scholarly journals COVID-19 Pandemic: Perspective of an Italian Tertiary Care Pediatric Center

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 311 ◽  
Author(s):  
Daniele Donà ◽  
Carlo Giaquinto ◽  
Eugenio Baraldi ◽  
Alessandra Biffi ◽  
Piergiorgio Gamba ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Phone Call ◽  
Nasopharyngeal Swab ◽  
Administrative Staff ◽  
Double Gate ◽  
Rapid Spread ◽  
Novel Coronavirus ◽  
Pediatric Center

Since February 2020, Italy has been faced with the dramatic spread of novel Coronavirus SARS-CoV-2. This impetuous pandemic infection forced many hospitals to reorganize their healthcare systems. Predicting a rapid spread of the SARS-CoV-2 virus within our region, the Department for Women’s and Children’s Health promptly decided (i) to revise the distribution of the clinical areas in order to create both designated COVID-19 and COVID-19-free areas with their own access, (ii) to reinforce infection prevention control (IPC) measures for all healthcare workers and administrative staff and (iii) to adopt the new “double-gate approach”: a phone call pre-triage and nasopharyngeal swab for SARS-CoV-2 detection before the admission of all patients and caregivers. Between 21 February 2020 till 04 May 2020, only seven physicians, two nurses and two of the administrative staff resulted positive, all during the first week of March. No other cases of intra-department infection were documented among the healthcare workers since all the preventive procedures described above were implemented. It is predicted that similar situations can happen again in the future, and thus, it is necessary to be more prepared to deal with them than we were at the beginning of this COVID-19 pandemic.

scholarly journals Compliance to infection prevention and control practices for prevention of SARS-CoV-2 transmission at tertiary care hospital in North Mumbai

2021 ◽  
Vol 8 (10) ◽  
pp. 4837
Author(s):  
Kinjal Patel ◽  
Suraj Purusottaman ◽  
Trupti Carval ◽  
Lekhan Narvekar
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Infection Prevention And Control ◽  
Care Hospital ◽  
And Control

Background: Infection control practices played a major role in prevention of SARS-CoV-2 in healthcare settings. Aim of the study was to know the compliance to infection control and prevention practices by healthcare workers in COVID-19 pandemic and the measures taken for prevention of SARS-CoV-2 spread in the hospital.Methods: An observational study was conducted at tertiary care hospital for a period of one month. All healthcare workers involved in patient care of COVID-19 and non COVID-19 was observed for their infection control practices. Areas were divided in two category, intensive care unit and indoor wards for audit. Environmental samples of various surfaces from intensive care unit and wards were taken and analyzed for the presence of SARS-CoV-2 RNA by reverse transcriptase polymerase chain reaction.Results: Overall compliance to infection prevention practices were improved during pandemic. Hand hygiene compliance in intensive care unit and indoor wards of COVID-19 unit were 78.66% and 74.36% whilst in non COVID-19 units was 72.47% and 62.31% respectively. Compliance to revised biomedical waste (BMW) policy at COVID-19 unit were 85.20% and 71.49% in intensive care unit and ward respectively. However, at non COVID-19 unit, it was 65.22% and 57.60%. Nursing station and doffing area of ICU at non-COVID-19 unit showed presence of SARS-CoV-2 virus. While all samples collected from COVID-19 unit were negative.Conclusions: Infection prevention and control practices play a key role to curtail transmission of infection. Awareness among healthcare workers, hospital environment, and usage of personal protective equipment should be optimized even at non COVID-19 facility.

scholarly journals Prospective Observational Study of Screening Asymptomatic Healthcare Workers for SARS-CoV-2 at a Canadian Tertiary Care Center

2020 ◽  
Author(s):  
Deepali Kumar ◽  
Victor H Ferreira ◽  
Andrzej Chruscinski ◽  
Vathany Kulasingam ◽  
Trevor J Pugh ◽  
...  
Keyword(s):  
Health Care ◽  
Healthcare Workers ◽  
Protein Microarray ◽  
Care Center ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Nasopharyngeal Swab ◽  
Care Workers ◽  
Protein Microarray Analysis ◽  
Care Worker

We screened three separate cohorts of healthcare workers for SARS-CoV-2 via nasopharyngeal swab PCR. A seroprevalence analysis using multiple assays was performed in a subgroup. The asymptomatic health care worker cohorts had a combined positivity rate of 29/5776 (0.50%, 95%CI 0.32-0.75) compared to the symptomatic cohort rate of 54/1597 (3.4%) (ratio of symptomatic to asymptomatic 6.8:1). Sequencing demonstrated several variants. The seroprevalence (n=996) was 1.4-3.4% depending on assay. Protein microarray analysis showed differing SARS-CoV-2 protein reactivities and helped define likely true positives vs. suspected false positives. Routine screening of asymptomatic health care workers helps identify a significant proportion of infections.

