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Navigating the Challenges of Infection Control in the COVID-19 Era

In the midst of escalating COVID-19 hospitalizations, healthcare professionals are reflecting on their past encounters with the virus and its implications for current procedures.

Dr. Theodore Pak recalls his first encounter with a COVID-19 patient back in April 2020. Despite initially testing negative twice, an elderly man named John (a pseudonym for privacy) who was admitted indefinitely for bacterial pneumonia and a urinary infection, unexpectedly developed COVID-19 symptoms a week later. The unbelievable reality was that he had contracted the disease within the hospital. Despite being moved to a COVID-19 unit, John’s health increasingly deteriorated, resulting in his passing. This experience left a profound impact on Dr. Pak, reminding him of the gravity of hospital-acquired infections.

In 2020, hospitals implemented universal masks and screening tests to minimize the spreading of the virus. However, as guidelines from the Centers for Disease Control and Prevention (CDC) and the Society for Healthcare Epidemiology of America (SHEA) were relaxed in 2022, preventative measures were notably scaled back. This shift could have dire consequences as the rate at which COVID-19 transmission leads to fatalities remains significant, despite the presence of tailored vaccines. Vulnerable groups such as the elderly, disabled, immunocompromised individuals, and patients with major underlying health conditions are still at elevated risk. Furthermore, long COVID presents formidable health challenges, even to those who are healthy and vaccinated.

The transmission of COVID-19 in hospitals is an emerging problem that remains pressing for health management administrations. Despite the significant need to curb the spread of the virus, many health professionals face pressure to overlook safety measures such as mandatory masking in healthcare settings. Though hospitals face fiscal constraints and the need to resume elective care, sidelining safety could risk the wellbeing of patients and healthcare workers alike.

The prevalence of acquired hospital infections remains alarming, evidenced by high mortality rates even when comprehensive protective measures were employed. This raises questions about the sufficiency of current methods to prevent the transmission of the virus. Cross-contamination amongst patients in close proximity, such as roommates, is a significant factor.

The CDC discontinued mandating hospitals to report hospital-acquired COVID in May 2023. Consequently, there is a lack of data to assess the aftermath of discontinuing COVID-19 infection control in healthcare settings. Moreover, the names of hospitals where patients contracted COVID-19 remain confidential. The demand is now for transparency, stringent reporting, and incentives for hospitals to actively prevent COVID-19, similar to their efforts with other less fatal infections.

Recently, despite expert suggestions to strengthen health care infection control policies, there has been a push to further dilute existing guidelines. The proposal to consider surgical masks as effective as well-fitting N95 masks has met with strong resistance from healthcare workers.

Most CDC Healthcare Infection Control Practices Advisory Committee (HICPAC) members represent large hospitals, leaving smaller healthcare entities and consumers without effective representation. The hope now lies in ensuring that the public health guidance is more transparent and inclusive of both patients and health care workers. Effective infection control methods must be prioritized to protect patients like John from exposure to pandemic pathogens such as COVID-19. The knowledge and experiences from the past three years should serve as a blueprint for safeguards amongst patients and healthcare professionals to combat the ongoing pandemic.


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