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86. Viewpoint: Time to Consider Penalties for COVID-19
Unvaccinated
We may need to pivot to the strategy adopted
by Singapore, to have voluntarily unvaccinated individuals pay at
least a portion of their care. It is very easy to act irresponsibly
when others are funding your safety net. SARS-CoV-2 is endemic, and
we must adapt to live with it. This is based on observing that
immunity from SARS-CoV-2, whether from vaccines or infections, is
short lived, asymptomatic spread is frequent and the incubation time
is very short, making identification of contacts problematic and
vaccinations not having enough time to ward off disease. To cope
with this pandemic, we need to decrease the spread of this virus.
Executive action is needed for the formation of a National Public
Health Service (possibly by fully implementing the Department of
Veterans Affairs' 4th mission), along with the reappointment of a
Coronavirus Task Force in the US. Building this pandemic response
foundation is an overriding imperative.
References Infection
Control Today. Jan. 9, 2022.
https://www.infectioncontroltoday.com/view/viewpoint-time-to-consider-penalties-for-covid-19-unvaccinated
85. Even ‘Mild’ COVID-19 Can Make You the Sickest You’ve Ever
Been
SARS-CoV-2 causes a system infection and
is commonly detected in the heart and brain, exemplified by the loss
of smell from brain tissue destruction and loss of cardiac function
from myocarditis. There are well over 12,000 Kentuckians have died
of COVID-19. Even with Kentucky having some of the lowest in-network
costs for COVID-19 hospital care in the nation, the total bill so
far is just shy of 1 billion dollars ($990,040,866). This alone is
an unsustainable amount, but it does not include the cost of
outpatient care, mass testing, and chronic treatment for those
afflicted with long-COVID-19. What is so infuriating is that the
vast majority of individuals who are hospitalized are unvaccinated.
It is imperative that they are uniformly adopted to suppress the
spread of the virus in the community and prevent damage to our
economy and the collapse of essential services.
References Infection
Control Today. Jan. 4, 2022.
https://www.infectioncontroltoday.com/view/even-mild-covid-19-can-make-you-the-sickest-you-ve-ever-been
84. Viewpoint: Those Who Underestimate Omicron Aren’t
Doing the Math
Infectivity causes more harm and deaths
than lethality and in the case of Omicron more than makes up for its
somewhat milder infections in immunologically naive individuals. Our
best protection is to become fully vaccinated, including boosters,
along with optimizing ventilation in buildings, wearing N95 masks
and frequent testing. Schools might be able to be opened with a
degree of safety, if these mitigation strategies are rigorously
followed, but if not, both students and teachers will be at risk. In
addition, it needs to be remembered that Omicron causes more severe
disease in children than with other variants.
References Infection
Control Today. Jan. 3, 2022.
https://www.infectioncontroltoday.com/view/viewpoint-those-who-underestimate-omicron-aren-t-doing-the-math
83. Omicron More Infectious in Younger People, People of
African Ethnicity, Study States
Omicron can significantly avoid immunity
created by both prior infections and vaccines, and younger people
and people of “African ethnicity” have higher rates of infection
with Omicron than with Delta, says a new study. Many are looking at
the total infections and see a much lower hospitalization rate, not
realizing that there is a much larger number of cases and the
expansion is largely due to reinfections and breakthrough infections
which produce milder disease. The unvaccinated and those not
previously infected are looking at a fate similar to Delta and those
with waning immunity from vaccines or previous infections may endure
a fate not that much better. The bottom line is if we ignore the
pandemic, it is possible that with the high infectivity of Omicron
the sheer number of cases may overwhelm the world’s health care
systems. No one knows for sure. But what is known is that everyone
needs to obtain a booster if they are 6 months after the second dose
of an mRNA vaccine, and to become vaccinated even if they had a
previous infection.
References
Infection Control Today. Dec. 23, 2021.
https://www.infectioncontroltoday.com/view/omicron-more-infectious-in-younger-people-people-of-african-ethnicity-study-states
82. Countries Around the Globe Deluged by Delta, as Omicron
Threat Grows
Even though Omicron may not have as high
of a fatality rate, its infectivity being 3 times higher than the
Delta variant creates grave risk to nations. Overstressed health
care systems may collapse.
