Containing COVID-19 outside the isolation ward: The impact of an infection control bundle on environmental contamination and transmission in a cohorted general ward - 26/08/20
, Xiang Ying Jean Sim, MRCP b, c, Edwin Philip Conceicao c, May Kyawt Aung, MPH c, Kwee Yuen Tan, BSN, RN c, Kwan Ki Karrie Ko, FRCPath d, e, Hei Man Wong, MRCP b, c, Limin Wijaya, MRCP b, Ban Hock Tan, MRCP b, Indumathi Venkatachalam, FRACP b, c, Moi Lin Ling, FRCPA c
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Highlights |
• | Cases of COVID-19 may be housed outside isolation wards prior to detection. |
• | A bundle of infrastructural enhancements, improved PPE, and social distancing was implemented. |
• | Of 253 staff close-contacts and 45 patient close-contacts of 28 index cases, 1 patient contact tested positive. |
• | Environmental sampling was positive for SARS-CoV-2 in 5 out of 28 cases. |
• | An infection control bundle mitigated COVID-19 transmission in a general ward setting. |
Résumé |
Background |
During an ongoing outbreak of COVID-19, unsuspected cases may be housed outside of dedicated isolation wards.
Aim |
At a Singaporean tertiary hospital, individuals with clinical syndromes compatible with COVID-19 but no epidemiologic risk were placed in cohorted general wards for COVID-19 testing. To mitigate risk, an infection control bundle was implemented comprising infrastructural enhancements, improved personal protective equipment, and social distancing. We assessed the impact on environmental contamination and transmission.
Methods |
Upon detection of a case of COVID-19 in the dedicated general ward, patients and health care workers (HCWs) contacts were identified. All patient and staff close-contacts were placed on 14-day phone surveillance and followed up for 28 days; symptomatic contacts were tested. Environmental samples were also obtained.
Findings |
Over a 3-month period, 28 unsuspected cases of COVID-19 were contained in the dedicated general ward. In 5 of the 28 cases, sampling of the patient's environment yielded SARS-CoV-2; index cases who required supplemental oxygen had higher odds of environmental contamination (P = .01). A total of 253 staff close-contacts and 45 patient close-contacts were identified; only 3 HCWs (1.2%, 3/253) required quarantine. On 28-day follow-up, no patient-to-HCW transmission was documented; only 1 symptomatic patient close-contact tested positive.
Conclusions |
Our institution successfully implemented an intervention bundle to mitigate COVID-19 transmission in a multibedded cohorted general ward setting.
Le texte complet de cet article est disponible en PDF.Key Words : Containment, Coronavirus, SARS-CoV-2, Cohort, Nosocomial, Open ward
Abbreviations : AIIR, AGP, ARD, COVID-19, CT, HCW, IPE, IW, PCR, PPE, RSW
Plan
| Conflict of interest: None to report. |
Vol 48 - N° 9
P. 1056-1061 - septembre 2020 Retour au numéro
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