Becker's Clinical Quality & Infection Control

6 INFECTION CONTROL Why COVID-19 may complicate fight against antibiotic resistance By Mackenzie Bean M any medical leaders have report- ed widespread antibiotic use for COVID-19 patients at their hospi- tals, which may contribute to rising rates of antibiotic resistance, according to the Uni- versity of Minnesota's Center for Infectious Disease Research and Policy in Minneapolis. Even though COVID-19 is caused by a virus, some clinicians resorted to using antibiotics due to clinical uncertainty and the risk of secondary bacterial infections among seri- ously ill patients. "I think, undoubtedly, we've seen more anti- biotic use, because sometimes clinicians are unsure … and there really are no effective treatments for COVID-19," Anurag Malani, MD, director of the infection prevention and antimicrobial stewardship programs at Ann Arbor, Mich.-based Saint Joseph Mercy Health System, told the website for the Center for Infectious Disease Research and Policy. COVID-19 testing delays also contributed to higher antibiotic use early in the pan- demic. Instead of waiting several days for test results, many clinicians gave antibi- otics to patients with symptoms of severe community-acquired pneumonia in case it was bacterial, according to Valerie Vaughn, MD, a hospitalist at Ann Arbor-based Michigan Medicine. When the pandemic begins to slow, hos- pitals in hard-hit states like Michigan and New York will have more time to review clinical data on COVID-19 patients. ey should look at how many patients received antibiotics and, of those, how many got a secondary infection, according to Debbie Goff, PharmD, a pharmacist who special- izes in antibiotic stewardship at e Ohio State University Wexner Medical Center in Columbus. From there, hospitals should identify the factors that put COVID-19 patients at risk of infection to promote more targeted antibiotic use, Dr. Goff said. n WHO official clarifies comments on asymptomatic spread of COVID-19 By Anuja Vaidya A top World Health Organization official backpedaled on comments she made that COVID-19 transmission by infected but asymptomatic people is "very rare," The New York Times reported. On June 8, Maria Van Kerkhove, PhD, head of the WHO's emerging diseas- es and zoonosis unit, said that although a person with COVID-19 who is not showing symptoms can spread the virus, "it still seems to be rare." Dr. Van Kerkhove confirmed June 9 that the comments were based on two or three studies and saying that transmission of the virus by asymptomatic individuals worldwide is rare is a "misunderstanding." She further clarified that the estimates of asymptomatic transmission came from models, which do not provide an accurate picture of the spread of the virus. Scientists and health experts were quick to call out the comments as con- fusing and even "irresponsible." Scientists also criticized the comments in light of the fact that they may have policy implications, as many countries have implemented rules around wearing masks and social distancing due to the risk of asymptomatic or pre-symptomatic spread. Dr. Van Kerkhove and WHO officials reiterated the importance of social distancing, along with other measures, such as testing, tracing, quarantine and isolation, to help curb the pandemic, the Times reported. n 71% of Americans would likely get COVID-19 vaccine, survey finds By Mackenzie Bean N early three-fourths of Americans said they would get vaccinated against COVID-19, according to a Washington Post-ABC News poll. The survey includes responses from a national sample of 1,001 U.S. adults collected via phone from May 25-28. Four survey findings: 1. Forty-three percent of respondents said they would definitely get a COVID-19 vaccine, while 28 percent said they probably would. 2. Fifty-seven percent of respondents said it was more important to control the pandemic's spread, even if it hurts the economy. 3. In contrast, 37 percent said it was more important to restart the economy, even if it hurts pandemic response efforts. 4. Sixty-eight percent of respondents said they were somewhat or very worried about a second COVID-19 wave this fall. 5. Forty-two percent said they personally knew someone diagnosed with COVID-19, up 11 percent from late March. n

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