Adoption of infection prevention and control practices by healthcare workers in Québec: A qualitative study

2019 ◽  
Vol 40 (12) ◽  
pp. 1361-1366
Author(s):  
Eve Dubé ◽  
Armelle Lorcy ◽  
Nathalie Audy ◽  
Nadia Desmarais ◽  
Patrice Savard ◽  
...  
Keyword(s):  
Prevention And Control ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Tertiary Care ◽  
Medical Laboratory ◽  
Infection Prevention And Control ◽  
Clinical Practices ◽  
Good Communication ◽  
Qualitative Research Design ◽  
And Control

AbstractObjective:To describe barriers and facilitators to the adoption of recommended infection prevention and control (IPC) practices among healthcare workers (HCWs).Methods:A qualitative research design was used. Individual semistructured interviews with HCWs and observations of clinical practices were conducted from February to May 2018 in 8 care units of 2 large tertiary-care hospitals in Montreal (Québec, Canada).Results:We interviewed 13 managers, 4 nurses, 2 physicians, 3 housekeepers, and 2 medical laboratory technologists. We conducted 7 observations by following IPC nurses (n = 3), nurses (n = 2), or patient attendants (n = 2) in their work routines. Barriers to IPC adoption were related to the context of care, workplace environment issues, and communication issues. The main facilitator of the IPC adoption by HCWs was the “development of an IPC culture or safety culture.” The “IPC culture” relied upon leadership support by managers committed to IPC, shared belief in the importance of IPC measures to limit healthcare-associated infections (HAIs), collaboration and good communication among staff, as well as proactivity and ownership of IPC measures (ie, development of local solutions to reduce HAIs and “working together” toward common goals).Conclusions:Adoption of recommended IPC measures by HCWs is strongly influenced by the “IPC culture.” The IPC culture was not uniform within hospital and differences in IPC culture were identified between care units.

scholarly journals Comparing Dynamics and Determinants of Severe Acute Respiratory Syndrome Coronavirus 2 Transmissions Among Healthcare Workers of Adult and Pediatric Settings in Central Paris

2020 ◽  
Author(s):  
Adrien Contejean ◽  
Jérémie Leporrier ◽  
Etienne Canouï ◽  
Fanny Alby-Laurent ◽  
Emmanuel Lafont ◽  
...  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Home Care ◽  
Healthcare Workers ◽  
Tertiary Care ◽  
Direct Care ◽  
University Hospital ◽  
Nasopharyngeal Swab ◽  
Continuous Increase ◽  
Out Of Home Care ◽  
Care Facilities

Abstract Background Healthcare workers (HCWs) have paid a heavy toll during the coronavirus disease 2019 (COVID-19) outbreak. Routes of transmission remain to be fully understood. Methods This prospective study compared a 1500-bed adult and 600-bed pediatric setting of a tertiary-care university hospital located in central Paris. From 24 February until 10 April 2020, all symptomatic HCWs were screened for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on a nasopharyngeal swab. HCWs screened positive were questioned on their profession, symptoms, and occupational and nonoccupational exposures to SARS-CoV-2. Results Among 1344 HCWs tested, 373 were positive (28%) and 336 (90%) corresponding questionnaires were completed. Three hospitalizations and no deaths were reported. Most HCWs (70%) had patient-facing occupational activities (22% in COVID-19 dedicated units). The total number of HCW cases peaked on 23 March, then decreased slowly, concomitantly with a continuous increase of compliance to preventive measures (including universal medical masking and personal protective equipment [PPE] for direct care to COVID-19 patients). Attack rates were of 3.2% and 2.3% in the adult and pediatric settings, respectively (P = .0022). In the adult setting, HCWs more frequently reported exposure to COVID-19 patients without PPE (25% vs 15%, P = .046). Report of contacts with children attending out-of-home care facilities dramatically decreased over the study period. Conclusions Universal masking, reinforcement of hand hygiene, and PPE with medical masks for patients’ care allowed protection of HCWs and containment of the outbreak. Residual transmissions were related to persistent exposures with undiagnosed patients or colleagues and not to contacts with children attending out-of-home care facilities.

scholarly journals Fear, Anxiety, Stress, and Depression of novel coronavirus (COVID-19) pandemic among patients and their healthcare workers

