Becker's Clinical Quality & Infection Control

15 INFECTION CONTROL Animals most likely source of COVID-19, WHO report shows By Erica Carbajal T he virus that causes COVID-19 likely jumped from bats to humans via another animal, according to a 123-page report from the World Health Organization released March 30, The New York Times reported. The origins report outlines several possible scenarios as to how the SARS- CoV-2 virus spread to humans. A scenario in which the virus spread directly from bats to humans is unlikely because the coronavirus seen in bats is evolu- tionarily distant from the one in humans, according to the report obtained by the Times and first reported by the Associated Press. The theory of the virus accidentally escaping from a Chinese laboratory is "ex- tremely unlikely," the research team said in the report. Some critics say Chinese officials, including scientists affiliated with the gov- ernment, had too much oversight on the WHO's investigation, according to the Times. The report was also repeatedly delayed as Chinese officials tried to postpone a WHO team's visit to China investigate the virus's origin, which has stirred concerns over transparency. These concerns prompted a small group of scientists in early March to call for a separate inquiry into the COVID-19 pandemic's origin — one that doesn't rule out the possibility that the virus accidentally escaped from a laboratory in the Chinese city of Wuhan, or from someone who became infected in the lab, according to the Times. Still, the WHO team has maintained the report is independent. n Harlem Hospital and vaccine hesitancy in Black communities: 6 takeaways for hospital leaders By Gabrielle Masson A bout half of eligible staff at New York City-based Harlem Hospital had received a COVID-19 vaccine as of March 24, reflecting wariness in the Black community and prompting conver- sations about how leaders can acknowledge these fears while still encouraging vaccina- tion, reported e New York Times. Harlem Hospital, also branded as NYC Health + Hospitals/Harlem, is known for providing healthcare to the Black commu- nity and had the lowest staff COVID-19 vaccination rate among New York City hospitals at one point. As of mid-March, the hospital had a 51 percent staff vaccina- tion rate, putting it in the middle of the 11 hospitals in the city's public system. Vaccine hesitancy at Harlem Hospital, where a majority of the staff is Black, reflects broader trends across the nation, administrators said. Six key takeaways for hospital leaders, per the Times: 1. At Harlem Hospital and across the U.S., confidence in COVID-19 vaccines is rising among Black Americans. Though initially more skeptical, Black Americans are now about as willing to get vaccinated as their white counterparts, and politics is emerging as a greater determinant of willingness, according to polls conducted in late February. 2. Harlem Hospital's low vaccination rate wasn't surprising to leaders. A poll in late 2020 showed that only 30 percent of hospi- tal employees were willing to be vaccinated, said Eboné Carrington, the hospital's CEO. Black staff cited concern tied to the legacy of medical injustices and general skepti- cism about the vaccine's quick development under a presidential administration they didn't trust. "e staff reflects a population of people who traditionally are reluctant to vaccinate, and not just hesitant, but right- fully fearful, at having been wronged," Ms. Carrington said. 3. Mitchell Katz, MD, president and CEO of NYC Health + Hospitals, noted the lack of long-term studies about the vaccines, along with the negative experiences many Black and brown Americans have had with healthcare providers. Dr. Katz said he was going to be patient and focus on personal outreach, such as one-on-one conversa- tions, to boost vaccination rates. 4. "I think that the history of medical experimentation on Black people plays a role in some of the decision-making," said Keisha Wisdom, BSN, RN, nursing chief at Harlem Hospital. "It is real, and it is some- thing we have to talk about. And then find a way to continue that dialogue." 5. Some nurses said they didn't feel an urgency to get the vaccine because they already had COVID-19, Ms. Wisdom said, adding that some staff felt more secure now that there weren't personal protective equip- ment shortages. 6. Jasmine Travers, PhD, RN, assistant professor at the Rory Meyers College of Nursing at New York University, said that empathizing with staff reluctance is good, but not enough. "We should not just chalk up a refusal to that person's own wishes; we also need to look into ourselves and understand how we are ap- proaching it. We can't tiptoe around the subject," Dr. Travers said. "It's one thing to want to be respectful, but we have to interrogate people around how we can better support them. What is the work that needs to be done?" n

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