tetano
Editor, Senior Moderator
Infect Control Hosp Epidemiol. 2020 May 8:1-16. doi: 10.1017/ice.2020.207. [Epub ahead of print]
Respiratory surveillance wards as a strategy to reduce nosocomial transmission of COVID-19 through early detection: the experience of a tertiary hospital in Singapore.
Wee LE[SUP]1,[/SUP][SUP]2[/SUP], Hsieh JYC[SUP]3[/SUP], Puah GC[SUP]4[/SUP], Tan Y[SUP]3[/SUP], Conceicao EP[SUP]5[/SUP], Wijaya L[SUP]2[/SUP], Tan TT[SUP]2[/SUP], Tan BH[SUP]2[/SUP].
Author information
Abstract
OBJECTIVES:
Patients with COVID-19 may present with respiratory syndromes indistinguishable from those caused by common viruses. Early isolation and containment is challenging. While screening all patients with respiratory symptoms for COVID-19 has been advocated, the practicality of such an effort has yet to be assessed.
METHODS:
Over a six-week period during a COVID-19 outbreak, our institution introduced a "respiratory surveillance ward" (RSW) to segregate all patients with respiratory symptoms in designated areas, where appropriate personal protective equipment (PPE) could be utilised till COVID-19 testing was done. Patients could be transferred out if COVID-19 tests were negative on 2 consecutive occasions, 24 hours apart.
RESULTS:
Over the study period, 1178 patients were admitted to the RSWs. The mean length-of-stay (LOS) was 1.89 days (S.D=1.23). Amongst confirmed cases of pneumonia admitted to the RSW, 1.61% (5/310) of patients tested positive for COVID-19. This was comparable to the pickup rate from our isolation ward. A total of 126 HCWs were potentially exposed to these cases; however, only 3 HCWs (2.38%, 3/126) required quarantine as the majority used appropriate PPE. A total of 13 inpatients overlapped with the index cases during their stay in the RSW; of the 13 exposed inpatients, 1 patient subsequently developed COVID-19 post-exposure. No patient-HCW transmission was detected despite intensive surveillance.
CONCLUSION:
Our institution successfully utilised the strategy of an RSW over a six-week period to contain a cluster of COVID-19 infection and avoid patient-HCW transmission. However, this was resource-intensive in terms of testing and bed capacity.
KEYWORDS:
COVID-19; Surveillance; coronavirus; early detection
PMID:32381147DOI:10.1017/ice.2020.207
Respiratory surveillance wards as a strategy to reduce nosocomial transmission of COVID-19 through early detection: the experience of a tertiary hospital in Singapore.
Wee LE[SUP]1,[/SUP][SUP]2[/SUP], Hsieh JYC[SUP]3[/SUP], Puah GC[SUP]4[/SUP], Tan Y[SUP]3[/SUP], Conceicao EP[SUP]5[/SUP], Wijaya L[SUP]2[/SUP], Tan TT[SUP]2[/SUP], Tan BH[SUP]2[/SUP].
Author information
Abstract
OBJECTIVES:
Patients with COVID-19 may present with respiratory syndromes indistinguishable from those caused by common viruses. Early isolation and containment is challenging. While screening all patients with respiratory symptoms for COVID-19 has been advocated, the practicality of such an effort has yet to be assessed.
METHODS:
Over a six-week period during a COVID-19 outbreak, our institution introduced a "respiratory surveillance ward" (RSW) to segregate all patients with respiratory symptoms in designated areas, where appropriate personal protective equipment (PPE) could be utilised till COVID-19 testing was done. Patients could be transferred out if COVID-19 tests were negative on 2 consecutive occasions, 24 hours apart.
RESULTS:
Over the study period, 1178 patients were admitted to the RSWs. The mean length-of-stay (LOS) was 1.89 days (S.D=1.23). Amongst confirmed cases of pneumonia admitted to the RSW, 1.61% (5/310) of patients tested positive for COVID-19. This was comparable to the pickup rate from our isolation ward. A total of 126 HCWs were potentially exposed to these cases; however, only 3 HCWs (2.38%, 3/126) required quarantine as the majority used appropriate PPE. A total of 13 inpatients overlapped with the index cases during their stay in the RSW; of the 13 exposed inpatients, 1 patient subsequently developed COVID-19 post-exposure. No patient-HCW transmission was detected despite intensive surveillance.
CONCLUSION:
Our institution successfully utilised the strategy of an RSW over a six-week period to contain a cluster of COVID-19 infection and avoid patient-HCW transmission. However, this was resource-intensive in terms of testing and bed capacity.
KEYWORDS:
COVID-19; Surveillance; coronavirus; early detection
PMID:32381147DOI:10.1017/ice.2020.207