Rapid Control of Hospital-Based Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Clusters Through Daily Testing and Universal Use of N95 Respirators

Baker, Meghan A; Rhee, Chanu; Tucker, Robert; Badwaik, Amy; Coughlin, Cassie; Holtzman, Meghan; Hsieh, Candace; Maguire, Angela M.; Blaeser, Elizabeth Mermel; Seetharaman, Saranya; Solem, Ofelia; Vaidya, Vineeta; Klompas, Michael

doi:10.1093/cid/ciac113

Cited by 27 publications

(27 citation statements)

References 13 publications

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“…This definition does not account for the long incubation period for SARS CoV-2 and the possible false negative initial testing at admission. Nonetheless, it is clear that infection control interventions are effective at reducing nosocomial transmission of COVID-19, although other factors, such as the spatial blueprints of health care settings (e.g., the use of shared/semiprivate vs. private rooms) may also influence transmission patterns 27 , 28 .…”

Section: Discussionmentioning

confidence: 99%

Nosocomial COVID-19 at a comprehensive cancer center during the first year of the pandemic: Lessons learned

Khawaja

Srinivasan

Spallone

et al. 2023

American Journal of Infection Control

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Section: Discussionmentioning

confidence: 99%

Nosocomial COVID-19 at a comprehensive cancer center during the first year of the pandemic: Lessons learned

Khawaja

Srinivasan

Spallone

et al. 2023

American Journal of Infection Control

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“…7,8 N95 respirators provide better respiratory protection for healthcare workers than medical masks and also provide better source control to reduce the risk of transmission to patients. [9][10][11] The advantages of universal N95s over medical masks, however, must be balanced against higher costs, less comfort, and logistical challenges related to fit testing.…”

Section: Discussionmentioning

confidence: 99%

Survey of coronavirus disease 2019 (COVID-19) infection control policies at leading US academic hospitals in the context of the initial pandemic surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) omicron variant

Rhee

Baker

2022

Infect. Control Hosp. Epidemiol.

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Objective: To assess COVID-19 infection policies at leading U.S. medical centers in the context of the initial Omicron wave. Design: Electronic survey study eliciting hospitals’ policies on masking, personal protective equipment, cohorting, airborne infection isolation rooms (AIIRs), portable HEPA filters, and patient/employee testing. Setting and participants: Hospital epidemiologists from U.S. News top 20 hospitals and 10 hospitals in the CDC Prevention Epicenters program. Methods: Survey results were reported using descriptive statistics. Results: 23/30(77%) hospital epidemiologists completed the survey between February 15-March 3, 2022. 18(78%) hospitals used medical masks for universal masking while 5(22%) used N95 respirators. 16(70%) required universal eye protection. 22(96%) used N95s for routine COVID-19 care while 1(4%) reserved N95s for aerosol-generating procedures. 2(9%) utilized dedicated COVID-19 wards, 8(35%) used mixed COVID-19/non-COVID-19 units, and 13(57%) used both dedicated and mixed units. 4(17%) used AIIRs for all COVID-19 patients, 10(43%) prioritized AIIRs for aerosol-generating procedures, 3(13%) used alternate risk-stratification criteria, and 6(26%) did not routinely use AIIRs. 9(39%) did not use portable HEPA filters, but 14(61%) used them for various indications, most commonly as substitutes for AIIRs when unavailable or for specific high-risk areas or situations. 21(91%) tested asymptomatic patients on admission, but post-admission testing strategies and preferred specimen sites varied substantially. 5(22%) required regular testing of unvaccinated employees; 1(4%) reported mandatory weekly testing even for vaccinated employees during the Omicron surge. Conclusions: There is substantial variation in leading hospitals’ COVID-19 infection control practices. Clearer public health guidance and transparency around hospitals’ policies may facilitate more consistent national standards.

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“…These include the following measures: (1) Increase the vaccination rate of the general population; 2 (2) Develop vaccines and/or anti-SARS-CoV-2 immunoglobulins against emerging and potential variants; 58-62 (3) Administer booster vaccines for non-responders; 63-64 (4) Accelerate clinical trials of intranasal SARS-CoV-2 vaccines to prevent transmission; 65 (5) Assessment of humoral immune response of children, the elderly, and immunocompromised persons within 1-3 months after vaccine booster shot; 45,[66][67][68][69][70][71] and (6) Incorporate additional protective measures for individuals with persistent (a fourth or fifth dose) negative humoral immune response after booster vaccination, such as injection of anti-SARS-CoV-2 immunoglobulins, antiviral drug treatment, usage of N95 masks in endemic areas, etc. [41][42][43][72][73][74][75][76][77]…”

Section: Discussionmentioning

confidence: 99%

Immunological findings in a group of individuals who were non-responders to standard two-dose SARS-CoV-2 vaccines

Zeng

Yang

Qi³

et al. 2022

Preprint

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Coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic. The virus has infected more than 505 million people and caused more than 6 million deaths. However, data on non-responders to SARS-CoV-2 vaccines in the general population are limited. The objective of the study is to comprehensively compare the immunological characteristics of non-responders to SARS-CoV-2 vaccines in the 18-59 years with that in the 60 years and older using internationally recognized cutoff values. Participants included 627 individuals who received physical examinations and volunteered to participate in COVID-19 vaccination from the general population. The main outcome was an effective seroconversion characterized by anti-SARS-CoV-2 spike IgG level of at least 4-fold increase from baseline. Profiling of naive immune cells was analyzed prior to vaccination to demonstrate baseline immunity. Outcomes of effective seroconversion in the 18-59 years with that in the 60 years and older were compared. The quantitative level of the anti-spike IgG was significantly lower in the 60 years and older and in men among the 18-59 years. There were 7.5% of non-responders among the 18-59 years and 11.7% of non-responders in the 60 years and older using the 4-fold increase parameter. The effective seroconversion rate was significantly related to the level of certain immune cells before vaccination, such as CD4 cells, CD8 cells and B cells and the age. An individual with a titer of anti-SARS-CoV-2 spike IgG that is below 50 BAU/mL might be considered a non-responder between 14-90 days after the last vaccine dose. Booster vaccination or additional protective measures should be recommended for non-responders as soon as possible to reduce disease severity and mortality.

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Rapid Control of Hospital-Based Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Clusters Through Daily Testing and Universal Use of N95 Respirators

Cited by 27 publications

References 13 publications

Nosocomial COVID-19 at a comprehensive cancer center during the first year of the pandemic: Lessons learned

Nosocomial COVID-19 at a comprehensive cancer center during the first year of the pandemic: Lessons learned

Survey of coronavirus disease 2019 (COVID-19) infection control policies at leading US academic hospitals in the context of the initial pandemic surge of the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) omicron variant

Immunological findings in a group of individuals who were non-responders to standard two-dose SARS-CoV-2 vaccines

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