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70.  Viewpoint: On COVID Boosters, CDC Panel Must Recover Ball That FDA Panel Fumbled
Health care workers know all too well the lasting and debilitating effects of long COVID-19. They were one of the first to become vaccinated and are some of the first experiencing breakthrough infections. They are tired, burned out, and many are on the brink of collapse.
Initially, the FDA's concern appeared to be centered on having solid data which showed severe breakthrough infections were developing, especially in those who are biologically at high risk for disease. After the second vote, the concern was focusing on individuals having a high risk of exposure to COVID-19, regardless of the biological susceptibility of the individual. It would be more reasonable to either reconsider the initial proposal of offering boosters to all who are 16 years of age or older, or at least offering boosters to those who are 30 years of age or older, plus individuals who are at high risk for severe long COVID. Not including individuals with non-occupational exposure was unwise, since the proposal now may exclude caregivers of unvaccinated school age children, and places these caregivers at an unnecessary risk.  References  Infection Control Today.  Sept. 20, 2021.       

69.  FDA Panel Sidesteps Decision for Broad Distribution of Booster Shots   
Some medical experts say that in this case, inaction is also an action—either the US gives boosters or does not. That decision needs to be based on the best available evidence. Instead, there seems to be a desire to wait another 6 months for pristine randomized controlled studies. The logic of distinguishing between occupational and non-occupational high-risk exposure and why that makes a true difference was not evident. In addition, if exposure indeed is a major variable to obtaining a booster—shouldn’t the initial question about far-reaching availability of booster shots be readdressed?  References Infection Control Today.  Sept. 18, 2021.  
68.  Viewpoint: We’re Reopening Schools Too Quickly
The further away from an infected person you are, the less likely you are to contract the disease. But you are still not safe at 6 feet. The virus is airborne and can spread much further to the back of the classroom. There are those who advocate for herd immunity, but in reality, this is a fool’s dream. Teleschooling and hybrid programs may be a vital long-term strategy. They were not fully successful last year, but instead of discarding this strategy we should be developing improvements. It is apparent that the SARS-CoV-2 pandemic is an extremely difficult ever-changing problem. We must slow down the spread of this virus by adopting a layered approach so our pharmaceutical industry has time to catch up with development of therapeutics and next generation vaccines.   References  Infection Control Today.  Sept. 10, 2021.   

67.  Mu Variant Might Escape Immunity from Vaccines, Past Infection. 
After the Delta surge subsides, another surge is expected, possibly from the Mu variant. If Mu completely escapes immunity from vaccines and past infections, we must resort to stringent public health strategies. It is also becoming apparent we cannot vaccinate our way out of this pandemic. The vaccine’s effectiveness is waning, and the variants are becoming resistant making the wearing of masks, in a mask resistant population, an imperative. It was welcome news to finally have a clinical trial published by research from Stanford which demonstrated the effectiveness of surgical masks in curtailing COVID-19 infections.In those over 60, there was a decrease of 34.7%. Mask usage became even more important with a recent report in the CDC’s Morbidity and Morality Weekly Report (MMWR) demonstrating aerosolization in schools. A school outbreak was traced back to an unvaccinated, mildly symptomatic teacher who reportedly read unmasked to her 24 students who presumably were wearing masks.  References  Infection Control Today.  Sept. 6, 2021.   
66.  Viewpoint: Should US Adopt an Elimination Strategy Against COVID-19?
On July 29, 2021, Infection Control Today® sounded the alarm regarding vaccine breakthrough infections and waning immunity, citing Israeli data which found vaccine effectiveness in the prevention of all infections and symptomatic infections to be only 16% after 5 months from full vaccination.
In nursing homes, we need to administer boosters to residents who were fully vaccinated early in this pandemic. Nursing home residents are the most frail and highest risk members in our society.
In Beijing the total cases in an outbreak were reported to be less than 10. China used over 100 million tests to eradicate what would be classified as a very small outbreak by US standards.   References  Infection Control Today.  Aug. 25, 2021.  

65.  Viewpoint: Expanding Booster Shots to US Adults Needed to Happen
In the Middle Ages a pandemic wiped out 50% of the world’s population. Presently we have a much higher population density, making us a feeding buffet for infectious disease…. If we do not follow the recommendations of modern science and public health, we are no better off than if we were living in the Middle Ages. "We do not have the luxury of waiting. Delta is here. In the case of delta, inaction is also an action, and an expedited decision is needed. Currently, the United States is discarding vaccines and these vaccines are known to be very safe. If we do not administer boosters to this high-risk population, we risk having a catastrophe on our hands.” The solution, if you have not already done so, get vaccinated. If you are vaccinated and are at risk of immunity waning, get a booster as soon as they are available.    References  Infection Control Today.  Aug. 18, 2021.   

64.  Take a Stand Now to Stop COVID-19 Variants
Herd immunity is no longer possible, the virus is mutating and likely has animal hosts. We must raise the bar on public health outcomes, not only focusing on deaths but also morbidity and long-hauler syndrome which can be all too common, even occurring with vaccine breakthrough infections. An emerging pattern is that each new wave which envelops a nation is caused by different variants of the virus. It also is apparent that each major wave is caused by a variant which possesses immune escape properties. Slowing down the replication and mutation of this virus is of utmost importance. We must plan and invest in long-term solutions. This virus might disappear, similar to the 1918 flu, or it could be present for decades. Consistent messaging and widespread embracement of vaccines along with public health measures are key to providing our pharmaceutical industry the necessary time to formulate new vaccines and therapeutics which can effectively treat and prevent infections.  References  Infection Control Today.  Aug 17, 2021    

63.  Messaging Muddle: Pushing Vaccination as COVID Vaccines’ Effectiveness Wanes
While not perfect, the mRNA vaccines do markedly reduce the chances of hospitalizations from critical disease and death.  This is a huge plus. Combining all of these reports shows that to control this pandemic we need to enact multiple layers of prevention including effective masking, vaccinations, upgrading ventilation systems and social distancing.  This virus is endemic.It is here to stay, and new variants are waiting in the wings to cause another surge with reinfections and breakthrough infections.  If we do this, we will be able to start to learn to live with this virus, we cannot simply wish it away.   References  Infection Control Today.  Aug. 12, 2021.     

