Becker's Clinical Quality & Infection Control

12 INFECTION CONTROL States failing to comply with federal guidelines to report probable coronavirus cases By Anuja Vaidya N early half of U.S. states were going against federal guidelines in early June by not reporting probable coro- navirus cases and deaths, which may have misconstrued the full scale of the virus's spread, experts told e Washington Post. The CDC and Council of State and Ter- ritorial Epidemiologists work together to issue guidelines on tracking diseases in the U.S. In April, the organizations recom- mended states count probable cases and deaths related to the coronavirus along with laboratory-confirmed cases and deaths. Probable cases and deaths include instances where symptoms and exposure indicate coronavirus infection but was not confirmed by testing. A review conducted by the Post found at least 24 states were not reporting probable coronavirus cases and deaths, including California, Florida and New York. Some states said they were collecting the information but not reporting it public- ly. New Jersey officials said the state is reporting probable coronavirus cases and deaths to the CDC but is not disclosing those numbers on its website. Officials in Montana, Rhode Island and the District of Columbia said they haven't re- ported any probable cases or deaths because there have not been any, "citing low numbers or the wide availability of testing," the Post reported. South Dakota officials said the state reports probable deaths but not cases. Other states are reporting probable cases, but they are not distinguishing between probable cases and confirmed ones. Part of the problem is that the public is re- questing daily updates on the situation from state agencies that are underfunded using sys- tems that are outdated, the Post reported. n Direct COVID-19 patient care may not be main source of healthcare worker infections, 2 studies suggest By Anuja Vaidya W orking closely with COVID-19 patients may not be the prima- ry cause of infection among healthcare workers, two studies from China and the Netherlands found. The first study included data on 9,684 healthcare workers in Wuhan, China, collected from Jan. 1 to Feb. 9. Of that group, 110 were diag- nosed with COVID-19. Researchers found that the infection rate was 0.5 percent among healthcare workers providing direct care to pa- tients with confirmed or suspected COVID-19 and 1.6 percent among healthcare workers in other clinical departments. Researchers also found that nurses younger than 45 not directly caring for patients with COVID-19 were more likely to be infected, compared to physicians 45 and older working directly with those patients. The second study examined 9,705 healthcare workers in two hospitals in the Netherlands during March. About 14 percent — 1,353 workers — reported fever or respiratory symptoms and were tested, of which 86 had COVID-19. Only about 3 percent of the healthcare workers with COVID-19 reported having been exposed to a hospital patient diag- nosed with the disease. Researchers concluded that the workers likely acquired the virus in the community during the early phase of the virus spreading locally. Both studies were published in JAMA Network Open. n Recovered COVID-19 patients who retest positive aren't infectious, study finds By Anuja Vaidya P atients who recover from COVID-19 and then retest positive are not infec- tious and cannot transmit the virus, according to research cited by Bloomberg. Health officials in South Korea studied 285 COVID-19 patients who recovered and later tested positive for the virus. Virus samples collected from the patients could not be grown from culture, which suggests that the patients were shedding non-infectious or dead virus, Bloomberg reported. The study was conducted by the Korean CDC, and its results will change proto- cols in the country. Korean officials will no longer require recovered patients to test negative for the virus before leaving isolation and returning to public spaces, according to the report. n

• Cover