patient safety & quality
By J . Hudson Garrett Jr ., PhD , MSN , MPH , MBA , FNP-BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , MSL-BC , CPPS , CPHQ , NREMT , CADS , FACDONA , FAAPM , FNAP
CDC Releases New Guidance on Potential Additional Routes of COVID-19 Transmission
Recently , the Centers for Disease Control and Prevention
( CDC ) released new guidance specific to the modes of transmission of COVID-19 . This new guidance , which was released on Oct . 6 , 2020 , details an additional route of potential infection transmission : “ airborne .” It is important to note that the term “ airborne ” transmission within healthcare settings has specific connotations regarding the appropriate level of respiratory protection and personal protective equipment ( PPE ) required for personnel protection .
In this new guidance update , the CDC has provided additional details regarding the potential of low-frequency potential spread of COVID-19 infection in environment where air flow is stagnant , and ventilation is inadequate . SARS-CoV-2 virus , which causes COVID-19 infection , can be spread via aerosols in the air in certain environments . COVID-19 remains a highly transmissible virus and spreads most often during close and prolonged contact with an infected person . Respiratory droplets , containing SARS-CoV-2 virus can be spread when a person sneezes , coughs , or sings . These small droplets can be transmitted in aerosols for longer distances before eventually falling to the floor .
The new CDC Guidance states the following points regarding the potential airborne transmission of COVID-19 :
●Some infections can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours . These viruses may be able to infect people who are further than 6 feet away from the person who is infected or after that person has left the space .
●This kind of spread is referred to as airborne transmission and is an important way that infections like tuberculosis , measles , and chicken pox are spread .
●There is evidence that under certain conditions , people with COVID-19 seem to have infected others who were more than 6 feet away . These transmissions occurred within enclosed spaces that had inadequate ventilation . Sometimes the infected person was breathing heavily , for example while singing or exercising .
●Under these circumstances , scientists believe that the amount of infectious smaller droplet and particles produced by the people with COVID-19 became concentrated enough to spread the virus to other people . The people who were infected were in the same space during the same time or shortly after the person with COVID-19 had left .
●Available data indicate that it is much more common for the virus that causes COVID-19 to spread through close contact with a person who has COVID-19 than through airborne transmission .
This new CDC guidance is similar to recommendations for several other highly transmissible respiratory infections where aerosols may remain suspended in the air for an extended period of time , especially in indoor environments where the air circulation is inadequate . However , it is important to note that this route is not the most common mode of the transmission of COVID-19 . The
CDC ’ s core infection control recommendations have not changed and include fundamental interventions which aim to reduce the presence of viable virus in the environment , protect healthcare personnel and patients , and mitigate the potential spread of the SARS-CoV-2 virus . The CDC ’ s Core Recommendations to assist with mitigation of COVID-19 include :
●Hand Hygiene : Hand Hygiene may be performed with either soap and water or an alcohol-based hand rub with an alcohol concentration between 60-90 %. It is also important that any alcohol-based hand rubs be properly cleared through the Food and Drug Administration to ensure both safety and efficacy . Hand Hygiene remains the single most important infection prevention intervention that is in our arsenal as healthcare providers .
●Face Coverings or Masks : CDC continues to recommend the use of a universal face coverings for the general community and the use of FDA-cleared masks for healthcare providers to create universal source control .
●Universal Screening : Screening of both healthcare providers and also patients / visitor for potential infectious respiratory diseases
●Social Distancing : Remaining at a distance of six feet or greater will help reduce the potential dispersal of contaminated droplets from one person to another .
●Disinfection : Disinfection of High-Touch Surfaces with an Environmental Protection Agency ( EPA ) -registered disinfectant greatly reduces the presence of viable virus on environmental surfaces and medical devices . The EPA has published a new
List N which identifies all EPA-registered disinfectants that are deemed effective against SARS-CoV-2 virus on hard , non-porous surfaces .
Fighting COVID-19 requires a persistent and interprofessional approach to infection prevention and control . The development of additional diagnostic testing , therapeutics , and most recently vaccines to fight COVID-19 will help healthcare providers to further reduce the impacts of the ongoing COVID-19 pandemic . Operation Warpspeed and the core infection control practices such as hand hygiene , proper use of PPE , and the routine disinfection of the healthcare environment will all directly help curb the spread of COVID-19 .
J . Hudson Garrett Jr ., PhD , MSN , MPH , MBA , FNP-BC , IP-BC , PLNC , CFER , AS-BC , VA-BC , MSL-BC , CPPS , CPHQ , NREMT , CADS , FACDONA , FAAPM , FNAP , is president and CEO of Community Health Associates , LLC . He also serves as an adjunct assistant professor of medicine in the Division of Infectious Diseases at the University of Louisville School of Medicine . Garrett is a frequent lecturer globally on patient safety , infectious diseases , and medical device reprocessing and safety . He may be reached at :
Hudson . garrett @ chaassociates . com