The ‘thorny 5th Moment for Hand Hygiene’: hands and surfaces collide

We talk often about the 5 Moments for Hand Hygiene but frequently neglect the 5th moment (after contact with a patient’s environment). So much so, that you might even describe this as the “Cinderella moment for hand hygiene”! Could it be that the Cinderella moment is actually the most important in the transmission of pathogens that cause HCAI? Maybe sometimes. But that’s missing the point. If we don’t focus our attention on all moments for hand hygiene, we won’t be as effective as we could be in preventing cross-transmission.

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ESPAUR report to kick of WAAW 2021

It’s great to see the latest ESPAUR report published at the start of World Antibiotic Awareness Week 2021. There’s some good news in the report, but also some warning shots about our need to refocus on the risks attached to antimicrobial resistance as we move into the Covid endemic.

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COVID-19 and PPE: don’t forget your eyes!

One of the questions I get asked a lot is “where is the evidence that wearing eye protection reduces the risk of exposure to SARS-CoV-2, because it’s really annoying to wear and creates other risks related to reduced vision”. A new systematic review examines the effect of eye protection on reducing healthcare worker exposure to SARS-CoV-2. The short answer is that there is enough evidence to convince me that eye protection should be part of our SARS-CoV-2 PPE ensemble.

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Setting our IPC priorities for the next 3-5 years

In honour of Infection Prevention and Control Week (#IIPW) 2021, I thought I put up a quick post based on a talk I did on Friday last week about the ‘Future of Healthcare and of Infection Prevention and Control’ (you can download my slides here). I used it as an opportunity to put across my strategic priorities for the next 3-5 years. And COVID-19 is bottom of the list – keep reading to find out why…

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Monoclonal antibodies to prevent household transmission of SARS-CoV-2

A remarkable new NEJM study has shown that the prophylactic administration of monoclonal antibodies reduces the risk of household contacts developing symptomatic or asymptomatic infection with SARS-CoV-2. For those who did develop symptomatic infection, monoclonal antibodies reduced to duration of disease and the duration of high viral load. This study opens up the possibility of a new tool to prevent the spread of SARS-CoV-2 to vulnerable patients in our hospitals. Is the future of managing hospital contacts of SARS-CoV-2 the prophylactic administration of monoclonal antibodies?

Visual abstract from the study
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To FFP or not to FFP: variation in national guidelines on respiratory protection during the COVID-19 pandemic

Probably the most contentious aspect of the COVID-19 pandemic has been PPE for staff. And within that, the most contentious aspect of PPE has been respiratory protection when caring for patients with confirmed or suspected COVID-19: to FFP or not to FFP? I have been involved in a review of international guidelines to identify variation and track the changes in the guidelines over time. Things have changed as evidence has emerged, but international guidelines still disagree on where and when FFP respirators should be worn when caring for patients with suspected or confirmed COVID-19. The review also tracked variation and changes in recommendations about what should be considered an AGP.

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Hospital-onset COVID-19 (HOCI): a systematic review

As we get into gear to prepare for the next epidemic wave of COVID-19 affecting healthcare providers (hoping that it will not come), it’s a good time to review where we have got to with the surveillance of healthcare-associated COVID-19. Colleagues at Imperial have just published a systematic review of the latest literature on this important issue. Whilst uncertainties remain about surveillance definitions and exactly what “healthcare-associated COVID-19 infection” is, the message is clear that healthcare-providers must have in place clear and rapid systems for identifying healthcare-associated COVID-19 to prevent the spread of the SARS-CoV-2 virus in healthcare facilities.

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B.1.617.2: an update

PHE released the latest epidemiological summary of the B.1.617.2 VOC (aka “the variant that was first identified in India”) a few days ago. Evidence is emerging rapidly, and the datasets are far from conclusive. But it now seems clear that B.1.617.2 is more transmissible, causes no more hospitalisation or mortality, and vaccine effectiveness is slightly reduced when compared with other variants.

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