Interventions to control nosocomial transmission of SARS-CoV-2: a modelling study.
Thi Mui Pham,Hannan Tahir,Janneke van de Wijgert,Janneke van de Wijgert,Bastiaan van der Roest,Pauline M. Ellerbroek,Marc J.M. Bonten,Martin C. J. Bootsma,Mirjam Kretzschmar +8 more
TLDR
In this article, the authors developed an agent-based model and compared the impact of personal protective equipment (PPE), screening of healthcare workers (HCWs), contact tracing of symptomatic HCWs and restricting HCWs from working in multiple units (HCW cohorting) on nosocomial SARS-CoV-2 transmission.Abstract:
Emergence of more transmissible SARS-CoV-2 variants requires more efficient control measures to limit nosocomial transmission and maintain healthcare capacities during pandemic waves. Yet the relative importance of different strategies is unknown. We developed an agent-based model and compared the impact of personal protective equipment (PPE), screening of healthcare workers (HCWs), contact tracing of symptomatic HCWs and restricting HCWs from working in multiple units (HCW cohorting) on nosocomial SARS-CoV-2 transmission. The model was fit on hospital data from the first wave in the Netherlands (February until August 2020) and assumed that HCWs used 90% effective PPE in COVID-19 wards and self-isolated at home for 7 days immediately upon symptom onset. Intervention effects on the effective reproduction number (RE), HCW absenteeism and the proportion of infected individuals among tested individuals (positivity rate) were estimated for a more transmissible variant. Introduction of a variant with 56% higher transmissibility increased — all other variables kept constant — RE from 0.4 to 0.65 (+ 63%) and nosocomial transmissions by 303%, mainly because of more transmissions caused by pre-symptomatic patients and HCWs. Compared to baseline, PPE use in all hospital wards (assuming 90% effectiveness) reduced RE by 85% and absenteeism by 57%. Screening HCWs every 3 days with perfect test sensitivity reduced RE by 67%, yielding a maximum test positivity rate of 5%. Screening HCWs every 3 or 7 days assuming time-varying test sensitivities reduced RE by 9% and 3%, respectively. Contact tracing reduced RE by at least 32% and achieved higher test positivity rates than screening interventions. HCW cohorting reduced RE by 5%. Sensitivity analyses show that our findings do not change significantly for 70% PPE effectiveness. For low PPE effectiveness of 50%, PPE use in all wards is less effective than screening every 3 days with perfect sensitivity but still more effective than all other interventions. In response to the emergence of more transmissible SARS-CoV-2 variants, PPE use in all hospital wards might still be most effective in preventing nosocomial transmission. Regular screening and contact tracing of HCWs are also effective interventions but critically depend on the sensitivity of the diagnostic test used.read more
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Airborne protection for staff is associated with reduced hospital-acquired COVID-19 in English NHS Trusts.
TL;DR: In this article, the authors compared the use of airborne respiratory protection (RPE, eg FFP3 masks) against those using mostly droplet precautions (eg surgical masks), and found that RPE use was associated with a 33% reduction in HAI odds in the Delta wave, and 21% in the Alpha wave.
Journal ArticleDOI
Airborne protection for staff is associated with reduced hospital-acquired COVID-19 in English NHS trusts
TL;DR: The use of respiratory protection equipment was associated with a 33% reduction in the odds of hospital-acquired infection (HAI) in the Delta wave, and a 21% reduction of HAI in the Alpha wave (P<0.00001) as mentioned in this paper .
Journal ArticleDOI
Health system impacts of SARS-CoV − 2 variants of concern: a rapid review
Justine Dol,Leah Boulos,Mary Somerville,Lynora Saxinger,Alexander Doroshenko,Stephanie E. Hastings,Bearach Reynolds,Allyson J. Gallant,Hwayeon Danielle Shin,Helen P-S. Wong,D. Crowther,M. Macdonald,Ruth Martin-Misener,H. McCulloch,Andrea C. Tricco,Janet Curran +15 more
TL;DR: In this paper , a rapid review aimed to provide a synthesis of evidence related to health system responses to the emergence of SARS-CoV-2 variants of concern worldwide, with potential implications for hospital and health system capacity and control measures.
Journal ArticleDOI
Rapid antigen testing as a reactive response to surges in nosocomial SARS-CoV-2 outbreak risk
TL;DR: In this paper , the authors simulate SARS-CoV-2 transmission in a long-term care hospital with varying COVID-19 containment measures in place (social distancing, face masks, vaccination).
Journal ArticleDOI
Rapid antigen testing as a reactive response to surges in nosocomial SARS-CoV-2 outbreak risk
David R M Smith,Audrey Duval,Jean-Ralph Zahar,Niels Kévin Sofía Ajmal George Cynthia Hendrickx Jean Jijón Oodally Shirreff Tamandjou,Niels Hendrickx,Kévin Jean,Sofía Jijón,A. Wahed Oodally,George Shirreff,Cynthia Raissa Tchuem Tamandjou,Lulla Opatowski,Laura Temime +11 more
TL;DR: In this article , the authors simulate SARS-CoV-2 transmission in a long-term care hospital with varying COVID-19 containment measures in place (social distancing, face masks, vaccination).
References
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TL;DR: In the UK and the USA, risk of reporting a positive test for COVID-19 was increased among front-line health-care workers, and adequacy of PPE, clinical setting, and ethnic background were also important factors.