Minimizing intra-hospital transmission of COVID-19: the role of social distancing

Wee, Liang En; Conceicao, Edwin Philip; Sim, Xiang Ying Jean; Aung, Myat Moe Thwe; Tan, Kwee Yuen; Wong, Hei Man; Wijaya, Limin; Tan, Ban Hock; Ling, Moi Lin; Venkatachalam, Indumathi

doi:10.1016/j.jhin.2020.04.016

Cited by 94 publications

(94 citation statements)

References 6 publications

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“…Although 5 previously unsuspected cases surfaced in the RSW over the 6-week period, only 13 patients were potentially exposed due to enhanced cohorting, whereas a single patient that surfaced in our institution's cohorted general ward resulted in the potential exposure of 18 patients. 18 Given the importance of adequate PPE, 26 even a single case of COVID-19 can result in the quarantine of large numbers of HCWs if detected late, further straining hospital resources. 27 However, our study also reflects the practicality and costs of such a resource-intensive effort.…”

Section: Discussionmentioning

confidence: 99%

“…Beds were spaced at least ∼2 m apart by reducing the number of beds in a cohort room from 6 to 3, and partitions were placed between patient beds. 18 Patients admitted to the RSW could be transferred for clinically urgent procedures/imaging investigations prior to the results of SARS-CoV-2 tests. In this case, patients wore surgical masks when being transferred and HCWs transporting patients wore N95 masks with PPE at the receiving end, adapted to the kind of procedure being performed (eg, full PPE for all potential aerosol-generating procedures).…”

Section: Respiratory Surveillance Wards (Rsws): Admissions Criteria mentioning

confidence: 99%

“…In this case, staff had previously observed mingling between the mobile patients in the room, without compliance to surgical masks; subsequently, social distancing was reinforced, and advisories were posted in prominent areas to prevent mingling. 18…”

Section: Case Detectionmentioning

confidence: 99%

See 2 more Smart Citations

Respiratory surveillance wards as a strategy to reduce nosocomial transmission of COVID-19 through early detection: The experience of a tertiary-care hospital in Singapore

Wee

Hsieh

Phua

et al. 2020

Infect. Control Hosp. Epidemiol.

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Objectives: Patients with COVID-19 may present with respiratory syndromes indistinguishable from those caused by common viruses. Early isolation and containment is challenging. Although screening all patients with respiratory symptoms for COVID-19 has been recommended, the practicality of such an effort has yet to be assessed.Methods: Over a 6-week period during a SARS-CoV-2 outbreak, our institution introduced a "respiratory surveillance ward" (RSW) to segregate all patients with respiratory symptoms in designated areas, where appropriate personal protective equipment (PPE) could be utilized until SARS-CoV-2 testing was done. Patients could be transferred when SARS-CoV-2 tests were negative on 2 consecutive occasions, 24 hours apart.

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Section: Discussionmentioning

confidence: 99%

Section: Respiratory Surveillance Wards (Rsws): Admissions Criteria mentioning

confidence: 99%

See 1 more Smart Citation

Respiratory surveillance wards as a strategy to reduce nosocomial transmission of COVID-19 through early detection: The experience of a tertiary-care hospital in Singapore

Wee

Hsieh

Phua

et al. 2020

Infect. Control Hosp. Epidemiol.

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“…The World Health Organization has declared a social distance of at least 1 m among patients and healthcare workers at inpatient facilities, as well as other spaces, like outpatient facilities, and other communities, like home and public areas [ 6 ]. Other organisations also released statement of social distancing with 1.5 m [ 7 , 8 ] or 2 m [ 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Social Distance Monitor with a Wearable Magnetic Field Proximity Sensor

