to continue focusing on mitigation strategies , particularly vaccination . Although SARS-CoV-2 genetic variants will keep emerging , vaccines have so far largely retained their ability to prevent fatal and other severe COVID-19 outcomes . Concerns that such variants will soon evade current vaccines may be overstated , as both the mRNA and adenovirus-DNA vaccines encode for the entire spike protein , providing robust and complex antibody-mediated as well as T-cell immune responses . Furthermore , vaccines can be rapidly modified , if necessary , to adapt to future variants . It is crucial to focus on the key public health objectives of preventing death and other severe disease outcomes , rather than continuing to use numbers of reported cases as the main metric . In any event , maintaining a constant state of emergency until the pandemic is over is not viable . Public health decision-making requires transparency and debate , which are often precluded by emergency orders . A more realistic public health goal is to adjust mitigation and treatment goals as the pandemic evolves , minimizing negative outcomes including the unintended harms associated with unfocused or irrelevant control efforts .”
Regarding the future , Halperin , et al . ( 2021 ) observe , “ COVID-19 is the second major respiratory viral pandemic in just over a decade and the third coronavirus pandemic within two decades . More pandemics are likely in the coming years , whether from new coronaviruses and / or from other pathogens . We clearly must do everything possible to prevent and be better prepared for future pandemics and other public health emergencies , and must learn and apply lessons from the recent experience with mitigating COVID-19 . Regarding prevention , policymakers need to take prudent actions immediately to reduce the likelihood of future pandemics , including addressing environmental destruction that brings different species into closer contact with humans , restricting the trafficking of animals , and strengthening biosecurity in laboratories that work with potential human pathogens . Preparation for the next pandemics should include detailed plans by international organizations that are widely vetted and agreed upon . Lockdowns and quarantines , when ( and only if ) necessary , need to be designed equitably and to include protection , prioritization , and compensation for those most vulnerable , including the elderly , the poor , and workers in frontline and informal jobs . Effective mechanisms must also be established to address equity in access to treatments and vaccines , prioritizing those at highest risk . We certainly must avoid another situation where public health authorities and politicians are left to fly blind and then try to clean up the damage later . It would be a grave error to respond to a new pandemic without applying lessons from the current one .”
References :
Halperin DT , Hearst N , Hodgins S , Bailey RC , et al . Revisiting COVID-19 policies : 10 evidence-based recommendations for where to go from here . BMC Public Health . Vol . 21 , article number 2084 . Nov . 13 , 2021 .
Palmore TN and Henderson DK . Healthcare-Associated Infections in the Time of Pandemic COVID-19 . Infection Control & Hospital Epidemiology . Web ( Aug . 25 , 2021 ).
Rebmann T , Alvino RT , Mazzara RL and Sandcork J . Infection preventionists ’ experiences during the first nine months of the COVID-19 pandemic : Findings from focus groups conducted with Association of Professionals in Infection Control & Epidemiology ( APIC ) members . Am J Infect Control . Vol . 49 , No . 9 . Pp . 1093-1098 . Sept . 1 , 2021 . DOI : https :// doi . org / 10.1016 / j . ajic . 2021.07.003
Weiner-Lastinger LM , et al . The impact of COVID-19 on healthcare-associated infections in 2020 ; A summary of data reported to the National Healthcare Safety Network . Infection Control & Hospital Epidemiology . Web ( Aug . 25 , 2021 ).
Comparing Occupational Sharps Injuries & Mucocutaneous Exposures Across a Pandemic
By Amber H Mitchell , DrPH , MPH , CPH , and Ginger B Parker , MBA
Despite being amid a worldwide global infectious disease pandemic occupational sharps injuries and mucocutaneous incidents didn ’ t change notably from 2019 to 2020 . That doesn ’ t mean , however , that there weren ’ t important differences .
Regarding PPE use , there was increased reporting of surgical mask use ( 3.3 percent increased to 26.2 percent ). The increased frequency of use was anticipated , but there was only a very slight increase in eye protection use ( 3.6 percent to 5.2 percent ), despite 80.7 percent of all exposures happening to the face or head .
Additionally , in both 2019 and 2020 , 0 percent of workers indicated they were wearing respiratory protection . Given widespread focus on increasing respirator use in healthcare facilities , this is quite surprising . This illustrates that prior , and during the pandemic , workers continue to be under-prepared for blood and body fluid exposures to the face . Essentially , nothing changed .
These mucus membrane exposures are extremely high-risk exposures since the mucosa are so vessel rich . As those working in occupational infection prevention , we must remain diligent about not only providing face PPE but making it immediately accessible when and where it is needed .
As it relates to sharps injuries and needlesticks , there weren ’ t notable differences pre- and peri-pandemic , but many procedures were cancelled or delayed , including elective surgeries . Therefore , it is possible that because fewer non-COVID patients were seen , fewer devices were used . This would be interesting to analyze .
As well , EPINet does not currently capture a wide base of non-acute , ambulatory and urgent care centers . Therefore , injuries and exposures occurring in those facilities saw more people , because they were diverted away from acute care , were not captured in this dataset .
To note , the use of engineering controls like devices with sharps injury protection features are still lower than acceptable . This changed drastically ( 52.2 percent to 36.9 percent ) and especially in operating rooms . This could mean that fewer people are being injured by devices with these protective features , but it could equally mean that there was less focus on sharps injury prevention during the pandemic so that safer device use declined . Improving safer device use in the OR is an ongoing challenge , especially since suture needles continue to be the most frequent injury device ( 23.7 percent ) compared to all other devices .