Influence of public health and infection control interventions during the severe acute respiratory syndrome coronavirus 2 pandemic on the in-hospital epidemiology of pathogens: In hospital versus community circulating pathogens

Abstract

Background: The first detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Germany was reported in early February 2020. In addition, extensive control measures on the coronavirus disease 2019 (COVID-19) pandemic have been placed in Germany since March 2020. These include contact and travel restrictions, distance rules, mandatory wearing of face masks and respirators, cancellation of mass events, closures of day-care centers, schools, restaurants and shops, isolation measures, and intensified infection control measures in medical and long-term care facilities. Changes in demand or access to health care services and intensified control measures can lead to changes in transmission dynamics and imply effects on the overall occurrence of infectious diseases in hospitals.Methods: To analyze the impact of infection control measures implemented in public on infectious diseases in hospitals, surveillance data from Marburg University Hospital were analyzed retrospectively. The analysis was conducted from January 2019 to June 2021, referred to hospital occupancy and mobility data in the county of Marburg-Biedenkopf, and correlated to control measures in hospitals and the general population.Results: The COVID-19 pandemic and associated measures immediately impacted the occurrence of infectious diseases at the Marburg University Hospital. Significant changes were detected for virus-associated respiratory and gastrointestinal diseases. The massive drop in norovirus infections was significantly affected by the onset of the pandemic (P = 0.028). Similar effects were observed for rotavirus (up to -89%), respiratory syncytial virus (up to -98%), and adenovirus infections (up to -90%). The decrease in gastrointestinal and respiratory virus detection rates was significantly affected by the decline in mobility (P < 0.05). Of note, since April 2020, there have been no detected influenza cases. Furthermore, Clostridioides difficile-related infections declined after late 2020 (- 44%). In contrast, no significant changes were detected in the prevalence of susceptible and drug-resistant bacterial pathogens. In particular, the detection rates of methicillin-resistant Staphylococcus aureus isolates or multidrug resistant (MDR) and extended drug resistant (XDR) bacteria remained constant, although the consumption of hand disinfectants and protective equipment increased.Conclusions: The COVID-19 pandemic and associated public health measures had a significant impact on infectious diseases and the detection of pathogens at the Marburg University Hospital. Significant changes were observed for community transmissible infections, while no such effects on pathogens primarily associated with nosocomial transmission could be detected.

Detection of hospital environmental contamination during SARS-CoV-2 Omicron predominance using a highly sensitive air sampling device

“…However, frequent testing to identify infected individuals remains a cornerstone in curbing community transmission and has been modeled to be an effective intervention for countries transitioning toward endemicity (7). This is especially important in hospital settings where nosocomial SARS-CoV-2 and other infectious pathogens continue to pose a risk to vulnerable populations and healthcare workers (8)(9)(10). Therefore, an effective hospital surveillance programme, which allows rapid implementation of appropriate containment measures and re-allocation of healthcare resources is vital to mitigate preventable loss of life and the burden on the healthcare sector (7,10).…”

Technologies and therapeutics for ongoing prevention of respiratory infections

“…An unexpected but positive phenomenon resulting from the mass implementation of these pandemic measures was the significant drop in non-COVID-19 respiratory viral infections and gastrointestinal viral infections globally. [4][5][6][7] An astounding decrease in influenza virus infections in both northern and southern hemispheres was by far one of the most noteworthy changes in non-COVID-19 disease incidence during the pandemic period. [8][9][10] Comprehensive analysis of the GISRS FluNet database in a 2022 study 10 showed that influenza cases sharply fell during the initial months of the pandemic to <100 cases per week.…”

“…The near‐simultaneous global implementation of these nonpharmaceutical interventions helped to slow down the community transmission of SARS‐CoV‐2, mitigated the burden of disease on healthcare resources and allowed time to develop vaccines and treatments. An unexpected but positive phenomenon resulting from the mass implementation of these pandemic measures was the significant drop in non‐COVID‐19 respiratory viral infections and gastrointestinal viral infections globally 4–7 …”