HIS webinar on challenges and solutions related to IPC for COVID-19

The Healthcare Infection Society has put out a rather innovative interactive webinar on some challenges and solutions related to IPC for COVID-19. The webinar was an expert panel Q&A format, and worked really well.

The panel was chaired by Prof Hilary Humphreys (a consultant microbiologist) and included Cariad Evans (consultant virologist), Peter Hoffman (consultant clinical scientist), Martin Kiernan (infection control nurse – and fellow blogger!), and Chris Settle (consultant microbiologist).

Here’s the webinar, with some of my notes below.

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There’s more to IPC & AMS than COVID-19

As parts of the world begin to contemplate life on the other side of this pandemic, it’s time to address that niggle in the back of our minds as our attention has been focussed on COVID-19: what’s been happening with those other HCAI and AMR issues that usually occupy our days (and nights)? This helpful opinion piece in ICHE discusses the impact of COVID-19 on our usual HCAI & AMR practice.

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Explore the spread of COVID-19

A quick blog to flag a truly brilliant piece of interactive applied epidemiology. This lovely little calculator allows you to play around with the visualisation of country temporal trends in confirmed cases, reported deaths, and recovered cases.

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COVID-19: Learning rapidly from an overwhelmed healthcare system in Bergamo, Italy

A very sobering piece published in NEJM Catalyst Innovations in Care Delivery (a new digital journal in the NEJM group) describes a catastrophic situation in a hospital in Bergamo, Italy, which has been overrun by COVID-19. We all have much to learn from this experience: about pandemic preparedness, response, and the key role of IPC at all stages of this pandemic.

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COVID-19 – visualising the impact of social distancing

As we move through the gears of the response to the COVID-19 pandemic, the UK has entered lockdown – total social distancing. I’ve had many conversations with friends and family about what’s going on and why these extreme measures are necessary. I’ve pointed everybody who’s asked to the Imperial College London modelling, predicting a rapidly overwhelmed healthcare system if the trajectory of the UK epidemic doesn’t change. And pointed them in the direction of these rather cool visualisations of the logic behind social distancing (by cartoonist Toby Morris and microbiologist Siouxsie Wiles):

social distancing impact

COVID-19 and Q-fever: random observation or something to evaluate?

“The course of an epidemic is defined by a series of key factors, some of which are poorly understood at present for COVID-19” (Roy Anderson Lancet, March 9th)

While several of the factors are obvious and come to mind immediately, others, might at this point be speculation or indiscriminate observations that need further scientific evaluation.

One of the latter category, might be the observation I would like to share in this post. One of the regions of the Netherlands that presently has one of the highest COVID-19 rates, is a region in the South of the country. To our knowledge there is only one thing unusual about that region; About ten years ago, the region was in the midst of the Dutch Q-fever epidemic. Could one of those key factors that we don’t understand and that may lead to area’s with exceptional high rates of COVID-19 be previous infectious diseases such as Q-fever, or more general a higher prevalence of previous long damage, due to infectious diseases? 

Have a look at the graphs and please share your thoughts.

With thanks to my colleague Bert Mulder, Nijmegen

COVID-19 and a lack of PPEs

Schermafbeelding 2020-03-20 om 15.27.13.png

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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COVID-19: hello social distancing

The UK government yesterday announced a far-reaching package of social distancing measures to suppress the spread of COVID-19. These are based on some Imperial College London modelling work, published here. The model predicts that the UK approach to mitigate the impact of the UK epidemic would indeed reduce the overall number of people affected and those who die, but would still leave hundreds of thousands dead in an overwhelmed healthcare system. In contrast, a more intensive suppression approach would be effective in reversing the epidemic trend and keep the number of new cases to a low level – in the short term, at least.

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Considering the role of environmental contamination in the spread of COVID-19

We know that respiratory viruses can be spread through droplets, occasionally aerosols, and contact routes (see Figure 1). But what is the relative importance of these transmission routes for the SARS-CoV-2 virus, which causes COVID-19? A new pre-print paper published yesterday provides evidence that the stability of the SARS-CoV-2 coronavirus is broadly comparable to the ‘original’ SARS coronavirus (SARS-CoV-1) on dry surfaces and in aerosols. This paper supports an important role for dry surface contamination and aerosols in the spread of SARS-CoV-2, and suggests that improved environmental persistence isn’t the key to the relative success of SARS-CoV-2 over SARS-CoV-1.

Figure 1: Transmission routes of respiratory viruses (from this review article).

covid transmission routes

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