry.

Author(s):  
Taito Kitano ◽  
Pierre-Philippe Piché-Renaud ◽  
Helen E Groves ◽  
Laurie Streitenberger ◽  
Renee Freeman ◽  
...  

Abstract Visitor restriction policies in pediatric wards during the novel coronavirus (COVID-19) outbreak are variable. Among 36 hospitals that responded to our survey, 97% allowed at least 1 visitor, with 67% restricting to 1 caregiver. Sixty-nine percent required the visitor to wear personal protective equipment and only 19% allowed non-household visitors.


2020 ◽  
Author(s):  
ZHONGNENG XU

The novel coronavirus, SARS-CoV-2, caused lethal human respiratory infections, and there is a big problem to control the disease. The application of other viruses to compete with the novel coronavirus was proposed in this paper. On the viewpoint of receptor competition, resource competition, and cross immunity, an attempt should be made to select a natural virus, such as the common coronavirus causing the common cold in human, or transform a virus with biotechnology in order to resist the novel coronavirus. Similar scenarios were suggested to deal with other viruses like human immunodeficiency virus. Microecological communities of viruses could form an independent research area to dig the deeper biological and medical significance. The present study provided the information to further the theoretical implication and medical application of the study of virus interactions.


Author(s):  
Reid Mimmack ◽  
Elijah Germo ◽  
Garrett Augustine ◽  
Kumar Belani

Abstract In March 2020, the World Health Organization declared the novel coronavirus (COVID-19) outbreak a worldwide pandemic. The pandemic led to concerns of shortages regarding healthcare-related resources, including personal protective equipment (PPE), ventilators, and more. The uniquely designed COVEX respirator with face shield was engineered and manufactured by Augustine Surgical, Inc. to combat the PPE shortage. The novel COVEX mask is an “all-in-one” face shield and filter with a Viral Filtration Efficiency (VFE) greater than 99%. A standard respirator qualitative fit test was completed on the COVEX respirator as well as the current medical standard 3M N95 respirator. Fit test studies comparing the two masks yielded similar outcomes. The COVEX respirator had a qualitative fit test pass rate of 96.6% and the 3M N95 respirator had a pass rate of 93.3% (n=30). Participants also reported other variables comparing the comfort and fit of each mask, which is described further in the discussion. The COVEX respirator with face shield passed a standardized qualitative fit test at a rate similar to the current medical standard N95 respirator. Our results suggest that the COVEX mask may be a viable PPE option in the future.


2020 ◽  
Vol 37 (7) ◽  
pp. 402-406 ◽  
Author(s):  
Jeanne Noble ◽  
Nida Felicija Degesys ◽  
Elizabeth Kwan ◽  
Edward Grom ◽  
Cortlyn Brown ◽  
...  

By 11 February 2020 when the WHO named the novel coronavirus (SARS-CoV-2) and the disease it causes (COVID-19), it was evident that the virus was spreading rapidly outside of China. Although San Francisco did not confirm its first locally transmitted cases until the first week of March, our ED and health system began preparing for a potential COVID-19 surge in late February 2020.In this manuscript, we detail how the above responses were instrumental in the rapid deployment of two military-grade negative-pressure medical tents, named accelerated care units (ACU). We describe engagement of our workforce, logistics of creating new care areas, ensuring safety through personal protective equipment access and conservation, and the adaptive leadership challenges that this process posed.We know of no other comprehensive examples of how EDs have prepared for COVID-19 in the peer-reviewed literature. Many other EDs both in and outside of California have requested access to the details of how we operationalised our ACUs to facilitate their own planning. This demonstrates the urgent need to disseminate this information to our colleagues. Below we describe the process of developing and launching our ACUs as a potential model for other EDs around the country.


2020 ◽  
Vol 258 (5) ◽  
pp. 1049-1055 ◽  
Author(s):  
Tracy H. T. Lai ◽  
Emily W. H. Tang ◽  
Sandy K. Y. Chau ◽  
Kitty S. C. Fung ◽  
Kenneth K. W. Li

2020 ◽  
Author(s):  
David J Zorko ◽  
Shira Gertsman ◽  
Katie O'Hearn ◽  
Nicholas Timmerman ◽  
Nasser Ambu-Ali ◽  
...  

Background: The high demand for personal protective equipment (PPE) during the novel coronavirus outbreak has created global shortages and prompted the need to develop strategies to conserve supply. Surgical mask PPE have a broad application of use in a pandemic setting, but little is known regarding decontamination interventions to allow for their reuse. Objective: Identify and synthesize data from original published studies evaluating interventions to decontaminate surgical masks for the purpose of reuse. Methods: We searched MEDLINE, Embase, CENTRAL, Global Health, the WHO COVID-19 database, Google Scholar, DisasterLit, preprint servers, and prominent journals from inception to April 8, 2020 for prospective original research on decontamination interventions for surgical mask PPE. Citation screening was conducted independently in duplicate. Study characteristics, interventions, and outcomes were extracted from included studies by two independent reviewers. Outcomes of interest included impact of decontamination interventions on surgical mask performance and germicidal effects. Results: Seven studies met eligibility criteria: one evaluated the effects of heat and chemical decontamination interventions applied after mask use on mask performance, and six evaluated interventions applied prior to mask use to enhance antimicrobial properties and/or mask performance. Mask performance and germicidal effects were both evaluated in heterogenous test conditions across a variety of mask samples (whole masks and pieces or individual mask layers). Safety outcomes were infrequently evaluated. Mask performance was best preserved with dry heat decontamination. Germicidal effects were best in salt-, N-halamine- and nanoparticle-coated masks. Conclusion: There is limited evidence on the safety or efficacy of surgical mask decontamination. Given the heterogenous methods used in the studies to date, we are unable to draw conclusions on the most appropriate, safest intervention(s) for decontaminating surgical masks for the purpose of reuse.