62.  Get Vaccinated Even If You’ve Gotten COVID-19, Study Suggests
A CDC investigation shows 2.3 times the number of reinfections with natural immunity compared to breakthrough infections in those who are vaccinated.  Public Health England (PHE) briefing includes updated hospitalization data for Delta, which shows that in the period since the last update on July 19, "1467 people were hospitalised with cases of Delta confirmed by sequencing or genotyping." Of these, 808 (55.1%) were unvaccinated, while 512 (34.9%) had received both doses of a vaccine. This supports the Health Ministry of Israel’s data which shows waning of vaccine protection in those who are over 60 years of age and are more than 5 months post vaccination. As Infection Control Today® reported, 8.6% of breakthrough infections in this group of elderly patients have resulted in hospitalization and 2% have resulted in death.   References   Infection Control Today. Aug 8, 2021.   

61.  Lambda Variant, COVID-19 Animal Hosts Present Deadly Mix
Data collected by Britain’s Scientific Advisory Group for Emergencies, Japanese researchers, and the US Department of Agriculture paint a picture of a growing challenge. Taken together, the report from SAGE, the viruses’ establishment of an animal host and the news regarding the lambda variant is an extremely deadly mix. We need to come together as a society so we can slow down the spread of this virus so viral recombination will not occur, and genetic drift slows. In addition, we need to formulate strategies to prevent the spread from animal hosts to mankind. Above all, we need to learn how to live with this virus so our pharmaceutical giants can develop and manufacture vaccines faster than the virus can mutate.  References  Infection Control Today.  Aug. 5, 2021.   

60.  COVID-19 Booster Shots for Older Americans Might be Needed
Overall, the vaccines are still very effective in preventing hospitalizations and deaths, with the exception of those over 60 who have been fully vaccinated before the end of January 2021. Most of the infections in Israel are caused by the Delta variant. Overall if there was a breakthrough infection: 8.6% hospitalized and 2% died. However, the test positivity rate appears to be low, about 0.3%, indicating that vaccines afford protection against infection. Those who are not vaccinated need to become vaccinated and, similar to Israel, those over the age of 60 who were fully vaccinated before January of this year, should be considered for a booster.   Infection Control Today.    References   Infection Control Today.  Aug. 2, 2021.    

59.  Latest Data Point to a Need for COVID-19 Booster Shots
Overall, The Israeli data found that after 2 doses of the vaccine the effectiveness in the prevention of infection with the Delta variant was 39% and the prevention of symptomatic disease was 41%. However, the main observation is that once immunity takes hold, the infections by the alpha variant (in May—middle graph) almost disappeared. But in late June and July, the Delta variant emerged and markedly decreased the vaccine’s ability to prevent breakthrough infections. Surprisingly, as indicated by anecdotal reports, the young are not spared. The Israeli data need to be confirmed. A good first step would be for the CDC to release its data on reinfections so all can evaluate it.   References   Infection Control Today.  July 29, 2021.   

58. Viewpoint: CDC Continues to Bumble COVID-19 Response
We need to have a paradigm shift in the way we view this virus, planning and implementing strategies to allow us to live with an endemic pathogen. Needless-to-say, early recognition of aerosolization would require the use of N-95 masks and make upgrading ventilation systems an imperative. Others are starting to follow former Surgeon General Jerome Adams’ advice. On July 19, 2021, the American Academy of Pediatrics recommended that all children over the age of 2, regardless of vaccination status, wear masks in schools this fall.  References  Infection Control Today. July 20, 2021.   

Kentucky Health News: 


  57.  Stage May be Set for Next COVID-19 Surge
Beating back infection is a numbers game: viruses against antibodies. If the virus changes its armor so the antibodies cannot attach, it develops an advantage. However, it can also produce viruses which are more efficient at attaching to and invading cells, or simply just produce a lot more viruses, overwhelming the immune system.
As we are on the beginnings of another COVID-19 surge, many are starting to question whether we can vaccinate our way out of this pandemic. Can we vaccinate our way into herd immunity? Possibly not, because 3 barriers are shedding doubt on accomplishing this goal.  References  Infection Control Today.  July 13, 2021.   

56.  We Might Ignore the Delta Variant, but It’s Not Ignoring the U.S.
"It has been two weeks since Infection Control Today® sounded the alarm that the Delta variant (B1617.2, Double Mutation Indian Variant) was spreading rapidly in the United States. On June 15, the Centers for Disease Control and Prevention (CDC) issued a warning regarding the variant and declared it a “variant of concern.” As Australia and Singapore have adopted a zero tolerance to COVID-19, closing down sectors of the country with even 2 or 3 cases, we have adopted a wait-and-see policy, largely ignoring the potential dangers posed by these new variants. And there is now a Delta Plus variant (AY.1 & AY.2) which has emerged in India which is more resistant to monoclonal antibodies, including antibody cocktails and has also entered the United States. For now, I would strongly advise every person (even those who have had COVID-19) to be fully vaccinated to boost one’s immunity to the highest possible level and wear masks when indoors in poorly ventilated buildings. It is far too soon to be fully reopening our society."  References  Infection Control Today.  June 21, 2021.

