With A Crash Course In Infection Prevention, The World Faces A New Normal
by George Clarke, CEO of UMF Corporation
COVID-19 has spread rapidly around the globe, upending lives, communities and life as we know it in the process. As of this writing, COVID-19 has infected more than 5 million people globally in 187 countries. More than 1.5 million people in the U.S. have tested positive for the disease, and that number is rising. With no vaccine, treatment or cure, COVID-19 has led to more than 335,000 deaths and is projected to cost the global economy $1 trillion in 2020. All that doesn’t consider the psychological, societal and community impacts of closed schools, shuttered businesses, social distancing, sheltering at home and self-isolation.
In 2018, the World Health Organization (WHO) predicted and warned nations that they needed to prepare for "Disease X.” According to the WHO, Disease X represents “the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease.” Unfortunately, most of the world did not heed these warnings, which is clear from our current inadequate preparation and disaster response to COVID-19. Most countries have been flat-footed in their initial reactions to the virus, leading to the global pandemic we are currently fighting.
COVID-19 And Antimicrobial Resistance (AMR)
COVID-19 disease is caused by the virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), one of many types of microbes, which include bacteria, fungi, protozoa and viruses. While most microbes are harmless and even helpful in humans, some can cause disease. The COVID-19 disease is incredibly difficult to treat once it has manifested as pneumonia, at which point deadly secondary bacterial infections often accompany the virus.
Drugs used to treat microbial infections are called antimicrobials, the most common of which are antibiotics, which fight bacteria. However, antimicrobial resistance (AMR) has steadily increased over the past decades, threatening effective prevention and treatment of a steadily increasing range of severe infections. AMR happens when microbes mutate as a result of being overexposed to antimicrobial drugs (e.g., antibiotics, antivirals, antimalarials). At this point, medicines become ineffective at fighting the infections, and the risk of spread to others increases.
When it comes to bacterial infections alone, the Centers for Disease Control and Prevention (CDC) indicate that more than 2.8 million antibiotic-resistant infections occur in the U.S. annually, and more than 35,000 people die as a result of them. Nearly twice as many annual deaths from antibiotic-resistant infections were reported in the 2019 report as compared with the CDC’s 2013 report.
Fighting The Virus And Shining A Light On Hidden Heroes
In a desperate attempt to fight COVID-19, the world has been forced to take a crash course in infection prevention, from learning how to properly wash our hands and refraining from touching our faces to effectively disinfecting surfaces and wearing masks. Essential workers — nurses, doctors, delivery people, grocery store clerks, pharmacists and first responders — are resoundingly heralded as the heroes during this trying time. Less commonly acknowledged are the environmental services (ES) staff who are tasked with cleaning up before, during and after COVID-19 cases come through hospitals. Too often, ES staff are hidden in the background, yet their role is more crucial now than ever.
SARS-CoV-2 is highly contagious. It is communicable through the air and can linger on surfaces for days. Cleaning all surfaces of a patient’s room and throughout the hospital are critical to contain the spread of the virus. Healthcare workers on the front lines — including clinicians and staff at hospitals, long-term care facilities and clinics — must embrace a multimodal approach to infection prevention and control, which should include:
• Enterprisewide multimodal intervention advocated from the C-suite.
• ES staff training and recognition programs to incentivize and arm the staff with best practices for cleaning patient rooms and other areas.
• Best-practice environmental processes, best-in-class cleaning products and EPA-registered disinfectants that are proven effective against the challenge at hand while ensuring that they do not put ES staff at risk.
Unfortunately, some healthcare organizations historically have looked at ES as an area where they can cut costs, often outsourcing the function to reduce overhead. No doubt, the current pandemic will change that view.
A New Normal
As the world grapples with COVID-19 and endures its devastating toll, we wonder what our new normal will look like. From attending school and going to work to traveling and shopping for essentials to visiting your doctor or dentist, the foreseeable future will be different from what we’ve known. Temperature checks and health clearances could be mandatory prior to entering buildings or participating in certain activities. And, infection prevention protocols across industries will be much debated and prioritized.
In healthcare, that means elevating the role of ES departments, which not only will help control the spread of COVID-19, but also will help prevent healthcare-acquired infections (HAIs), which infect 1.7 million and kill 99,000 Americans annually. The CDC advocates for compliance with environmental infection control measures — including cleaning and disinfecting all environmental surfaces — to decrease their risk among patients, especially the immunocompromised, the elderly and healthcare workers.
While it will be at least many months and likely years before we fully understand the toll COVID-19 will take on the world, one thing is certain: We must learn from this pandemic, instituting better protocols and procedures in order to prevent and better respond to future crises. Again, it’s not a matter of if; it’s a matter of when the next Disease X will attack.