Strategies of travel bans, masking, testing, financial incentives,
vaccinations and natural immunity were discussed. For example:
Singapore requires mask-wearing outside of the home (indoors and
outdoors) for people above the age of two. In Germany, a medical
grade mask—surgical or N95—is required in indoor spaces. The US may
need to follow the financial model of Singapore. Unlike Singapore, a
substantial portion of the US population is not becoming vaccinated
and/or is not following prevailing public health advice. If there is
a safety net of 100% payment from public money, there is no tangible
disincentive against promoting and/or engaging in dangerous
behavior. Infection Control Today.
References Dec.
20, 2021.
https://www.infectioncontroltoday.com/view/countries-around-the-globe-deluged-by-delta-as-omicron-threat-grows
81. Omicron’s Mild Symptoms Can’t Mask Danger It Poses.
The high rate of infection of the Omicron
variant, which is beginning to eclipse Delta infection in the United
Kingdom, poses a grave risk to the US health care system. The US has
a low rate of vaccination, a low rate of individuals obtaining
boosters, and a relatively large segment of our population which is
elderly or immunocompromised.
70% efficacy for Omicron hospitalizations with a two-dose mRNA
vaccine Sound great. But this is South African data and they have
just been recently vaccinated. Immunity may not have waned. Please
obtain a booster.
References
Infection Control Today. Dec. 14, 2021.
https://www.infectioncontroltoday.com/view/omicron-s-mild-symptoms-can-t-mask-danger-it-poses
80. Omicron Proving to Be Nothing to Sneeze At
Only a small percentage of the Omicron
variant of COVID-19 cases require hospitalization so far, but high
infectivity may turn this small percentage into a large number of
patients, which will further stress our health care system. In the
United Kingdom, it has been observed that the Omicron variant causes
less severe disease, but it risks overwhelming their health care
system with 5 thousand admissions to the hospital each day. Omicron
currently is responsible for 30% of all cases in London.
References
Infection Control Today. Dec. 11, 2021.
https://www.infectioncontroltoday.com/view/omicron-proving-to-be-nothing-to-sneeze-at
79. Viewpoint: What Doesn’t Kill You Mutates and Tries
Again
The looming surge from the Omicron
variant may well have a lower case-fatality-rate but its high
infectivity will further strain our health care system and fill our
hospitals. Hospital costs for complex cases (on the ventilator or in
the ICU) ranges from $132,000 to $472,000. Co-Pays (without waivers)
for privately and employer-insured patients average $3,800 per
hospitalization. The looming surge from the Omicron variant may well
have a lower case-fatality-rate but its high infectivity will
further strain our health care system and fill our hospitals.
References
Infection Control Today. Dec. 8, 2021.
https://www.infectioncontroltoday.com/view/viewpoint-what-doesn-t-kill-you-mutates-and-tries-again
78. COVID-19 Omicron May Be More Infectious, Deadlier Than
Delta
If the infectivity, lethality, and immune
avoidance of the Omicron variant is confirmed, it will be of utmost
importance that all who can, become vaccinated. In addition,
antiviral medications will become of prime importance. Omicron
appears to be much more transmissible than the Delta variant. It is
already spreading around the globe and is reported to be increasing
exponentially in regions where it has taken hold.The epicenter of
the Omicron variant is in Gauteng Province, South Africa.As can be
seen from the graph below, hospitalizations tripled in just 2 weeks.
References
Infection Control Today. Nov. 29, 2021.
https://www.infectioncontroltoday.com/view/covid-19-omicron-may-be-more-infectious-deadlier-than-delta
77. Smallpox Scare Offers Lessons About COVID-19 Vaccine
Uptake
The recent story of finding previously
unknown smallpox vials at the bottom of a deep freezer in
Pennsylvania should serve as a reminder of the need for the
strictest research precautions when handling dangerous pathogens and
the dangers of any virus research program, especially gain of
function research. Unfortunately, the vaccine hesitancy movement has
placed us all at high risk for infectious disease. Those who are
against mandatory vaccinations of frontline workers need to take a
page from history and follow the lead of the Continental Army where
an estimated 90% of the deaths were from infectious disease. After
smallpox mandates were enacted in 1777, “the isolated infections
that sprung up among Continental regulars during the southern
campaign failed to incapacitate a single regiment.” With SARS-CoV-2
we are significantly weakening our nation by not abiding by public
health advice and widely embracing vaccinations.