55.  Not Quite Over Yet: COVID-19 Variants on Rise in the U.S.
As the United States emerges from the COVID-19 pandemic, nobody really wants to hear (and few media outlets report) that the rapid emergence of immune escape COVID-19 variants pose a clear and present danger of a setback. Over three weeks, the percentage of genomic testing which was comprised of the Indian Double Mutation Variant, or Delta Variant, jumped from 1% to 7% in the U.S. The data was derived from, a website operated by Scripps Research and funded by the NIC, the Centers for Disease Control and Prevention (CDC) and National Center for Data for Health.  References  Infection Control Today.  June 7, 2021. 
54.  Viewpoint: CDC Might Help COVID-19 Make a Comeback in U.S.
The day before the publication of the modeling study’s dire warning, the CDC abruptly removed mask and physical distancing requirements for those who are vaccinated. Unfortunately, this will probably also result in many unvaccinated individuals unmasking.
Those of you who advocate reopening at the peril of those who are vaccine hesitant—letting nature decide the fate of the ill-informed—need to remember that survival is not the same as recovery. Let’s not be cavalier in our approach to a return to a new normal. Let’s be smart and cautious. Continued masking and social distancing for a few months, possibly just a few weeks, is a small price to pay to assure the safety of our nation.  References  Infection Control Today.  May 18, 2021.  

53.  COVID-19 Model Says 905,289 Died of the Disease in U.S.
Infection preventionists need to stress the importance of aerosolization with increased recommendations for N-95 masks and we all need to realize that a prerequisite of reopening a business, school or public venue should be safe ventilation. Nowhere is safe inside a poorly ventilated building. The six-foot rule does not apply. Infection preventionists need to stress the importance of aerosolization with increased recommendations for N-95 masks and we all need to realize that a prerequisite of reopening a business, school or public venue should be safe ventilation with an increased number of complete air exchanges along with air sanitization.  References  Infection Control Today.  MAY 8, 2021.

52.  Infection Preventionists Must Ward Off a COVID Comeback
What happens in India, or anywhere else in the world, doesn't stay there. The longer COVID-19 hangs around, the more chance it has of mutating into a variant that the vaccines won't stop. Policymakers have falsely equated outdoor safety, produced by the rapid dissipation of aerosols, with safety from droplets and have ill-advised not wearing masks at some outdoor events. This may be effective in suppressing community spread, but it will not afford adequate protection for the individual.  References   Infection Control Today.  May 4, 2021.   

51.  Viewpoint: Health Care Professionals—Get Vaccinated or Get Out
In the last 2 months COVID-19 cases have not fallen. They are hovering above 60,000 per day (7 day moving average). Some have wondered why doubling the number of vaccinated Americans has not budged the numbers. There are two reasons: variants and vaccine hesitancy.Thus, even with the E484K variants, vaccination appears to provide substantial protection against severe COVID-19. However, for the most part, severe is defined as dying or being hospitalized. This is a very low bar to set for community health. I personally know too many of my friends who have had “mild” COVID and are now suffering from chronic dyspnea and heart disease, such as arrhythmias.
If you work in a health care facility, you need to be vaccinated against SARS-CoV-2. If you choose not to become vaccinated, then you should choose not to be working in a health care setting.  Infection Control Today.  Apr. 22, 2021. References  

50.  COVID-19 Variants Make Road to Normal a Bit Rocky
Infection preventionists (IPs) are now faced with delivering a difficult message. It is much easier to advocate for vaccinations which prevent disease, than it is for vaccinations which lessen the severity of disease or reduces your chances of becoming infected.
Thus, both natural (post-infection) and vaccine immunity appear to provide excellent protection against COVID-19. At least for the original strain or wild-type of the virus.
One must ask, why are some sounding the alarm? Fauci recently has stated that the COVID-19 case rate has creeped up from around 30,000 to 40,000 cases per day to 60,000 cases per day. And he warns we do not want to declare victory prematurely because of the viral variants.  Variants which are of special concern contain one of two new spike protein mutations which can evade immunity. Thus, both natural and vaccine immunity appear to provide excellent protection against COVID-19. At least for the original strain or wild-type of the virus.  Infection Control Today.  Apr. 8, 2021.  References 

49.  Viewpoint: South African Variant Could Spur a New U.S. Surge
If one does the math, if a third of our population is vaccinated, which means they may be protected from severe illness but can become infected and spread the virus, it places those not vaccinated at grave risk. If these variants are more infectious and deadlier than last year’s, D614G, then we may be headed for another major surge. Those offering reassurance based on the upcoming warm weather have forgotten last year’s lessons and the major summer surges. The best advice is to get vaccinated and follow strict public health advice. Infection Control Today. Mar. 19, 2021.  References  

48.  Possible New Variant Causes Outbreak in Highly Vaccinated Nursing Home - Argues Against CMS's New Guidance.
As I have stated repeatedly, if we keep spreading around SARS-CoV-2, it may well mutate into a variant which evades the vaccines for coronavirus disease 2019 (COVID-19). According what recently went on in a Kentucky nursing home, the virus may well have done just that. According to WKYT: “The governor says a COVID-19 outbreak has been reported at a nursing home in eastern Kentucky. There are 41 cases reported, including five residents that have been hospitalized. Dr. Steven Stack says 30% of vaccinated individuals are symptomatic and 83% of the unvaccinated at the nursing home are showing symptoms.” It is reported that one vaccinated resident is hospitalized (1 in 71) with COVID-19, compared to 4 unvaccinated residents that are hospitalized (4 in 13). According to “85 percent of residents and 48 percent of staff opted to get a coronavirus vaccine.”  Infection Control Today.  Mar. 17, 2021.  References   