2021 ◽  
Author(s):  
Ashwin Parchani ◽  
K Vidhya ◽  
Prasan Kumar Panda ◽  
Vikram Singh Rawat ◽  
Yogesh Arvind Bahurupi ◽  
...  
Keyword(s):  
Mental Health ◽  
Healthcare Workers ◽  
Mental Health Problems ◽  
Care Center ◽  
Tertiary Care ◽  
Psychological State ◽  
Health Issues ◽  
Novel Coronavirus ◽  
Frontline Healthcare Workers ◽  
High Degree

Background Disease pandemics are known to cause psychological distress. The ensuing mental health issues are not only restricted to the patients and their relatives/friends but affect the healthcare workers (HCWs) as well. Our study aims to assess these psychological trends during the COVID-19 pandemic between the two most affected population groups, that is, patients and frontline healthcare workers. Methods A survey questionnaire including scales to assess fear, anxiety, stress, depression - PSS 10, and DASS 21 was distributed and sent to all COVID-19 suspected/confirmed individuals and healthcare workers at a tertiary care center along with a second visit after 14 days of answering the first questionnaire and this continued as follow up. Data were analyzed with the SPSS Version 23 using various tests of significance. Results In the community, COVID-19 patients in the age group 41-50 with respiratory tract symptoms and those who were home isolated/quarantined experienced a greater tendency of mental health problems. Healthcare workers posted in COVID-19 designated areas of the hospital displayed higher levels of stress, anxiety, and depression. Conclusion The high degree of uncertainty associated with novel pathogens has a profound effect on the psychological state of suspected/confirmed cases as well as healthcare workers. Within the community, individuals suspected of having COVID-19 display a significant mental health burden, while HCWs also experience an unprecedented amount of stress during such enduring situations.

scholarly journals Diagnostic testing for SARS-CoV-2 infection in HHT patients: nasopharyngeal versus oropharyngeal swab

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Fabio Pagella ◽  
Roberta Lizzio ◽  
Sara Ugolini ◽  
Giuseppe Spinozzi ◽  
Eugenia Maiorano ◽  
...  
Keyword(s):  
Current Knowledge ◽  
Diagnostic Testing ◽  
Nasopharyngeal Swab ◽  
Global Pandemic ◽  
Recurrent Epistaxis ◽  
Rapid Spread ◽  
Dominant Disease ◽  
History Of ◽  
Oropharyngeal Swab ◽  
Novel Coronavirus

AbstractOn March 11, 2020, WHO has defined the novel coronavirus disease SARS-CoV-2 (COVID-19) outbreak as a pandemic that still today continues to affect much of the world. Among the reasons for the rapid spread of SARS-CoV-2 infection, there is the role of asymptomatic or minimally symptomatic carriers. Therefore diagnostic testing is central to contain the global pandemic. Up to now real-time reverse transcriptase polymerase chain reaction-based molecular assays for detecting SARS-CoV-2 in respiratory specimens is the current reference standard for COVID-19 diagnosis. Based on current knowledge regarding the sensitivity of the molecular test, the highest positive detection rate is from lower respiratory tract specimens; alternatively it is possible to perform a nasopharyngeal or oropharyngeal swab. Nasopharyngeal swab is the preferred choice for SARS-CoV-2 testing since it seems to have a greater sensitivity; however the procedure is not always free of complications and an epistaxis can occur. Among patients with greatest risk of massive nosebleed there are HHT patients. Hereditary hemorrhagic telangiectasia is an autosomal dominant disease that leads to multiregional mucocutanous telangiectases and visceral arteriovenous malformations. Clinically, the presence of telangiectases in nasal mucosa is the cause of recurrent epistaxis. In HHT patients the execution of the nasopharyngeal swab can determine from little or no consequences to a massive epistaxis leading to the necessity of nasal packing generally followed by hospital admission. In HHT patients undergoing a diagnostic test to evaluate the SARS-CoV-2 infection status, especially in those patients with frequent epistaxis with a history of anemia and repeated hospitalizations, it is therefore advisable to perform an oropharyngeal swab. This, compared to the nasopharyngeal swab, exposes to a lower risk of severe nosebleeds related treatments, such as blood transfusions or invasive procedures. According to the risk-benefit assessment and based on our experience, we consider that, despite a lower diagnostic sensitivity, oropharyngeal swab is preferable to nasopharyngeal swab for the diagnosis of SARS CoV-2 infection in patients with HHT.

scholarly journals COVID-19 Pandemic in Nepal: A Threat to Low Resources Countries

