Preventive Measures Detain Nosocomial Coronavirus Transmission

Meticulous application of best practices for infection control can help protect healthcare workers from coronavirus disease (COVID-19), according to a new study.

The study, conducted at Queen Mary Hospital (QMH; Hong Kong, China) and the University of Hong Kong (HKU, China), reviewed infection control preparedness for COVID-19 in the first 42 days after announcement of a cluster of pneumonia in China, on December 31, 2019, (day 1) in Hong Kong. The 43 public hospitals tightened their infection control protocol. Any patient who screened positive was placed in an isolation room designed to prevent airborne infections. Hospital staff was trained on the use of personal protective equipment (PPE), meetings were held to discuss infection control, and handwashing measures were tracked regularly.

Additional measures undertaken included active and enhanced laboratory surveillance, early airborne infection isolation, rapid molecular diagnostic testing, and contact tracing for healthcare workers with unprotected exposure in the 43 hospitals. Epidemiological characteristics of confirmed cases, as well as environmental and air samples, were collected and analyzed. The results revealed that from day 1 to day 42, forty-two of 1,275 patients were confirmed with COVID-19 infection. Among these, only one of 13 confirmed cases in the first six weeks was locally acquired.

In the next 29 cases, 27 were locally acquired, and most belonged to one of eight family clusters. Of these, 11 were probably caught during a single gathering for sharing food--called “hot pot”-where the attendees used spoons or other utensils possibly contaminated with saliva to dip into serving pots. In all, 413 healthcare workers treated these cases; 11 were exposed without proper or adequate protection, and were placed on 14-day quarantine. None of the healthcare workers were infected, and nosocomial transmission was not observed. The study was published on March 5th, 2020, in Infection Control & Hospital Epidemiology.

“Appropriate hospital infection control measures can prevent healthcare-associated transmission of the coronavirus,” concluded lead author Vincent Cheng, PhD, of the QMH department of microbiology, and colleagues. “Vigilance in hand-hygiene practice, wearing surgical masks in the hospital, and appropriate use of personal protective equipment in patient care, especially when performing aerosol-generating procedures, are the key infection control measures to prevent hospital transmission of the virus.”

The newly discovered coronavirus emerging from Wuhan City, in Hubei Province (China), belongs to a family of viruses that include Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Additional cases have been identified in a growing number of countries, including the United States. Many of the initial patients in the outbreak in Wuhan reportedly had some link to a large seafood and animal market, suggesting animal-to-person spread. The outbreak is escalating quickly, with over 120,000 confirmed 2019-nCoV cases reported globally.

Related Links:
Queen Mary Hospital
University of Hong Kong