Bian

Zhou

Lukowicz

2020

Sensors

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Social distancing and contact/exposure tracing are accepted to be critical strategies in the fight against the COVID-19 epidemic. They are both closely connected to the ability to reliably establish the degree of proximity between people in real-world environments. We proposed, implemented, and evaluated a wearable proximity sensing system based on an oscillating magnetic field that overcomes many of the weaknesses of the current state of the art Bluetooth based proximity detection. In this paper, we first described the underlying physical principle, proposed a protocol for the identification and coordination of the transmitter (which is compatible with the current smartphone-based exposure tracing protocols). Subsequently, the system architecture and implementation were described, finally an elaborate characterization and evaluation of the performance (both in systematic lab experiments and in real-world settings) were performed. Our work demonstrated that the proposed system is much more reliable than the widely-used Bluetooth-based approach, particularly when it comes to distinguishing between distances above and below the 2.0 m threshold due to the magnetic field’s physical properties.

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“…To maintain functional patient care during the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic, 1 it is crucial to protect healthcare facilities from nosocomial coronavirus disease 2019 (COVID-19) outbreaks. As such, every hospital needs to separate patients with and without COVID-19 via a reliable triage algorithm to minimize the risk of nosocomial transmission during a time of everincreasing patient numbers.…”

Section: Introductionmentioning

confidence: 99%

SARS-CoV-2 serology increases diagnostic accuracy in CT-suspected, PCR-negative COVID-19 patients during pandemic

Schneider

Mijočević

Ulm

et al. 2020

Preprint

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Background: In the absence of PCR detection of SARS-CoV-2 RNA, accurate diagnosis of COVID-19 is challenging. Low-dose computed tomography (CT) detects pulmonary infiltrates with high sensitivity, but findings may be non-specific. This study assesses the diagnostic value of SARS-CoV-2 serology for patients with distinct CT features but negative PCR. Methods: IgM/IgG chemiluminescent immunoassay was performed for 107 patients with confirmed (group A: PCR+; CT±) and 46 patients with suspected (group B: repetitive PCR-; CT+) COVID-19, admitted to a German university hospital during the pandemic’s first wave. A standardized, in-house CT classification of radiological signs of a viral pneumonia was used to assess the probability of COVID-19. Results: Seroconversion rates (SR) determined on day 5, 10, 15, 20 and 25 after symptom onset (SO) were 8%, 25%, 65%, 76% and 91% for group A, and 0%, 10%, 19%, 37% and 46% for group B, respectively; (p<0.01). Compared to hospitalized patients with a non-complicated course, seroconversion tended to occur at lower frequency and delayed in patients on intensive care units. SR of patients with CT findings classified as high certainty for COVID-19 were 9%, 26%, 65%, 77% and 92% in group A, compared with 0%, 10%, 20%, 40% and 50% in group B (p<0.01). SARS-CoV-2 serology established a definite diagnosis in 12/46 group B patients. In 88% (8/9) of patients with negative serology >14 days after symptom onset (group B), clinico-radiological consensus reassessment revealed probable diagnoses other than COVID-19. Sensitivity of SARS-CoV-2 serology was superior to PCR >17d after symptom onset. Conclusions: Approximately one-third of patients with distinct COVID-19 CT findings are tested negative for SARS-CoV-2 RNA by PCR rendering correct diagnosis difficult. Implementation of SARS-CoV-2 serology testing alongside current CT/PCR-based diagnostic algorithms improves discrimination between COVID-19-related and non-related pulmonary infiltrates in PCR negative patients. However, sensitivity of SARS-CoV-2 serology strongly depends on the time of testing and becomes superior to PCR after the 2 nd week following symptom onset.

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Minimizing intra-hospital transmission of COVID-19: the role of social distancing

Cited by 94 publications

References 6 publications

Respiratory surveillance wards as a strategy to reduce nosocomial transmission of COVID-19 through early detection: The experience of a tertiary-care hospital in Singapore

Respiratory surveillance wards as a strategy to reduce nosocomial transmission of COVID-19 through early detection: The experience of a tertiary-care hospital in Singapore

Social Distance Monitor with a Wearable Magnetic Field Proximity Sensor

SARS-CoV-2 serology increases diagnostic accuracy in CT-suspected, PCR-negative COVID-19 patients during pandemic

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