2020 ◽  
Vol 3 (2) ◽  
pp. 1-5
Author(s):  
Seshananda Sanjel ◽  
Tarun Paudel ◽  
Sangita Sanjel
Keyword(s):  
General Public ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Health Workers ◽  
Protective Equipment ◽  
Prevention Strategies ◽  
First Line ◽  
Professional Workers ◽  
Contact Transmission ◽  
Novel Coronavirus

At present, the global community is experiencing a pandemic caused by a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that caused coronavirus disease 2019 (COVID-19), the third disease from a coronavirus to cause a global outbreak. Person-to-person transmission occurs through droplet or contact transmission and if there is a lack of rigorous infection control or if no proper personal protective equipment (PPE) is available, it may endanger the first-line healthcare workers. In Nepal most of the cases are those who traveled to China and India till date, the infection is transmitted to clusters of societies only. Health workers as well as the general public has to be protected from getting infection applying established and universal infection prevention strategies including social distancing, hand hygiene and application of personal protective devices as required. Person-to-person contact is one of the most predominant ways of transmission of the disease, hence general public as well as all the professional workers have to follow the infection prevention approaches.

scholarly journals SARS-CoV-2 is associated with high viral loads in asymptomatic and recently symptomatic healthcare workers

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248347
Author(s):  
M. Catherine McEllistrem ◽  
Cornelius J. Clancy ◽  
Deanna J. Buehrle ◽  
Nina Singh ◽  
Aaron Lucas ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Infection Prevention ◽  
Nasopharyngeal Swab ◽  
Symptom Duration ◽  
Rt Pcr ◽  
Personal Protection Equipment ◽  
Duration Of Symptoms ◽  
Viral Loads ◽  
Ct Value ◽  
Increased Risk

Background Healthcare workers (HCW) are at increased risk of SARS-CoV-2 infection from both patients and other HCW with coronavirus disease 2019 (COVID-19). RT-PCR cycle threshold (Ct) values of SARS-CoV-2 ≤ 34 and the first 7–9 days of symptoms are associated with enhanced infectivity. We determined Ct values and duration of symptoms of HCW with a positive SARS-CoV-2 test. As HCW often assume their greatest risk of acquiring SARS-CoV-2 is working on a COVID-19 unit, we also determined Ct values and symptom duration of inpatients with a positive SARS-CoV-2 test. Methods From 6/24/2020-8/23/2020, Ct values and duration of symptoms from 13 HCW, 12 outpatients, and 28 inpatients who had a positive nasopharyngeal swab for SARS-CoV-2 were analyzed. Results Among HCW with a positive SARS-CoV-2 test, 46.2% (6/13) were asymptomatic and requested testing due to an exposure to someone with COVID-19; 83.3% (5/6) of those exposures occurred in the community rather than in the hospital. The median Ct value of HCW was 23.2, and 84.6% (11/13) had a Ct value ≤ 34. The median Ct value of 29.0 among outpatients with COVID-19 did not significantly differ from HCW. In contrast, inpatients with a positive SARS-CoV-2 test had a median Ct value of 34.0 (p = 0.003), which translated into a median ~1,000-fold lower viral load than observed in HCW. Among those with symptoms related to COVID-19, no (0/6) HCW compared to 50% (6/12) of inpatients had symptoms for at least one week (p = 0.04). Conclusions At our institution, asymptomatic COVID-19 accounted for nearly half of the cases among HCW. Symptomatic HCW had high viral loads and short duration of symptoms, both of which are associated with peak infectivity. Infection prevention programs should educate HCW on these findings in an effort to increase adherence to the requirement to maintain six feet separation in workspaces and breakrooms, in addition to consistently wearing personal protection equipment.

scholarly journals Environmental contamination of the SARS-CoV-2 in healthcare premises: An urgent call for protection for healthcare workers

2020 ◽  
Author(s):  
Guangming Ye ◽  
Hualiang Lin ◽  
Liangjun Chen ◽  
Shichan Wang ◽  
Zhikun Zeng ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Healthcare Workers ◽  
Infection Prevention ◽  
Personal Protection ◽  
Personal Protection Equipment ◽  
Hand Sanitizer ◽  
Self Service ◽  
Contamination Levels ◽  
Novel Coronavirus ◽  
Isolation Ward