47.  Viewpoint: Nursing Home Guidance Endangers Elderly
Our elderly in nursing homes have been at grave risk for contracting coronavirus disease 2019 (COVID-19). Yesterday the Centers for Medicare and Medicaid Services (CMS) released revised nursing home guidelines for visitation recommendations. They are designed to provide relief to the grave psychological toll COVID-19 has inflicted through long-term isolation and separation of residents from loved ones. But one has to ask, are they safe? I have grave concerns.... Regardless of what we deeply desire to take place, or are able to mandate or recommend, the virus will spread relentlessly. It is an uncaring soulless machine which is evolutionarily programmed to inflict a devastating toll as it efficiently spreads and evolves throughout our communities. Enacting these recommendations at this time is reckless and places nursing home residents at undue risk.Our loved ones deserve better.   Infection Control Today.  March. 11, 2021.    

46.   Rush to Reopen Buys COVID-19 More Time
There needs to be a shift from droplet precaution standards to airborne spread standards and we need to invest in the safety of our frontline workers. Quite simply, this virus is aerosolized, meaning it is airborne. I really thought this had been decided last July when a letter was sent to the World Health Organization (WHO) by 329 top scientists from 33 countries. But although agencies responded by recognizing airborne spread in some of their statements and webpages, their recommendations on controlling spread and reopening of businesses and schools largely did not. Most importantly, the CDC needs to articulate firm and harmonized advisements which are consistent across all materials, recommendations and webpages. Until this happens, there will not be a demand for N95 masks and air sanitization units. Manufacturing will not gear up production and pathogens will continue to spread. We need to enact these reforms not only for COVID-19 and the next pandemic, but for other endemic dangerous pathogens. Our children deserve better than the status quo.  Infection Control Today.  Mar. 4, 2021.  References   
45.  Viewpoint: CDC’s School Reopening Plan Gets an ‘F’
The argument that preventative strategies need to be tailored to the needs and resources of local communities, along with a one-size-does-not-fit-all approach, may placate political pressures, but the virus does not care. You need to do what you need to do to control the disease. It needs to be clearly stated what needs to be done and if a community cannot comply and wants to open schools, then the parents need to be informed of the increased risks to students. Recommendations should not be changed to reassure families of a degree of safety which does not exist.....Frequent, (three times a week) screening of our athletes has been key to the opening of professional sports. Our students deserve the same safety precautions as professional athletes. Infection Control Today. Feb. 15, 2021.  References 
44.  Beginning of the End? Some Hopeful COVID Developments
The good news? The fact that 3 different viruses with 3 different lineages came up with the same mutation to evade natural immunity and the vaccines. And initial reports are that it only partially evades the vaccines. And one needs to ask, why did these viruses not come up with different mutations? After all they do not plan the mutations, they evolve by random chance. Maybe the answer is that this random amino acid combination is possibly the last major mutation the virus can produce without changing its ability to enter the cells or its infectivity. Infection Control Today.  Feb. 3, 2021. 

Kentucky Health News.  Feb. 3, 2021. 

43.  Problem: COVID-19 Hospital-Acquired Infections
HSJ analyzed England’s National Health Service Data regarding hospital-acquired SARS-CoV-2 infections. SARS-CoV-2 is the virus that causes COVID-19 and unfortunately HSJ found that hospital-acquired infections (HAIs) are not uncommon, estimated to cause almost 1 in 4 hospital COVID-19 cases. We need to have mandatory reporting of worker and patient acquisition of SARS-CoV-2 and the development of COVID-19 with metrics to provide us the most accurate estimate of cases so we can effectively plan and allocate resources.  Infection Control Today.  Jan. 20, 2021.  References  

42.  As Vaccine Rollout Stalls, Move Monoclonal Antibodies Into COVID Fight
As of January 16, 2021, only 39.4% of the 31.2 million allocated vaccine doses have been placed in arms. The original goal was to vaccinate 20 million citizens by the end of 2020. Until vaccines become widely available, it is imperative that those at high risk for severe COVID-19 be offered monoclonal antibody therapy. So far, the use of monoclonal antibodies has not been a priority in the United States’ COVID-19 response, and the medication has largely gone unused, with 80% of the 600,000 doses still “sitting on shelves.” Monoclonal antibodies need to be given within 3 days of diagnosis and to those who are at high risk for severe COVID-19. To locate a facility, the Dept. of Health and Human Services has posted a medication locator at:  Then click on the "Find Infusion Locations" screen button.  Infection Control Today.  Jan. 17, 2021.    References

41.  COVID-19 Variants Make Infection Prevention Harder
Infection preventionists need to spread the message and articulate the uncertainties of this new variant of COVID-19. They need to emphasize that it is just not the old who are at risk and employ stricter containment measures....  Many health departments are understaffed. In one Kentucky Public Health District, staffing has been cut almost in half over the last decade. Our stressed healthcare system has an inadequate infrastructure to administer the initial vaccine dose, let alone doubling the effort to administer the second dose. Infection Control Today. Jan. 4, 2021.  References  

