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Containing COVID-19 outside the isolation ward: The impact of an infection control bundle on environmental contamination and transmission in a cohorted general ward

2020; Elsevier BV; Volume: 48; Issue: 9 Linguagem: Inglês

10.1016/j.ajic.2020.06.188

1527-3296

Liang En Wee, Xiang Ying Jean Sim, Edwin Philip Conceicao, May Kyawt Aung, Kwee Yuen Tan, Karrie Kwan Ki Ko, Hei Man Wong, Limin Wijaya, Ban Hock Tan, Indumathi Venkatachalam, Moi Lin Ling,

COVID-19 epidemiological studies

During an ongoing outbreak of COVID-19, unsuspected cases may be housed outside of dedicated isolation wards.At a Singaporean tertiary hospital, individuals with clinical syndromes compatible with COVID-19 but no epidemiologic risk were placed in cohorted general wards for COVID-19 testing. To mitigate risk, an infection control bundle was implemented comprising infrastructural enhancements, improved personal protective equipment, and social distancing. We assessed the impact on environmental contamination and transmission.Upon detection of a case of COVID-19 in the dedicated general ward, patients and health care workers (HCWs) contacts were identified. All patient and staff close-contacts were placed on 14-day phone surveillance and followed up for 28 days; symptomatic contacts were tested. Environmental samples were also obtained.Over a 3-month period, 28 unsuspected cases of COVID-19 were contained in the dedicated general ward. In 5 of the 28 cases, sampling of the patient's environment yielded SARS-CoV-2; index cases who required supplemental oxygen had higher odds of environmental contamination (P = .01). A total of 253 staff close-contacts and 45 patient close-contacts were identified; only 3 HCWs (1.2%, 3/253) required quarantine. On 28-day follow-up, no patient-to-HCW transmission was documented; only 1 symptomatic patient close-contact tested positive.Our institution successfully implemented an intervention bundle to mitigate COVID-19 transmission in a multibedded cohorted general ward setting.