References
Infection Control Today. Nov. 17, 2021.
https://www.infectioncontroltoday.com/view/smallpox-scare-offers-lessons-about-covid-19-vaccine-uptake
76. Confused Messaging About Boosters Might Cause 5th Wave
of COVID
There is growing evidence that fully
vaccinated should be defined as having 3 doses of an mRNA vaccine.
The evidence is clear, and the path evident, we must expand our
efforts to stop viral spread, including the upgrading of indoor
ventilation along with the use of masks by all in public settings
and expansion of home testing. But above all we need to offer
boosters to all adults who are more than 5 to 6 months post
receiving an mRNA vaccine.
References Infection Control Today. Nov. 15,
2021.
https://www.infectioncontroltoday.com/view/confused-messaging-about-boosters-might-cause-5th-wave-of-covid
75. Natural Immunity vs. Super Immunity: Only a COVID-19
Vaccination Away
Many believe that super immunity can
develop in those who have had SARS-CoV-2 infections and have become
vaccinated. Meanwhile, fully vaccinated might mean getting 3 doses,
not 2. The bottom line is that all need to be vaccinated, even those
who have had previous infections. The definition of fully vaccinated
for mRNA vaccines needs to be changed to 3 doses, making previous
comparisons of infection versus 2 doses of a vaccine mute. In
addition, those previously infected should also become vaccinated.
How many doses and the exact vaccination schedule is still under
investigation. But for now, those receiving 2 doses of an mRNA
vaccine should obtain a booster and those with a previous infection
should become “super-immune” with a vaccination.
References
Infection Control Today. Nov. 2, 2021.
https://www.infectioncontroltoday.com/view/covid-19-booster-policy-in-flux-from-super-immunity-to-3-dose-discussions
74. COVID-19: Numbers Look Good, but Keep Guard Up
As of today, the outlook is very good and
the pandemic is on a trajectory of burning out, but there are valid
concerns which require that we continue our vigilance and public
health strategies. In the United Kingdom, cases from the Delta
variant spiked early on July 17, 2021, and then rapidly fell in
half. Then cases rose with the Delta plus variant on October 28,
2021, reaching another peak almost as high as the one in July. This
raised concerns that under certain conditions, the Delta plus
variant can successfully compete with the Delta variant and cause
another surge in the US.
References
Infection Control Today. Oct. 27, 2021.
https://www.infectioncontroltoday.com/view/covid-19-numbers-look-good-but-keep-guard-up
73. COVID-19 Boosters Need to be Encouraged
The term “mild COVID-19” is an oxymoron.
The devastating long-term effects of long COVID, along with future
emergence of cardiovascular disease in those with minimal initial
symptoms, reminds us that all SARS-CoV-2 infections may pose grave
dangers to those who contract the virus. As of October 24, 2021, the
United States has only 57% of its population fully vaccinated. It is
behind 50 other countries, including Cuba, Sri Lanka, Curacao, Fiji,
Mongolia, Bhutan, and Cambodia, let alone the European Nations.
Thus, we must encourage and administer boosters, but at the same
time it is of utmost importance that we decisively counter the
anti-vaxxer movement in the United States and increase the primary
vaccination rates in our country.
References Infection
Control Today. Oct. 25, 2021.
https://www.infectioncontroltoday.com/view/covid-19-boosters-need-to-be-encouraged
72. Viewpoint: Here’s Why COVID-19 Is Much Worse Than Flu
Unlike influenza, SARS-CoV-2 uses ACE2
receptors to infiltrate cells. Similar to HIV, SARS-CoV-2 can
silently spread throughout the host’s body and attack almost every
organ. Thus, COVID-19 has a myriad of different presentations, all
of which can result in severe and long-term sequelae.Just because
COVID-19 is asymptomatic or does not produce “severe” pulmonary
disease does not mean the patient does not have a serious
infection.It is of utmost importance for public health officials to
implement strategies to prevent the occurrence of long-term COVID-19
related disabilities and not just focus on acute pulmonary symptoms.