2020 ◽  
Author(s):  
Ilektra Athiana ◽  
Corinne Légeret ◽  
Patrick Bontems ◽  
Luigi Dall'Oglio ◽  
Paola De Angelis ◽  
...  

Abstract Background: As endoscopists are at risk to get infected by the novel Coronavirus SARS-CoV-2 during endoscopic procedures, the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) published recommendations regarding protection for the paediatric endoscopist and endoscopy suite staff. The aim of this survey was to investigate whether European paediatric gastroenterology centres applied the recommendations and how this extraordinary situation was handled by the different centres.Results: Twelve Paediatric European gastroenterology centers (from Belgium, Greece, Italy, Portugal, Slovenia, Spain, Switzerland, and United Kingdom) participated. Nine centres (75%) screened their patients for a possible COVID-19 infection before the procedure, the same amount of hospitals changed their practice based on the ESPGHAN recommendations. 67% of the centres reduced the staff in the endoscopy suite, 83% of the units used FFP2/3 masks and protective goggles during the procedure and 75% wore waterproof gowns.Conclusion: The global situation caused by COVID-19 changed so rapidly, and hospitals had to react immediately to protect staff and patients and could not wait for guidelines to be published. Furthermore, uniform guidelines could not be applied by all European hospitals at a certain time point of the viral spread, as different regions of Europe were not only affected differently by COVID-19, but also had different access to personal protective equipment.


2021 ◽  
Vol 17 (12) ◽  
pp. e1010162
Author(s):  
Alexandra Melton ◽  
Lara A. Doyle-Meyers ◽  
Robert V. Blair ◽  
Cecily Midkiff ◽  
Hunter J. Melton ◽  
...  

The novel coronavirus SARS-CoV-2, the causative agent of COVID-19 disease, has killed over five million people worldwide as of December 2021 with infections rising again due to the emergence of highly transmissible variants. Animal models that faithfully recapitulate human disease are critical for assessing SARS-CoV-2 viral and immune dynamics, for understanding mechanisms of disease, and for testing vaccines and therapeutics. Pigtail macaques (PTM, Macaca nemestrina) demonstrate a rapid and severe disease course when infected with simian immunodeficiency virus (SIV), including the development of severe cardiovascular symptoms that are pertinent to COVID-19 manifestations in humans. We thus proposed this species may likewise exhibit severe COVID-19 disease upon infection with SARS-CoV-2. Here, we extensively studied a cohort of SARS-CoV-2-infected PTM euthanized either 6- or 21-days after respiratory viral challenge. We show that PTM demonstrate largely mild-to-moderate COVID-19 disease. Pulmonary infiltrates were dominated by T cells, including CD4+ T cells that upregulate CD8 and express cytotoxic molecules, as well as virus-targeting T cells that were predominantly CD4+. We also noted increases in inflammatory and coagulation markers in blood, pulmonary pathologic lesions, and the development of neutralizing antibodies. Together, our data demonstrate that SARS-CoV-2 infection of PTM recapitulates important features of COVID-19 and reveals new immune and viral dynamics and thus may serve as a useful animal model for studying pathogenesis and testing vaccines and therapeutics.


Author(s):  
Nasia Safdar ◽  
Gage K. Moreno ◽  
Katarina M. Braun ◽  
Thomas C. Friedrich ◽  
David H. O’Connor

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.


Author(s):  
Seyed Hadi Kalantar ◽  
Seyed Mohammad Javad Mortazavi ◽  
Nima Bagheri ◽  
Seyed Ali Dehghan Manshadi ◽  
Alireza Moharrami ◽  
...  

Background: The novel coronavirus disease-2019 (COVID-19) has become a significant worldwide problem since January 2019. Hospitals have spent most of their time and logistics on patients with COVID-19. During this crisis, many healthcare providers have been infected with the disease, and occasionally, some wards and operating rooms were shut down as a result. Here, we explain our experience with the healthcare staff involvement with COVID-19 in our hospital. Methods: As a referral tertiary center, Imam Khomeini Hospital (Tehran, Iran) has 4,200 health-care workers (HCWs). From February 20, 2020 to August 21, 2020, we investigated the hospital database for COVID-19 involvement among the staff. Results: During the study period, 973 (23%) hospital HCWs were detected with COVID-19, 378 (9%) of whom were involved between June 21 and July 21, 2020. In the orthopedic department, 20 of 43 (46%) HCWs were infected with COVID-19. Conclusion: We believe that the increase in the incidence of the disease and higher risk of exposure is a highly noticeable factor which should be addressed by the administrative health officials.


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