Becker's Clinical Quality & Infection Control

7 INFECTION CONTROL Nurses station interactions may play role in hospital COVID-19 outbreaks By Mackenzie Bean H ospital-associated COVID-19 infections may stem from airborne virus spread among employees and patients in hospital common areas, such as nurses stations, according to a study published June 8 in JAMA Network Open. Researchers collected 510 air samples from various clinical areas of West Rox- bury VA Medical Center in Boston during a COVID-19 outbreak that infected 19 patients and staff members between Dec. 27, 2020, and Jan. 8, 2021. Researchers found genetically identical viral fragments in aerosols collected from nurses stations and in samples from patients or staff infected during the outbreak, "suggesting that aerosols may have contributed to hospital trans- mission," they said. Based on the temporal sequence of transmission, researchers said a symp- tomatic nurse may have introduced the virus in the affected hospital unit, which then spread to other nurses and patients. "Surveillance, along with ventilation, masking and distancing, may reduce the introduction of community-acquired SARS-CoV-2 into aerosols on hos- pital wards, thereby reducing the risk of hospital transmission," research- ers concluded. n HHS won't disclose hospitals where patients contracted COVID-19 By Molly Gamble T he Biden administration will not release data on COVID-19 transmission in individual hospitals, citing "privacy concerns," Politico reported June 25. The move is supported by the American Hospital Association, which supports the reporting of COVID-19 transmission in hospitals in aggregate versus at an individual level. "Reporting aggregate data is the most appropriate approach given the very low occurrence of hospital onset COVID-19," Nancy Foster, vice president of quality and patient safety for the AHA, told Politico in a statement. Patient advocates oppose keeping individual hospital data private, including Matthew Cortland, an immunocompromised disability rights activist. "A majority of voters want HHS to level with us – tell us how much coronavirus is spreading in the particular hospital we go to," Mr. Cortland told Politico. "But that transparency is inconvenient for the powerful hospital lobby." Health officials have debated the merits of identifying hospitals' infections since the Trump administration began collecting the information in 2020, three current and former officials told Politico. The counts are made up of patients who test positive after at least 14 days in the hospital, which ensures patients didn't contract COVID-19 before admission. The counts are likely undercounts because hospitals don't report people who test positive after being discharged. n outset. We need to stay especially humble at the outset of an outbreak, especially if it is with a novel pathogen. at new pathogen may not follow the patterns of previous infectious disease outbreaks. e COVID-19 pandemic and the new monkeypox outbreak have proven that we are more closely interrelated than ever be- fore in human history. Diseases that were previously in one country or continent can now easily spread around the world. To be better prepared for the next unusual and emerging infectious diseases, we need to make it easier for primary care clinics and hospitals to detect these illnesses rather than centralizing diagnostics at a small number of specialized labs with difficult patient access. Additionally, we must continue to invest in research of infectious diseases and expand our capability for treatment and preven- tion of these emerging infections with vaccines and therapeutic agents. And we must carefully consider and prepare for the unintended consequences that disease miti- gation strategies may have on the economy, education, patient care and mental health. Colleen Kra, MD. Associate CMO at Emory University Hospital (Atlanta): At Emory Healthcare, we have been think- ing about preparation and response to pandemics and healthcare employee safety since 2002. Our multidisciplinary teams within Emory's Serious Communicable Diseases Unit/Program based at Emory University Hospital can rapidly mobilize and access a multitude of resources, which can extend to the rest of our system when needed. With every surge during the pandemic thus far, having that bedrock has helped us in clinical decision-making and healthcare worker support. ere are several manuscripts published about Emory's close involvement with the National Emerging Special Pathogens Training and Education Center, which was established in 2015 to prepare and care for patients with Ebola virus disease and other special pathogens in the United States. Emory Healthcare is one of 10 Regional Emerging Special Pathogen Treatment Cen- ters, which undertook readiness activities that enabled them to play a pivotal role in the nation's COVID-19 pandemic response. A second paper illustrates the value of bio- containment units in the current pandemic and their potential role in preparing health- care facilities and health systems for future infectious disease threats. n

• Cover