In today’s in-depth discussion on the pressing issues in Infection Prevention and Control (IPC), esteemed expert, Saskia v. Popescu, PhD, MPH, MA, CIC, FAPIC, sheds light on her concerns regarding the anticipated ‘tripledemic’ of COVID-19, influenza, and respiratory syncytial virus (RSV) anticipated this winter. Fears are also rising about the intersection of these illnesses with mechanical ventilation and drug-resistant pathogens.
As we venture into the respiratory virus season, which typically ramps up in late November, initial indicators appear to suggest a moderate – rather than a severe – respiratory syndrome. However, examining key metrics reported by the Centers for Disease Control and Prevention (CDC) brings certain concerns into focus. During the week of October 15 to 21, 2023, the U.S test positivity rate for COVID-19 dipped slightly to 8.7%. Despite a 4.6% drop in emergency department visits diagnosed with COVID-19 from the previous week, it’s alarming to note a 12.5% increase in COVID-19 related deaths across the U.S. Furthermore, it is concerning that virus levels in wastewater samples have seen a rise, indicating increased virus activity in the population.
Turning our attention to influenza, the relative hold at 1.7% of positive clinical lab results is encouraging, considering over 44k specimens were tested in week 42, ending October 21st. However, a notable increase in outpatient respiratory illness rates is a cause for concern and warrants close monitoring.
Given the experiences of our colleagues in Australia during their influenza season, we may expect a more moderate impact and an earlier end. Nevertheless, this is an opportunistic time for healthcare organizations to ensure their workforces are vaccinated, establish strict masking and visitor restriction protocols, and develop robust data-driven strategies. Maintaining effective sanitary standards by wiping down high-touch surfaces diligently is crucial. Another essential step is ensuring that the masses receive their latest booster doses despite prevailing pandemic fatigue, as suboptimal vaccination rates may lead to an immune drop and larger issues over time.
Turning our view toward the realm of mechanical ventilation and drug-resistant pathogens, a compelling report in the Journal of the American Medical Association indicates a pressing need for increased surveillance of vented patients and deployment of stronger infection prevention strategies. The study’s findings uncovered a significant proportion of patients receiving mechanical ventilation tested positive for Candida auris, Acinetobacter baumannii, and carbapenem-resistant A baumannii.
Furthermore, this discussion touches on other sectors of IPC, including the development of inhaled therapies for lung infections in partnership with the pharmaceutical company Qnovia and the University of Virginia, exciting advancements in mRNA-based combination vaccines for influenza and COVID-19, and ongoing efforts to conquer Chronic Wasting Disease in Michigan’s deer population.