A helpful new study has combined shoe-leather epi and WGS to establish a transmission rate of CPE in hospitalised patients. Overall, 3 (2%) of 152 exposed patients ended up colonised with the same CPE from 47 index patient exposures. None of the 54 exposed staff ended up colonised with CPE. This transmission rate is a bit lower than I would have expected, but it’s also not zero!
Continue readingepidemiology
Omicron COVID-19 harm and winter IPC strategy
We have just published an evaluation of Omicron COVID-19 harm as a research letter in the Journal of Infection. This multicentre study reported the findings of a retrospective review of 129 patients with healthcare-associated Omicron COVID-19, and found that the harm profile was very different to previous waves: a small proportion of patients required supplemental oxygen, escalation to critical care, had an extended length of stay, or died from COVID-19. This informs our winter IPC strategy: whilst COVID-19 is more than “just a cold”, the balance between direct and indirect harms from COVID-19 has shifted towards preventing indirect harms (like reduced hospital throughput and delayed diagnosis) and more of a focus on other issues (e.g. flu, Gram-negative BSIs etc).
Continue readingImproving environmental hygiene reduces HCAI: but which monitoring method is most effective?
A superb cluster randomised trial has just been published in Clinical Infectious Diseases testing whether improved environmental hygiene via objective monitoring and feedback reduces HCAI. The study also tests whether ATP or UV fluorescent marker monitoring is more effective. The findings reinforce that improving environmental hygiene reduces HCAI, and (I think surprisingly) suggest that ATP is more effective than UV monitoring.
Continue readingDo stand-alone air disinfection units reduce HCAI?
Wow, it’s been ages since I’ve posted – sorry about that. I’m blaming the Omicron wave and my own personal dose of COVID-19 recently (you can see my reflections about that on Twitter…)
And so to today’s blog. Lots of interest in air disinfection systems. And some important research articles coming through. This one in JHI caught my attention, because there’s a suggestion of a link between improved air hygiene and reduced HCAI. However, I am unconvinced (from this study) that this link has been demonstrated – so a key opportunity for applied research!
Continue readingOmicron: things are moving quickly and looking better…but we’re not there yet
My last post on Omicron was on 22/12/2021, 15 days ago, which seems like a lifetime ago! Back then, there was a great deal of uncertainty about how Omicron would manifest clinically, and how this would translate into hospitalisations and deaths. We now known more, but there is still considerable uncertainty. The latest technical briefing from UKHSA provides additional epidemiological updates. And the latest ONS study on prevalence in the UK gives us some eye-watering figures: in the week ending 31/12/2021, 1 in 25 people in England were infected with COVID-19, and 1 in 15 people in London. There’s a lot of it about. Overall, the outlook is looking better, but it’s going to be a very bumpy ride for those working in healthcare over the next month or so.
Continue readingWhat is the evidence for droplet transmission for SARS-CoV-2?
A guest post from Dr Evonne Curran…
The disputed airborne mode of transmission in this pandemic requires further scrutiny. Researchers have thus far focused on presenting a case for airborne transmission1 rather than disputing that the ‘primary’ mode of transmission for SARS-CoV-2 is via droplets2.
Continue readingOmicron: buckle up for a bumpy ride
I’ve been meaning to write an update on the Omicron variant of concern for a few weeks’ now and it’s now or never, so here we go! The Omicron variant has a host of mutations compared with previous variants, which seems to have given it the ability to spread much more rapidly. This may well be due in part to the ability to side-step antibody mediated immunity obtained through previous infection and vaccination. Omicron is spreading rapidly in the community. We don’t yet know what impact the current rapid community spread will have on hospitalisations and ultimately deaths, so time will tell.
Continue readingB.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.
Continue readingThe Indian variant…
As you may have heard, there’s a new SARS-CoV-2 variant of concern (VOC) on the block. So what do we know about this new variant? And how much of a threat does it pose to the pre-COVID freedom that we can see on the near horizon?
Continue readingThe role of ventilation in preventing the transmission of SARS-CoV-2
I gave a talk at the Sussex Infection Prevention Development Week yesterday on ventilation and preventing the spread of SARS-CoV-2. I learnt a lot in putting together the talk, so thought I’d share my slides (here) and some of the key points. Ventilation is a crucial way to prevent the spread of SARS-CoV-2 (and other respiratory viruses), and I hope that improved ventilation in health and social care settings will be one of the good things to come out of this pandemic.
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Reflections on Infection Prevention and Control 