Becker's Clinical Quality & Infection Control

7 INFECTION CONTROL COVID-19 in the short and long term: 3 thoughts from Dr. Peter Hotez By Ashleigh Hollowell A head of the May 11 end of the COVID-19 public health emergency, Peter Hotez, MD, PhD, the dean of the National School of Tropical Medicine at Houston-based Baylor College of Medicine, told the Houston Chronicle April 27 that emerging variants, vaccine uptake and pandemic preparedness are top of mind for him. Here are three takeaways from his interview with the Chronicle. 1.) Emerging variants and subvariants Short-term, public health officials and clinicians must keep in mind the rise of a new variant, XBB.1.16, and the potential for future variants. XBB.1.16 is an omicron subvariant that the World Health Organization dubbed as a "variant of concern" in early April. In other countries, particularly India, XBB.1.16 has become the dominant strain of COVID-19. In the U.S. it has been spotted in several states, but has not replaced the current dominant strain yet. "Near term, we have to recognize that COVID-19 is still with us. XBB.1.5 and the new one, XBB.1.16, are slowly creeping up," Dr. Hotez said. 2.) Vaccine uptake e emergence of new variants and subvariants bring the need for updated vaccines. Americans have been slow to adopt the most recent bivalent vaccine released in September, which concerns Dr. Hotez. Since Americans have been slow to get the booster it's concerning for future iterations of vaccines to protect against other COVID-19 variants. "Only 17 percent of the eligible population has gotten the bivalent booster, which is going to be a problem in encouraging people to get a second," Dr. Hotez said. "e number of Americans accepting a second bivalent booster will be single-digit percentages." e low percentage of uptake could be problematic for future pandemic preparedness efforts. 3.) Pandemic preparedness Another pandemic could be on the horizon, Dr. Hotez noted, which means preparedness efforts should be a priority. "I've said that COVID-19 is the third major coronavirus over the last 20 years, with SARS in 2002 and MERS in 2012. en COVID in 2019. It looks as though every seven or eight years we get a new major coronavirus epidemic or pandemic," Dr. Hotez told the Houston Chronicle. "On that basis, a fourth major coronavirus is around the corner before 2030. We need to think about longer-term pandemic preparedness strategies for the end of this decade." n How this Texas system prevented HAIs from rising amid pandemic By Mackenzie Bean T he Veterans Affairs North Texas Health Care System in Dallas prevented healthcare-associated infection rates from rising during the pandemic — and reduced burnout among infection prevention and control team members — through a 14-month initiative, according to a study published April 26 in the American Journal of Infection Control. The findings suggest that proactive investment in preparedness initiatives can help health systems improve safety and maintain infection prevention work during infectious disease outbreaks. The serious infectious threat response initiative, first developed in 2015, outlines special processes for communication and care of patients presenting with emerging pathogens. In 2020, the health system's infection prevention team tailored the initiative in response to the pandemic. Efforts included launching COVID-19 surveillance, exposure management and a 24/7 call service staffed by infection preventionists and a hospital epidemiologist. "During the early months of the COVID-19 pandemic, healthcare facilities lacked essential infection prevention resources and information, and staff anxiety was incredibly high," study author Madhuri Sopirala, MD, director of infection prevention and control at the VA North Texas Health Care System, said in an April 27 news release."Our evaluation shows that the [system's] SITRI provided support and services that contributed meaningfully to patient safety and staff well-being during this time." Compared to 2019, staff members reported lower levels of exhaustion and reduced achievement in 2020 and 2021. Rates of central line-associated bloodstream infections, catheter-associated urinary tract infections, methicillin- resistant Staphylococcus aureus and Clostridioides difficile infections also decreased or stayed the same in the health system's acute care and long-term care settings. The initiative ran from March 2020 to May 2021 and cost the system about $360,000 in overtime pay for infection prevention and control staff who oversaw the 24/7 support line. n

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