General Practitioners’ Practice premises and Risk of Viral Cross-Transmission: A French Observational Multicenter Study

Abstract

Background: The common areas of general practitioners’ practices (eg, reception, secretariat, waiting room, toilets) are places at risk of cross-transmission of viral diseases such as COVID-19, however risk is poorly documented. Aim: To evaluate the risks of viral cross-transmission in general practitioners’ practices based on the organization of the common areas of the premises. Design and setting: Cross-sectional multicenter observational study in randomly selected general practitioners’ practices in a French department (Seine-Maritime). The practices were included in 4 strata (1, 2, 3–5, or ≥6 general practitioners). Method: Each practice was visited and a questionnaire describing practice organization, cleaning of the premises, screening of high-risk patients was completed on site and observation of the premises). Results: Data collection started in December 2019 and was discontinued due to the national lockdown related to the global SARS-CoV-2 pandemic. Eighty-two practices were analyzed. A hydroalcoholic solution was available in 7.3% of practices and surgical masks in 1.2%. In a majority of waiting rooms, the minimum distance between chairs facing each other was >2 m (78.0%), but was more frequently 1 m for chairs at 90° (53.7%). Overall, 79.3% of waiting rooms could be properly ventilated and waste bins were present in 23.9% of cases. A cleaning protocol was reported in 39.2% of practices. Conclusion: The COVID-19 epidemic allowed the national dissemination of standard precautions. It will be interesting to monitor over the next few years whether the renewed consideration of standard precautions to prevent viral cross-contamination will be maintained over time.

Lessons from the first wave of COVID-19 in Italy: A collection of design strategies to face pandemic situations in healthcare facilities

“…Heterogeneous strategies were utilized including easily cleanable transparent polymer dividers, no-touch elements for both entertainment and hand hygiene, and spatial rearrangement, while options for self-check-in were established to encourage waiting for visits outdoors in less crowded environments. 78,79 EDs represent a specific hospital functional area severely impacted by demands of the COVID-19 pandemic, exacerbating previously existing overcrowding issues in these areas. Accurate layout planning and overestimated space requirements along with independent and filtered compartmental spaces are noted to be important design strategies to aid EDs with patient managment.…”