One of the most important pieces of infection prevention is working with bed placement - we try to avoid shared rooms, but in emergent situations/overflow, the focus becomes on avoiding transmission of any infectious diseases (1/n)
For patients w/an ID, we try to pair like w/like - flu w/flu, MRSA w/MRSA, *if necessary*. Same with COVID. The assumption is never “they’re six feet apart, so we can mix it up” - we know patients may pass each other, move around, are in the room unmasked for a while, etc. (2/n)
Despite efforts to screen patients w/out infection for COVID-19 during the pandemic, it was still possible for some one to be incubating during hospitalization (but test neg on admission screening). This is the reality of an imperfect situation during a pandemic (3/n)
Bed placement is hard (shout out to my house supervisors!) but ultimately double-bunking patients is what we tried to avoid during surges. It was actually easier in COVID units but we still had to be mindful of secondary infections (MRSA, CRE, etc.) (4/n).
I share this because often people think that there’s an assumption the privacy curtain contains it all - we know it doesn’t - *that’s* why we avoid 2 patients in a room or at least do our damned best to try and screen/rule out infections that could put others at risk. (5/n)
Ultimately, this emphasizes the need to have better hospital surge capacity to avoid double-bunking. We saw this pose a huge issue for MERS transmission in South Korean hospitals in 2015. This is a risk outside of COVID and should be seen as an opportunity for improvement (6/6)
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