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Why psychiatry is different - challenges and difficulties in managing a nosocomial outbreak of coronavirus disease (COVID-19) in hospital care.
Antimicrob Resist Infect Control. 2020 12 01; 9(1):190.AR

Abstract

OBJECTIVE

Coronavirus disease (COVID-19) was officially declared a pandemic in March 2020. Many cases of COVID-19 are nosocomial, but to the best of our knowledge, no nosocomial outbreaks on psychiatric departments of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in Europe. The different nature of psychiatry makes outbreak management more difficult. This study determines which psychiatry specific factors contributed to a nosocomial outbreak taking place in a psychiatric department. This will provide possible interventions in future outbreak management.

METHOD

A case series describing a nosocomial outbreak in a psychiatric department of an acute care hospital in the Netherlands between March 13, 2020 and April, 14 2020. The outbreak was analyzed by combining data from standardized interviews, polymerase chain reaction (PCR) tests and whole genome sequencing (WGS).

RESULTS

The nosocomial outbreak in which 43% of staff of the psychiatric department and 19% of admitted patients were involved, was caused by healthcare worker (HCW)-to-HCW transmissions, as well as patient-to-HCW-to-patient transmission. We identified four aspects associated with the mental health care system which might have made our department more susceptible to an outbreak.

CONCLUSIONS

Infection control measures designed for hospitals are not directly applicable to psychiatric departments. Psychiatric patients should be considered a high-risk group for infectious diseases and customized measures should be designed and implemented. Extra attention for psychiatric departments is necessary during a pandemic as psychiatric HCWs are less familiar with outbreak management. Clear communication and governance is crucial in correctly implementing these measures.

Authors+Show Affiliations

Department of Psychiatry, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6534 SZ, Nijmegen, The Netherlands. j.rovers@cwz.nl.Department of Psychiatry, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6534 SZ, Nijmegen, The Netherlands.Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.Department of Psychiatry, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6534 SZ, Nijmegen, The Netherlands.Department of Viroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands.Department of Psychiatry, Canisius-Wilhelmina Hospital, Weg door Jonkerbos 100, 6534 SZ, Nijmegen, The Netherlands. Department of Viroscience, Erasmus University Medical Centre, Rotterdam, The Netherlands.Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands. Department of Medical Microbiology, Radboud University Medical Centre, Nijmegen, The Netherlands.Department of Medical Microbiology and Infectious Diseases, Canisius-Wilhelmina Hospital, Nijmegen, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

33261660

Citation

Rovers, J J E., et al. "Why Psychiatry Is Different - Challenges and Difficulties in Managing a Nosocomial Outbreak of Coronavirus Disease (COVID-19) in Hospital Care." Antimicrobial Resistance and Infection Control, vol. 9, no. 1, 2020, p. 190.
Rovers JJE, van de Linde LS, Kenters N, et al. Why psychiatry is different - challenges and difficulties in managing a nosocomial outbreak of coronavirus disease (COVID-19) in hospital care. Antimicrob Resist Infect Control. 2020;9(1):190.
Rovers, J. J. E., van de Linde, L. S., Kenters, N., Bisseling, E. M., Nieuwenhuijse, D. F., Oude Munnink, B. B., Voss, A., & Nabuurs-Franssen, M. (2020). Why psychiatry is different - challenges and difficulties in managing a nosocomial outbreak of coronavirus disease (COVID-19) in hospital care. Antimicrobial Resistance and Infection Control, 9(1), 190. https://doi.org/10.1186/s13756-020-00853-z
Rovers JJE, et al. Why Psychiatry Is Different - Challenges and Difficulties in Managing a Nosocomial Outbreak of Coronavirus Disease (COVID-19) in Hospital Care. Antimicrob Resist Infect Control. 2020 12 1;9(1):190. PubMed PMID: 33261660.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Why psychiatry is different - challenges and difficulties in managing a nosocomial outbreak of coronavirus disease (COVID-19) in hospital care. AU - Rovers,J J E, AU - van de Linde,L S, AU - Kenters,N, AU - Bisseling,E M, AU - Nieuwenhuijse,D F, AU - Oude Munnink,B B, AU - Voss,A, AU - Nabuurs-Franssen,M, Y1 - 2020/12/01/ PY - 2020/06/08/received PY - 2020/11/18/accepted PY - 2020/12/2/entrez PY - 2020/12/3/pubmed PY - 2021/1/5/medline KW - COVID-19 KW - Hospital outbreak management KW - Hospital psychiatry KW - Nosocomial outbreak SP - 190 EP - 190 JF - Antimicrobial resistance and infection control JO - Antimicrob Resist Infect Control VL - 9 IS - 1 N2 - OBJECTIVE: Coronavirus disease (COVID-19) was officially declared a pandemic in March 2020. Many cases of COVID-19 are nosocomial, but to the best of our knowledge, no nosocomial outbreaks on psychiatric departments of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in Europe. The different nature of psychiatry makes outbreak management more difficult. This study determines which psychiatry specific factors contributed to a nosocomial outbreak taking place in a psychiatric department. This will provide possible interventions in future outbreak management. METHOD: A case series describing a nosocomial outbreak in a psychiatric department of an acute care hospital in the Netherlands between March 13, 2020 and April, 14 2020. The outbreak was analyzed by combining data from standardized interviews, polymerase chain reaction (PCR) tests and whole genome sequencing (WGS). RESULTS: The nosocomial outbreak in which 43% of staff of the psychiatric department and 19% of admitted patients were involved, was caused by healthcare worker (HCW)-to-HCW transmissions, as well as patient-to-HCW-to-patient transmission. We identified four aspects associated with the mental health care system which might have made our department more susceptible to an outbreak. CONCLUSIONS: Infection control measures designed for hospitals are not directly applicable to psychiatric departments. Psychiatric patients should be considered a high-risk group for infectious diseases and customized measures should be designed and implemented. Extra attention for psychiatric departments is necessary during a pandemic as psychiatric HCWs are less familiar with outbreak management. Clear communication and governance is crucial in correctly implementing these measures. SN - 2047-2994 UR - https://www.unboundmedicine.com/medline/citation/33261660/Why_psychiatry_is_different___challenges_and_difficulties_in_managing_a_nosocomial_outbreak_of_coronavirus_disease__COVID_19__in_hospital_care_ L2 - https://aricjournal.biomedcentral.com/articles/10.1186/s13756-020-00853-z DB - PRIME DP - Unbound Medicine ER -