By Andreas Voss, Jan Kluytmans and Alexander Friedrich

As the surge of COVID-19 cases is hitting some of the Dutch hospitals hard, healthcare, in the areas being overwhelmed with cases, experience a shortage of PPEs and especially masks. In other Dutch regions with no or only a few cases, colleagues still believe that life is normal and PPEs can be ordered with a click on the computer. They look with awe at what colleagues in the midst of battling COVID-19 and shortages are facing. In addition, all healthcare-settings that do not usually use a lot of PPE’s (e.g. nursing homes and GPs), will be heavily understocked.

Still, infection control advice seems to be based on standard, safety-maximized procedures, thereby wasting valuable resources. As a consequence, HCWs in the Netherlands are still following these recommendations, by using FFP masks routinely, in low risk situations, while they should be saved for the high-risk procedures.

We believe that it is time to rethink our protocols, based on the fact that we still assume that COVID-19, in general, is based on droplet and contact transmission.

1. Restricted and risk-based use of FFP masks
2. Use of surgical masks for normal care of COVID patients
3. Efficient and extended use of FFP masks and other PPEs
4. Re-use of FFP masks

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Interesting results from Jabeen et al. that many of us might have missed, as they are published in a mycology journal and not in an infection control journal.  Persistence of Candida spp. on latex and nitrile gloves was highest for C. auris and C. parapsilosis.  Interestingly, persistence on nitril gloves was generally less than on latex gloves. Transmission of Candida spp. from gloves (latex, nitril not tested)  to urinary catheter surface was most effective for C. auris and C. albicans.

To be frank, the chosen methods and set-up of the experiments leave quite some room for improvement, but the basic idea of the experiment and the message it conveys are – while not new – of importance: Glove use can be an important factor in the spread of all microorganisms, and in this case, especially C. auris.

Previously it has been shown that glove-use may negatively effect hand hygiene behavior. After years of focusing our attention on hand hygiene compliance and hand-rub technique, this publication is an important reminder, to not forget about adequate glove-use.

Jabeen K, Mal PB, Tharwani A,Hashmi M, Farooqi J. Persistence of Candida auris on latex and nitrile gloves with transmission to sterile urinary catheters.  Medical Mycology, 2019, 0, 1–5 doi: 10.1093/mmy/myz033 Advance Access Publication Date: 0 2019

Compared with the general population, healthcare workers (HCWs) have an increased risk of being exposed to respiratory pathogens including flu, causing a potential threat for their own health and their patients’ safety.  At present, the problem of HCW vaccination seems to get the main attention when dealing with influenza prevention, whereas the problem of HCWswho work while feeling sick, seems to be far less addressed.  That is, until recently when Chow et al. studied hospital-acquired respiratory viral infections, sick leave policy, and a need for culture change.

The ISAC Infection Control Study group had already piloted a survey on the topic and wishes to poll your thoughts with the present survey.

While there is nothing to earn, except of the good feeling of having helped someone, we kindly ask you to take the questionnaire (takes 4-5 minutes) and send it to others, including friends or family not in healthcare, as we are especially interested in possible differences.

Link for the survey: https://www.surveymonkey.com/r/ISAC_Influenza

Thanks for helping and of course results will be back on this blog.