Language is such a small thing when terms are clearly defined and I accept that ‘physical distancing’ and ‘social distancing’ are synonymous. However, the aim in my view is to remain socially connected whilst physically distancing, so that’s why I’m using physical distancing instead of social distancing.
The second in the series of excellent Healthcare Infection Society (HIS) interactive audience-led webinars went out a few weeks ago. The theme for this was hospital-onset and hospital-acquired COVID-19 infections, and here’s the video.
As we begin to look to the other side of the peak of COVID-19, this issue of more widespread testing of patients, staff (and indeed the general population) for infection with the SARS-CoV-2 virus whether or not they have symptoms is looming large. We need to think carefully about the risk of false positives when interpreting the meaning of a positive PCR test in a group of people with a low prevalence of SARS-CoV-2.
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.
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.
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.
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):
“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
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.
- Restricted and risk-based use of FFP masks
- Use of surgical masks for normal care of COVID patients
- Efficient and extended use of FFP masks and other PPEs
- Re-use of FFP masks