40.  Vaccines Should Work Against New COVID-19 Strain
We must treat this strain with the respect it deserves, but we must not panic. There is no doubt that increased infectivity equates with increases in deaths, but it does not mean the vaccines will not work. It is imperative that we follow public health advice. Just remember what happened to the snow leopards in the Louisville Zoo, they are exceptionally good at enforcing social distancing, but not so good at wearing masks. They caught COVID-19. Thus, you must do both. And be steadfast, since we have to slow down the spread of SARS-CoV-2, so the viruses natural production laboratory does not outstrip the capacity of our pharmaceutical giants. Infection Control Today.  Dec. 22, 2020.  References
39.  Viewpoint: Monitoring Systems Track COVID Vaccine Reactions
V-Safe and VAERS are 2 monitoring systems for patients who are given a COVID-19 vaccine. Infection preventionists can play a vital role in educating about the strengths and drawbacks of each. However, questions remain. We do not know how long immunity will last, if those vaccinated can become infectious as an asymptomatic carrier, or how the vaccine affects special populations such as those who are pregnant, very young or immunosuppressed.  Infection Control Today. Dec. 15, 2020.  
38.  COVID-19 Vaccine? Hurry Up and Wait
At last, the vaccines are here! Or are they? There appears to be a shortfall, not enough to initially vaccinate even all of the frontline healthcare workers and nursing home residents against coronavirus disease 2019 (COVID-19). By some estimates only about 20% of the expected doses will be available by year’s end. Shortages can more easily be corrected, than the combating of anti-vaxxer misinformation. However recent polls have been reassuring, with those willing to take the COVID-19 vaccine increasing to 63%. Infection preventionists are an important component of this effort and need to actively articulate to both patients and on social media the need to be vaccinated and to follow public health advice. Infection Control Today.  Dec. 10, 2020.  References
37. Healthcare Workers Hit by COVID Need Workers Comp  
"Kevin Kavanagh, MD. In a wide-ranging discussion, Kavanagh—a member of Infection Control Today®’s Editorial Advisory Board—says that the nation isn’t doing nearly enough to help those on the frontlines battling the coronavirus disease 2019 (COVID-19) pandemic. Kavanagh says that “these frontline healthcare workers are putting their lives at risk, and also the lives of their families and loved ones. And they need to be given support; at least proper protective equipment. In my opinion, they should get presumptive workers comp, if they start to develop problems. This is a significant problem.” The public isn’t taking the disease seriously enough and leaders are not leading."  Infection Control Today.  Nov. 17, 2020.  

36.  Viewpoint: Healthcare Workers Not Being Protected from COVID
Faced with greater than three times the number of cases as the last surge, along with exponential growth with no end in sight, there is little hope healthcare workers can safely treat patients without a drastic change in policy and a more productive and secure supply line.  Infection Control Today. Nov. 16, 2020.   References  
35.  Viewpoint: Quackery Might Stall Progress Against COVID-19
The worst-case scenario is that if an effective and safe COVID-19 vaccine is found, a large segment of our population will elect to use hydroxychloroquine or another ineffective treatment instead, allowing the virus to continue to thrive, and devastate our nation. As a nation, we can easily defeat this virus, but it requires us to trust modern science and embrace a national strategy coordinated by public health officials and our federal government. Let’s not embrace attitudes and views of the 1800’s.  Infection Control Today.  Nov. 7, 2020.    References

34.  COVID Vaccine: What Infection Preventionists Need to Know
Kevin Kavanagh, MD: "Infection preventionists will need to make sure that they still have access to adequate PPE, even if the vaccine comes out [and they] really need to look at the experimental group that was used for the EUA."   And believe me, if I was a frontline healthcare worker at my age, a vaccine would really have to have a lot of complications and concerns before I would not get it. Now that's just a personal view. Because if it adds any armor to protect me from a highly infectious disease that's very prevalent in our community, that has a high rate of fatality, and even a higher rate of chronic disability, I would opt for that vaccine. 
33.  FDA Panel Reviews Many Challenges Facing a COVID Vaccine  -- Vaccines: Safety & Efficacy

The overall cost for society is far too high for a flawed and relaxed vaccine approval process. If the vaccine has low effectivity and primarily prevents mild disease, it will offer little protection to society and may cause inconceivable harm. To paraphrase Peter Luri, MD, MPH, from the Center for Science in Public Interest—The benefits of a minimally effective vaccine can be negated if the public relaxes wearing masks and social distancing. But even worse, if the vaccine is ineffective, it will further fuel the antivaccine movement for decades to come.  Infection Control Today.  Oct. 25, 2020.      References 