AbstractImportanceA large number of healthcare workers (HCWs) were infected by SARS-CoV-2 during the ongoing outbreak of COVID-19 in Wuhan, China. Hospitals are significant epicenters for the human-to-human transmission of the SARS-CoV-2 for HCWs, patients, and visitors. No data has been reported on the details of hospital environmental contamination status in the epicenter of Wuhan.ObjectiveTo investigate the extent to which SARS-CoV-2 contaminates healthcare settings, including to identify function zones of the hospital with the highest contamination levels and to identify the most contaminated objects, and personal protection equipment (PPE) in Wuhan, China.DesignA field investigation was conducted to collect the surface swabs in various environments in the hospital and a laboratory experiment was conducted to examine the presence of the SARS-CoV-2 RNA.SettingSix hundred twenty-six surface samples were collected within the Zhongnan Medical Center in Wuhan, China in the mist of the COVID-19 outbreak between February 7 - February 27, 2020.ParticipantsDacron swabs were aseptically collected from the surfaces of 13 hospital function zones, five major objects, and three major personal protection equipment (PPE). The SARS-CoV-2 RNAs were detected by reverse transcription-PCR (RT-PCR).Main Outcomes and MeasuresSARS-CoV-2 RNAsResultsThe most contaminated zones were the intensive care unit specialized for taking care of novel coronavirus pneumonia (NCP) (31.9%), Obstetric Isolation Ward specialized for pregnant women with NCP (28.1%), and Isolation Ward for NCP (19.6%). We classified the 13 zones into four contamination levels. The most contaminated objects are self-service printers (20.0%), desktop/keyboard (16.8%), and doorknob (16.0%). Both hand sanitizer dispensers (20.3%) and gloves (15.4%) were most contaminated PPE.Conclusions and RelevanceMany surfaces were contaminated with SARS-CoV-2 across the hospital in various patient care areas, commonly used objects, medical equipment, and PPE. The 13 hospital function zones were classified into four contamination levels. These findings emphasize the urgent need to ensure adequate environmental cleaning, strengthen infection prevention training, and improve infection prevention precautions among HCWs during the outbreak of COVID-19. The findings may have important implications for modifying and developing urgently needed policy to better protect healthcare workers during this ongoing pandemic of SARS-CoV-2.Key PointsQuestionWhat was the hospital setting contamination status, the most contaminated objects and PPE of SARS-CoV-2 during the outbreak of COVID-19 in Wuhan, China?FindingsThe most contaminated zones were the intensive care unit for novel coronavirus pneumonia (NCP) (31.9%), Obstetric Isolation Ward specialized for pregnant women with NCP (28.1%), and Isolation Ward for NCP (19.6%). The most contaminated objects and PPE are self-service printers (20.0%), hand sanitizer dispensers (20.3%), and gloves (15.4%).MeaningThe findings may have important implications for modifying and developing urgently needed policy to better protect healthcare workers during this ongoing pandemic of SARS-CoV-2.

scholarly journals Surveillance and identification of clusters of healthcare workers with coronavirus disease 2019 (COVID-19): Multidimensional interventions at a comprehensive cancer center

2020 ◽  
pp. 1-6 ◽  
Author(s):  
Ella J. Ariza-Heredia ◽  
Elizabeth Frenzel ◽  
Sherry Cantu ◽  
Mary Carlson ◽  
Georgia Thomas ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Infection Prevention ◽  
Contact Tracing ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Initial Cluster ◽  
Polymerase Chain ◽  
Novel Coronavirus ◽  
Spread Of Infection ◽  
Respiratory Coronavirus

Abstract Background: Cases of novel coronavirus disease 2019 (COVID-19) were first reported in Wuhan, China, in December 2019. In this report, we describe 3 clusters of COVID-19 infections among healthcare workers (HCWs), not associated with patient exposure, and the interventions undertaken to halt ongoing exposure and transmission at our cancer center. Methods: A cluster of cases was defined as 2 or more cases of severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–positive COVID-19 among HCWs who work in the same unit area at the same time. Cases were identified by real-time reverse transcription polymerase chain reaction testing. Contact tracing, facility observations, and infection prevention assessments were performed to investigate the 3 clusters between March 1 and April 30, 2020, with subsequent implementation of containment strategies. Results: The initial cluster involved HCWs from an ancillary services unit, with contacts traced back to a gathering in a break room in which 1 employee was symptomatic, although not yet diagnosed with COVID-19, with subsequent transmission to 7 employees. The second cluster involved 4 employees and was community related. The third cluster involved only 2 employees with possible transmission while working in the same office at the same time. A step-up approach was implemented to control the spread of infection among employees, including universal masking, enhanced cleaning, increase awareness, and surveillance testing. No nosocomial transmission to patients transpired. Conclusions: To our knowledge, this is the first report of a hospital-based cluster of COVID-19 infections among HCWs in a cancer hospital describing our steps to mitigate further transmission.

Sign in / Sign up

Export Citation Format

Share Document