Tis the season for respiratory infections.
COVID-19 cases are already high in much of the country, and respiratory syncytial virus (RSV) and influenza infections typically increase in fall and winter. Accurately identifying potential sources of infection via contact tracing can help you stop the spread of these infections in your healthcare facility.
The highly contagious Delta variant is fueling COVID-19 infections throughout the country. COVID-19 vaccination remains highly effective in preventing serious illness and hospitalization, but a study that looked at vaccine effectiveness in frontline healthcare workers in eight different U.S. locations found that COVID-19 vaccine effectiveness declined by nearly 30 percentage points since Delta became the dominant coronavirus strain in the United States.
Other studies have noted declining antibody levels in the months after vaccination, and a May 2021 study published in Nature suggests that neutralizing antibody levels are highly predictive of immune protection. As a result, the U.S. Department of Health and Human Services has announced a plan to begin offering COVID-19 booster shots this fall.
RSV is known as a major nosocomial hazard on pediatric wards during the fall and winter months. Although RSV levels were lower-than-normal during the ‘20-’21 winter – likely due to widespread masking and continued closures of many schools and childcare centers – healthcare providers must remain vigilant. When RSV patients are hospitalized, medical staff “are often instrumental in its [nosocomial] transmission,” according to an article in Clinical Infectious Diseases.
Seasonal influenza remains a threat also. Though flu levels were historically low in ’20-’21, children’s return to school, coupled with decreased mask-wearing in many parts of the country, may result in robust influenza spread. In hospital settings, nosocomial influenza outbreaks often result from asymptomatic infections and disproportionately affect frail and elderly patients.
Healthcare workers were among the first to receive COVID-19 vaccinations when they gained emergency approval from the FDA, and it’s now been more than eight months since many providers’ last COVID-19 shot. Many of these providers are living and working in communities with high levels of COVID-19 spread, and they may be susceptible to infection while the U.S. Center of Disease Control’s Advisory Committee on Immunization Practices and the U.S. Food and Drug Administration consider possible booster shot recommendations.
The University of California San Diego Health workforce has reported a significant increase in COVID-19 infections among vaccinated staff members. According to a letter to the editor published in the September 1, 2021 edition of the New England Journal of Medicine, in July 2021, the COVID-19 attack rate for workers who completed vaccination in January or February was 6.7/1000 persons, compared to 3.7/1000 persons for those who completed vaccination between March and May. (The attack rate for unvaccinated employees was 16.4/1000.) These statistics support claims that vaccinated healthcare workers may be at increased risk of infection as time goes on. And that fact points to a disturbing possibility: vaccinated healthcare workers may be exposed to COVID-19 in the community and could unwittingly bring the virus to work and spread it to patients and colleagues.
Similarly, healthcare workers – and other patients – can inadvertently bring RSV or influenza in the hospital setting, threatening the health and well-being of staff and patients alike.
When an unexpected case of COVID-19, RSV, or influenza is identified in a staff member or patient, it’s vitally important to trace that individual’s contacts. Performance Bubble Plots, available to facilities that use Clean Hands-Safe Hands technology, make it easy to quickly identify which providers spent significant time in relevant patient rooms. The more interactions a staff member has with a patient, the larger their bubble. If a staff member unexpectedly tests positive for COVID-19 or influenza, a scan of recent Performance Bubble Plots can help with exposure tracing by revealing, at a glance, which patients may have experienced significant exposure.
Our Performance Bubble Plots and Concierge Contact Tracing service can also help hospital leadership make smart staffing decisions when a patient tests positive for a contagious respiratory virus. Staff members who had multiple interactions with that patient (as represented by a large bubble) may need to be tested and possibly quarantined. Other staff members can likely continue working under close supervision.
As we head into winter ‘21-’22, contract tracing remains a critically important infection prevention tool.