32.  Viewpoint: The “Not So” Great Barrington Declaration
Recently, an international group of scientists signed a declaration advocating for achieving herd immunity from coronavirus disease 2019 (COVID-19) by opening communities and business, while protecting the vulnerable with "focused protection." The Declaration states: "A comprehensive and detailed list of measures, including approaches to multi-generational households, can be implemented, and is well within the scope and capability of public health professionals." But to be honest, I’m not sure how this can be done.
Currently, the United States is undergoing a third peak of infections on our first wave and the metrics, of cases and test positivity rates are increasing.
For infection preventionists and frontline healthcare workers, the Great Barrington Declaration places their lives and livelihood at risk. A field hospital has been activated in Wisconsin and the state is at risk of running out of hospital beds and trained staff.  Infection Control Today.  Oct. 15, 2020.    References
31.  Q&A: Are Infection Preventionists Being Misinformed?
Kevin Kavanagh, MD: “Many of the infection preventionists over the last six months now have more experience than many of the policymakers up in DC, because they’ve lived it firsthand. And they’ve seen how COVID-19 can spread. And they’re starting to develop a good idea of how to stop it.” “There have been a number of statements from the CDC or at least with the CDC label on it, which have been disturbing,” Kavanagh tells ICT®. Some of those disturbing statements can be attributed to the fact that the CDC and the rest of the world didn’t quite know what it was dealing with, but not all of them. Kavanagh worries that political pressure may be at work. One of the ways infection preventionists (IPs) can educate themselves is to look at what’s being done in other countries, and read the comments under pre-print studies. Also, experience counts, and IPs have now had months of dealing with the coronavirus.  Infection Control Today.  Oct. 9, 2020.  
30.  School Daze: COVID-19 Spreads Fear, Confusion:
"Opening schools should depend upon low rates of viral spread in the community, widespread testing, rigorous following of public health guidelines, and upgrading the physical infrastructure of our buildings. Our schools are anything but healthy buildings.18 Concerns have existed for decades regarding both the air quality and the crowded conditions our children are exposed to. COVID-19 should be viewed as an opportunity for transformation, allowing us to build a better school system with smaller class sizes for better education and implement strategies to prevent the spread of all infectious diseases"  Infection Control Today Oct 2020. (Page 28)
5f2ddf41a688625d1f8afd54dcb8e87d7cb5cbfa.pdf   References
29.  Trick or Treat … or COVID-19? Yes it is Airborne
Traditional trick or treating is viewed as a high-risk-activity by the CDC. Of course, we all knew Halloween would be problematic. An important caveat for Halloween is not to use your Halloween mask to prevent the spread of coronavirus. It will offer very little protection. These recommendations contain many important lessons both for Halloween and how we should be living our lives in general. And Yes it is Airborne.  Infection Control Today.  Sept. 28, 2020.      References
28.  Eli Lilly Neutralizing Antibodies: Breakthrough for COVID-19 Treatment?
Eli Lilly announced preliminary results to their SARS-CoV-2 neutralizing antibody product, LY-CoV555, which was reported to have spectacular results with a 72% decrease in hospitalizations or ER visits when mildly or moderately symptomatic patients are given the drug within 3 days of diagnosis.
As observed in the Eli Lilly study, those newly diagnosed patients who are obese or have advanced age are the most likely to become hospitalized, and I feel initially this innovative product should be targeted toward these high-risk patients.  Infection Control Today.  Sept. 17, 2020.    Download Original Article    References

Updated Oct. 8, 2020.  Downloaded Article  (The article was updated again on Nov. 10 by ICT Editorial Board Staff)
27.  Taking Aim at Antibiotic-Resistant Bacteria During COVID - A review of the Fall 2020 PACCARB Meeting.
Patients afflicted with COVID-19 have an increased susceptibility to antibiotic resistant infections both from prolonged hospitalizations and the use of immunocompromising agents such as dexamethasone. Infection Control Today.  Sept. 16, 2020.    References
26.  Is COVID-19 Primarily a Heart and Vascular Diseases?
Thus, the once thought asymptomatic patients who luckily dodged a bullet and were spared from the ravages of the disease, may indeed be truly sick. A significant portion of them may develop myocarditis along with vascular vasodilation with resultant hypoxemia. This pathological process could easily be more significant than the pulmonary effects of the virus, since it is present in both symptomatic and asymptomatic patients. And could explain the debilitating symptoms of fatigue and mental fog which “long-haulers” are experiencing, many of which had a mild initial illness. Infection Control Today.  Sept. 8, 2020.    References
25.  Viewpoint: Infection Preventionist Guide to Dealing with COVID Misinformation
"It is imperative that infection preventionists engage and combat this messaging on social media and wherever it occurs. To not do so, allows misinformation to fan the pandemic, placing all of our lives at risk."
After one leave retorts to the misinformation, "you will notice that you have numerous exchanges with one individual. That this individual has left a junkyard full of highly complex and intwined web of misinformation. Yet for all of this work, when you go to the troll’s home page, it will most likely be blank. This tells you may be dealing with a professional. If the troll responded to you throughout the entire day, he may well be on a payroll." Sept. 7, 2020.  Infection Control Today.    References
24.  Q&A: Flu Data Show Potency of Anti-COVID Tactics Like Masking, Hand Hygiene
Wear a mask, good hand hygiene, follow social distancing guidelines: The strategies just mentioned might snuff out COVID-19 in the long term, says Kavanagh, if everybody follows them. “But when you look at the flu, which isn’t as infectious, you would expect it to just annihilate that type of a pandemic and organism and that’s what we’re seeing in the Southern Hemisphere,” says Kavanagh. “Now, that of course is contingent that we follow this guidance, which as you know, is anywhere but universally accepted by the American public.”  Aug. 18, 2020.  Infection Control Today. 
23.  The 2020 Flu: Dud or Devastation, It is Up To You
"This year we have to do more than just rely on the flu vaccine. Avoiding the flu plus COVID-19 catastrophe is contingent on the US widely embracing public health guidance of wearing masks, meticulous hand hygiene and social distancing."  "If one looks at the data from the CDC, the flu became almost nonexistent in the United States by the end of March, with a very steep drop-off in cases. The World Health Organization (WHO) data from the Southern Hemisphere is even more surprising. Summer is their peak Flu season. But unlike previous years no viral specimens were submitted to the WHO from many countries during the Summer months."  Infection Control Today.  Aug. 18, 2020.    References

22.  Infection Preventionists Might be Needed in Schools
Similar to our healthcare system as a whole, COVID-19 is shedding a light on deficiencies and the dearth of personal safeguards in our schools. Let us not forget, schools are a nidus for spreading the flu and other diseases. Opening schools should depend upon low rates of viral spread in the community, widespread testing, rigorous following of public health guidelines and upgrading the physical infrastructure of our buildings. COVID-19 should be viewed as an opportunity for transformation, allowing us to build a better school system with smaller class sizes for better education and implement strategies to prevent the spread of all infectious diseases.  Infection Control Today.  Aug. 10, 2020.

