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Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis.
Infect Control Hosp Epidemiol. 2020 10; 41(10):1196-1206.IC

Abstract

OBJECTIVE

In the current absence of a vaccine for COVID-19, public health responses aim to break the chain of infection by focusing on the mode of transmission. We reviewed the current evidence on the transmission dynamics and on pathogenic and clinical features of COVID-19 to critically identify any gaps in the current infection prevention and control (IPC) guidelines.

METHODS

In this study, we reviewed global COVID-19 IPC guidelines by organizations such as the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control (ECDC). Guidelines from 2 high-income countries (Australia and United Kingdom) and from 1 middle-income country (China) were also reviewed. We searched publications in English on 'PubMed' and Google Scholar. We extracted information related to COVID-19 transmission dynamics, clinical presentations, and exposures that may facilitate transmission. We then compared these findings with the recommended IPC measures.

RESULTS

Nosocomial transmission of SARS-CoV-2 in healthcare settings occurs through droplets, aerosols, and the oral-fecal or fecal-droplet route. However, the IPC guidelines fail to cover all transmission modes, and the recommendations also conflict with each other. Most guidelines recommend surgical masks for healthcare providers during routine care and N95 respirators for aerosol-generating procedures. However, recommendations regarding the type of face mask varied, and the CDC recommends cloth masks when surgical masks are unavailable.

CONCLUSION

IPC strategies should consider all the possible routes of transmission and should target all patient care activities involving risk of person-to-person transmission. This review may assist international health agencies in updating their guidelines.

Authors+Show Affiliations

School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia. Program for Emerging Infections, Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.North Coast Public Health Unit, New South Wales Health, Lismore, New South Wales, Australia. The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia.Centre for Population Health, New South Wales Health, Sydney, Australia.School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32408911

Citation

Islam, M Saiful, et al. "Current Knowledge of COVID-19 and Infection Prevention and Control Strategies in Healthcare Settings: a Global Analysis." Infection Control and Hospital Epidemiology, vol. 41, no. 10, 2020, pp. 1196-1206.
Islam MS, Rahman KM, Sun Y, et al. Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis. Infect Control Hosp Epidemiol. 2020;41(10):1196-1206.
Islam, M. S., Rahman, K. M., Sun, Y., Qureshi, M. O., Abdi, I., Chughtai, A. A., & Seale, H. (2020). Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis. Infection Control and Hospital Epidemiology, 41(10), 1196-1206. https://doi.org/10.1017/ice.2020.237
Islam MS, et al. Current Knowledge of COVID-19 and Infection Prevention and Control Strategies in Healthcare Settings: a Global Analysis. Infect Control Hosp Epidemiol. 2020;41(10):1196-1206. PubMed PMID: 32408911.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Current knowledge of COVID-19 and infection prevention and control strategies in healthcare settings: A global analysis. AU - Islam,M Saiful, AU - Rahman,Kazi M, AU - Sun,Yanni, AU - Qureshi,Mohammed O, AU - Abdi,Ikram, AU - Chughtai,Abrar A, AU - Seale,Holly, Y1 - 2020/05/15/ PY - 2020/5/16/pubmed PY - 2020/10/6/medline PY - 2020/5/16/entrez SP - 1196 EP - 1206 JF - Infection control and hospital epidemiology JO - Infect Control Hosp Epidemiol VL - 41 IS - 10 N2 - OBJECTIVE: In the current absence of a vaccine for COVID-19, public health responses aim to break the chain of infection by focusing on the mode of transmission. We reviewed the current evidence on the transmission dynamics and on pathogenic and clinical features of COVID-19 to critically identify any gaps in the current infection prevention and control (IPC) guidelines. METHODS: In this study, we reviewed global COVID-19 IPC guidelines by organizations such as the World Health Organization (WHO), the US Centers for Disease Control and Prevention (CDC), and the European Centre for Disease Prevention and Control (ECDC). Guidelines from 2 high-income countries (Australia and United Kingdom) and from 1 middle-income country (China) were also reviewed. We searched publications in English on 'PubMed' and Google Scholar. We extracted information related to COVID-19 transmission dynamics, clinical presentations, and exposures that may facilitate transmission. We then compared these findings with the recommended IPC measures. RESULTS: Nosocomial transmission of SARS-CoV-2 in healthcare settings occurs through droplets, aerosols, and the oral-fecal or fecal-droplet route. However, the IPC guidelines fail to cover all transmission modes, and the recommendations also conflict with each other. Most guidelines recommend surgical masks for healthcare providers during routine care and N95 respirators for aerosol-generating procedures. However, recommendations regarding the type of face mask varied, and the CDC recommends cloth masks when surgical masks are unavailable. CONCLUSION: IPC strategies should consider all the possible routes of transmission and should target all patient care activities involving risk of person-to-person transmission. This review may assist international health agencies in updating their guidelines. SN - 1559-6834 UR - https://www.unboundmedicine.com/medline/citation/32408911/Current_knowledge_of_COVID_19_and_infection_prevention_and_control_strategies_in_healthcare_settings:_A_global_analysis_ L2 - https://www.cambridge.org/core/product/identifier/S0899823X20002378/type/journal_article DB - PRIME DP - Unbound Medicine ER -