Since infection seems to be spreading within healthcare facilities in Melbourne, I'd like to highlight some work I did with colleagues in Boston about cohorting of patients.
There are repeated incidents worldwide where of healthcare facilities amplified infection
There are repeated incidents worldwide where of healthcare facilities amplified infection
To stop this, first the low hanging fruit:
You want to first, keep known COVID-19 patients separate from other patients.
You also want their healthcare workers (HCWs) to not interact with other patients or other HCWs
You want to first, keep known COVID-19 patients separate from other patients.
You also want their healthcare workers (HCWs) to not interact with other patients or other HCWs
So designating specific hospitals, or floors within a hospital for COVID-19 is important.
Next, you need to realize that introductions will happen, so you want to restrict transmission within the hospital.
Thus - masks (including patients) and all sorts of infection control measures are really important.
Thus - masks (including patients) and all sorts of infection control measures are really important.
But you still need to contain the size of the outbreaks that might happen. It's much easier to control if you confine it to one floor or some small unit.
How do you do that? You divide your non-COVID cohort into smaller subcohorts.
How do you do that? You divide your non-COVID cohort into smaller subcohorts.
We found that this can have a significant impact on the number of infections within a facility.
Here's the link: medrxiv.org/content/10.110…
Here's the link: medrxiv.org/content/10.110…
An extra comment -
in this pandemic, Italy saw China and thought, "we're different". UK/US saw Italy and thought "we're different". Within the US, many states saw New York and thought "we're different".
We actually aren't.
in this pandemic, Italy saw China and thought, "we're different". UK/US saw Italy and thought "we're different". Within the US, many states saw New York and thought "we're different".
We actually aren't.
Much of the death caused by this pandemic has resulted from transmission within healthcare facilities, skilled nursing facilities, and long-term care facilities.
Keeping infection out helps, but there need to be robust plans for when that fails.
Keeping infection out helps, but there need to be robust plans for when that fails.
And, I'm sure there are plans.
But since so many places got this wrong on the first pass, I want to encourage decision-makers to revisit every detail, and communicate to the people enacting those plans understand.
This can have a major impact on deaths.
But since so many places got this wrong on the first pass, I want to encourage decision-makers to revisit every detail, and communicate to the people enacting those plans understand.
This can have a major impact on deaths.