21.  New Study: Hydroxychloroquine Works in Monkeys, Not Humans
Thus, at this point, there is no compelling evidence to recommend the use of hydroxychloroquine for clinical use and several large organizations have suspended research involving this drug. There has been an enormous amount of valuable scientific resources which have been devoted to answering this scientific, now political, issue. These resources would have been better spent on more promising treatment modalities, such as studying Camostat mesilate or nafamostat mesylate therapy for COVID-19, a compound which has been shown to block TMPRSS2 .  Infection Control Today.  Aug. 3, 2020.   
20.  National Reporting System for All Dangerous Pathogens Needed
After decades of reluctance to implement a national reporting system, when COVID-19 came along we witnessed almost overnight the formulation of case definitions and comprehensive national reporting from all healthcare facilities.  A dangerous pathogen is a dangerous pathogen; we should not discriminate on our approach to COVID-19. The nursing home reporting policies for COVID-19 need to be adopted systemwide for all dangerous pathogens and our infrastructure permanently enhanced.  One may think that enhancement is a forgone conclusion. But we did not learn these lessons from the 1918 Spanish flu or from the Ebola, severe acute respiratory syndrome (SARS) or Middle East respiratory syndrome (MERS) outbreaks. Six months or 6 years after this epidemic our resolve may wane. IPs need to document their experiences and keep telling their stories so our memories of this horrific ordeal do not fade.  Infection Control Today.  July 20, 2020.  
19.  Viewpoint: Despite Happy Talk, We’re Far From Out of the COVID Woods
COVID-19 cases in many states have risen and the false narrative is that this is because of increased testing. But the rise in cases far outstrips the rise in testing... the young are not shielded from the viruses’ devastating effects. We need to take this pandemic seriously, the public needs to wear masks and practice social distancing. As stated by Avindra Nath, MD, the senior investigator at the Section of Infections of the Nervous System at National Institutes of Health: “It’s quite possible some will never get their health back." Infection Control Today.  June 22, 2020. 

18.  COVID-19 Experience Suggests Need for National Reporting System for Dangerous Pathogens
It is of utmost importance to screen healthcare staff and patients for dangerous pathogens along with the establishment of a national tracking system. The nursing home reporting policies for COVID-19 need to be adopted system wide for all dangerous pathogens and our infrastructure permanently enhanced.  One may think that enhancement is a forgone conclusion. But we did not learn these lessons from the 1918 Spanish flu or from the Ebola, SARS or MERS outbreaks. Six months or six years after this epidemic our resolve may wane. IPs need to document their experiences and keep telling their stories so our memories of this horrific ordeal do not fade.  Infection Control Today.  June 8, 2020.     
17.  Reopening After COVID-19 Needs to be Done Carefully
Kevin Kavanagh, MD, the board chairman of the patient advocacy group Health Watch USAsm, talks to Infection Control Today about the perils of reopening too quickly and the value of cloth masks. "What worries me the most about reopening is that people are going to say, 'Oh, it's over with' and not do any sort of protection, whether it's social distancing, wearing masks, not gathering in crowds. I really think that people will think, 'Well, we got this beat.'"  Infection Control Today.  May 28, 2020.   
16.  Why the Public Should Wear Masks During the COVID-19 Pandemic
Initially, the public was advised not to wear masks. However, this was before the importance of asymptomatic transmission was known. Recent studies have also underscored the growing importance of person-to-person transmission through the air. Guidance changed. It is now recommended for the public to wear cotton masks. This guidance is not intended to protect the wearer, but to help prevent the wearer from spreading the virus to others if they are an unknown asymptomatic carrier.   Infection Control Today.  May 27, 2020. 
15.  When COVID-19 Knocks on Nursing Homes’ Doors, Systemic Problems Welcome It.
"Despite nursing homes becoming a nidus of multi-drug resistant organisms (MDROs), the regulations for staffing infection preventionists (IPs) at nursing homes are far too lax. Nursing homes should have a full-time IP. Presently the regulations only specify a part-time IP without a specific required time commitment. In view of the large number of nursing home residents and the high drug-resistant carriage rate, a full-time position is certainly needed."  Infection Control Today.  May 7, 2020.    
14.  Viewpoint: COVID-19 Modeling: Lies, Damn Lies and Statistics.
We have now received our fourth projection on deaths. I'm not sure if it will be right or wrong, but the others have proven to not be correct, so I'm not hopeful for this one. That is actually good news because the last projection doubles the number of expected deaths to 134,475 by Aug 4, 2020."   Infection Control Today.  May 6, 2020.
13.  Viewpoint: Have You Heard About the Herd? It’s a COVID-19 Fallacy.

