• Infect Dis Health · May 2021

    Containment of COVID-19 and reduction in healthcare-associated respiratory viral infections through a multi-tiered infection control strategy.

    • Liang En Wee, Indumathi Venkatachalam, Xiang Ying Jean Sim, Kenneth Boon-Kiat Tan, Ruan Wen, Chee Kian Tham, Wee Hoe Gan, Kwan Ki Karrie Ko, Wan Qi Ho, Grace Teck Cheng Kwek, Edwin Philip Conceicao, Chong Yu Edwin Sng, Xin Hui Jorin Ng, Jie Yi Ong, Juat Lan Chiang, Ying Ying Chua, Moi Lin Ling, Thuan Tong Tan, and Limin Wijaya.
    • Singhealth Infectious Diseases Residency, Singapore; Department of Infectious Diseases, Singapore General Hospital, Singapore. Electronic address: ian.wee@mohh.com.sg.
    • Infect Dis Health. 2021 May 1; 26 (2): 123-131.

    BackgroundDuring the ongoing COVID-19 pandemic, healthcare-associated transmission of respiratory viral infections (RVI) is a concern. To reduce the impact of SARS-CoV-2 and other respiratory viruses on patients and healthcare workers (HCWs) we devised and evaluated a multi-tiered infection control strategy with the goal of preventing nosocomial transmission of SARS-CoV2 and other RVIs across a large healthcare campus.MethodsFrom January-June 2020, a multi-tiered infection control strategy was implemented across a healthcare campus in Singapore, comprising the largest acute tertiary hospital as well as four other subspecialty centres, with more than 10,000 HCWs. Drawing on our institution's experience with an outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003, this strategy included improved patient segregation and distancing, and heightened infection prevention and control (IPC) measures including universal masking. All symptomatic patients were tested for COVID-19 and common RVIs.ResultsA total of 16,162 admissions campus-wide were screened; 7.1% (1155/16,162) tested positive for COVID-19. Less than 5% of COVID-19 cases (39/1155) were initially detected outside of isolation wards in multi-bedded cohorted wards. Improved distancing and enhanced IPC measures successfully mitigated onward spread even amongst COVID-19 cases detected outside of isolation. COVID-19 rates amongst HCWs were kept low (0.13%, 17/13,066) and reflected community acquisition rather than nosocomial spread. Rates of healthcare-associated-RVI amongst inpatients fell to zero and this decrease was sustained even after the lifting of visitor restrictions.ConclusionThis multi-tiered infection control strategies can be implemented at-scale to successfully mitigate healthcare-associated transmission of respiratory viral pathogens.Copyright © 2020 Australasian College for Infection Prevention and Control. Published by Elsevier B.V. All rights reserved.

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