"Strategies of social distancing, not gathering in large crowds, wearing masks and protecting those at increased risk are required to manage this epidemic. Returning to life as usual with the dependence on herd immunity in a non-vaccinated population to control spread is almost certainly a false narrative."  Infection Control Today.  April 29, 2020.  
12.  Kevin Kavanagh & Lindsay Calderon. Lessons of the Hydroxychloroquine Debacle: Solid COVID-19 Research Matters.
"In the new reality of making decisions with limited and incomplete data, it is important that decision makers and scientists are free from biases.  Biases can be financial and even geopolitical pressure created by the huge trade war and divisive rhetoric between the United States and China. In a time of great national fear and stress, we must be careful in both reporting and interpreting messaging, including the results of unconfirmed research. Let’s not repeat the mistakes of HCQ for unproven benefits, since these are powerful drugs which may also cause harm."
Infection Control Today.  April 26, 2020.   
11 .   Viewpoint: CDC's Changing Guidance Underscores How COVID-19 Keeps Winning.
"Needless to say, additional PPE is desperately needed, hopefully both increased manufacturing and sterilization techniques will relieve the shortage. In addition, the strategy adopted by New York State to designate some facilities to exclusively treat COVID-19 patients and others for non-COVID-19 patients to help improve patient safety should be adopted in other areas of the nation.   We must make protecting our frontline healthcare workers and patients a priority. Rapid testing will go a long way in assuring the safety of patients by identifying asymptomatic carriers in healthcare workers and staff."  Infection Control Today.  April 15, 2020.   

10.  Viewpoint: As COVID-19 Spreads, Where's All the Money Hospitals Have Made?
"There is no excuse for running a system which is lean on hospital rooms, supplies and staff. Net-profits and assets are desirable, but not at the expense of public safety. Hospital staff are being asked to see patients under draconian conditions and at the same time they do not have an adequate economic and healthcare safety net. Healthcare workers do not need paid sick leave, they need adequate PPE and worker's compensation benefits, if they become infected. IPs are placing both themselves and their families' lives at grave risk under the crisis management CDC infectious disease recommendations. That is the very least we can do for them."   Infection Control Today(redacted version).  April 10, 2020:       

9.  Authorities are split on what to do if a person is already on ACE Inhibitors and ARBs
Many in the United States have advocated to stay the course, until more information is known.  Switching medications may be difficult at best.  At the least, until this controversy can be resolved, if you are on one of these medications one should perform strict social distancing and protect yourself from contracting COVID-19.  Staying safe at home is best and follow strict recommendations when contacting the public.   Infection Control Today.  April 7, 2020.    
Health Watch USAsm Summary of Recommendations Regarding ACE Inhibitors and ARBs with COVID-19.
8.  Churches Could be the Deadliest Places in the COVID-19 Pandemic.  
One may ask: Why am I calling out churches? The answer is asymptomatic spread and aerosolization of the virus from singing.   Infection Control Today.  April 3, 2020.   
7.  As COVID-19 Knocks on Nursing Homes' Doors, Full-Time Infection Preventionists Needed More Than Ever. "Despite nursing homes becoming a nidus of multi-drug resistant organisms (MDROs), the regulations for staffing infection preventionists (IPs) at nursing homes are far too lax. Nursing homes should have a full-time IP. Presently the regulations only specify a part-time IP without a specific required time commitment. In view of the large number of nursing home residents and the high drug-resistant carriage rate, a full time position is certainly needed." Infection Control Today. March 27, 2020.  Download PDF of Article  
6.  Evidence Continues to Link ACE Inhibitors to Severe COVID-19 Symptoms
There is mounting consensus that ACE inhibitors may be a primary driver of the severe symptoms. The concerns were originally raised in the Lancet. ACE inhibitors up regulate (increase) the ACE2 receptor. This is the receptor the COVID-19 virus uses to attack the lungs.  Infection Control Today.  March 26, 2020.    
Health Watch USAsm Summary of Recommendations Regarding ACE Inhibitors and ARBs with COVID-19.
5.  COVID-19: We'll Know We've Won the War Against COVID-19 When...
"Judging when we have won the war against the coronavirus is not simple. The good news is that we have the technology and know-how to confront and substantially mitigate these epidemics. What we have lacked is the willpower to implement this knowledge. If we are unable to rapidly transform our system and correct these flagrant deficiencies, then the worse projections from the Imperial College projections of 2.2 million United States citizen fatalities may come to pass" Infection Control Today. Mar. 20, 2020 (Online).      
4. COVID-19: IPs, Other Healthcare Workers at Greater Jeopardy Than Thought.
"Of extreme concern, of the 3711 Diamond Princess cruise ship passengers, 634 tested positive for SARS-CoV-2 (the virus which causes COVID-19) and of these 17.9% were asymptomatic and presumably could spread the virus." Infection Control Today. Mar. 17, 2020 (Online).   
3. Viewpoint: US Woefully Unprepared for COVID-19 Pandemic.
"A news commentator made the alarmist statement that we may get to the point where the national guard is escorting patients to a high school gym for placement on ventilators. This is of course a ridiculously misinformed statement since we do not have enough ventilators."
Infection Control Today. Mar. 11, 2020 (Online).  
2. We’re Losing the Fight Against COVID-19 So Far.
"We seem to be at risk of entering into a blame game and "politicizing" the problems. Our response to this contagion shows severe flaws in our healthcare delivery system. As one government official stated, "We have for whatever reason and there are many good ones, designed a system based on very lean staffing practices based on just-in-time supply chains and purchasing." Infection Control Today. Mar. 9, 2020 (Online).     
1. Infection Preventionists, Hospital Administrators Will Be on Frontlines of Coming COVID-19 Epidemic. "Preparation for the impending epidemic of the COVID-19 coronavirus is of utmost importance and will place a tremendous strain on our healthcare system that will require coordination between the IPs, administrators and the hospital's board. This impending epidemic underscores the importance of the work that the CDC is undertaking by using surveillance and quarantine strategies to delay entry and slow the spread of this pathogen." Infection Control Today. Feb. 27, 2020.  
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This webpage is for guidance only, always consult your healthcare provider and the CDC Website for information before making decisions relating to the coronavirus.