References
Infection Control Today. Sept. 27, 2021.
https://www.infectioncontroltoday.com/view/viewpoint-here-s-why-covid-19-is-much-worse-than-flu
71. Viewpoint: Politics, Bad Science Taints Decisions
About COVID-19
Even if not hospitalized, COVID-19 often
produces the most severe infection individuals will experience in
their lifetimes and can produce lasting symptoms of fatigue,
weakness, brain fog and cardiovascular damage. Walensky swiftly
acted and in the evening reversed the committee’s decision. I feel
this was a very wise decision which demonstrated proactive action
and the ability to separate political rhetoric from science. These
are not normal times; we need swift decisions which will often have
to be based upon experience and the preponderance of evidence. As
stated by John F. Kennedy “There are risks and costs to action. But
they are far less than the long-range risks of comfortable
inaction.”
References
Infection Control Today. Sept. 24, 2021.
https://www.infectioncontroltoday.com/view/viewpoint-politics-bad-science-taints-decisions-about-covid-19
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.
https://www.infectioncontroltoday.com/view/viewpoint-on-covid-boosters-cdc-panel-must-recover-ball-that-fda-panel-fumbled
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.
https://www.infectioncontroltoday.com/view/fda-panel-sidesteps-decision-for-broad-distribution-of-booster-shots
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.
https://www.infectioncontroltoday.com/view/viewpoint-we-re-reopening-schools-too-quickly
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.
https://www.infectioncontroltoday.com/view/mu-variant-might-escape-immunity-from-vaccines-past-infection
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.
https://www.infectioncontroltoday.com/view/should-us-adopt-an-elimination-strategy-against-covid-19-
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.
https://www.infectioncontroltoday.com/view/viewpoint-expanding-booster-shots-to-us-adults-needed-to-happen
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
https://www.infectioncontroltoday.com/view/take-a-stand-now-to-stop-covid-19-variants
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.
https://www.infectioncontroltoday.com/view/messaging-muddle-pushing-vaccination-as-covid-vaccines-effectiveness-wanes
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.
https://www.infectioncontroltoday.com/view/get-vaccinated-even-if-you-ve-gotten-covid-19-study-suggests
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.
https://www.infectioncontroltoday.com/view/lambda-variant-covid-19-animal-hosts-present-deadly-mix
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.
https://www.infectioncontroltoday.com/view/covid-19-booster-shots-for-older-americans-might-be-needed
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.
https://www.infectioncontroltoday.com/view/latest-data-point-to-a-need-for-covid-19-booster-shots
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.
https://www.infectioncontroltoday.com/view/cdc-arguably-continues-to-bumble-covid-19-response
Kentucky Health News:
https://ci.uky.edu/kentuckyhealthnews/2021/07/26/somerset-doctor-says-spread-strength-of-delta-variant-mean-its-too-late-to-vax-it-or-mask-it-both-needed-in-high-spread-areas/
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.
https://www.infectioncontroltoday.com/view/stage-may-be-set-for-next-covid-19-surge
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.
https://www.infectioncontroltoday.com/view/we-might-ignore-the-delta-variant-but-it-s-not-ignoring-the-u-s-
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 Outbreak.info, 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.
https://www.infectioncontroltoday.com/view/not-quite-over-yet-covid-19-variants-on-rise-in-the-u-s-
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.
https://www.infectioncontroltoday.com/view/viewpoint-cdc-might-help-covid-19-make-a-comeback-in-u-s-
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.
https://www.infectioncontroltoday.com/view/covid-19-model-says-905-289-died-of-the-disease-in-u-s-
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.
https://www.infectioncontroltoday.com/view/infection-preventionists-must-ward-off-a-covid-comeback
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
https://www.infectioncontroltoday.com/view/iewpoint-health-care-professionals-get-vaccinated-or-get-out
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 https://www.infectioncontroltoday.com/view/covid-19-variants-make-road-to-normal-a-bit-rocky
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
https://www.infectioncontroltoday.com/view/viewpoint-south-african-variant-could-spur-a-new-u-s-surge
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 Kentucky.com “85 percent of residents and 48
percent of staff opted to get a coronavirus vaccine.”
Infection Control Today. Mar. 17, 2021.
References
https://www.infectioncontroltoday.com/view/kentucky-nursing-home-outbreak-argues-against-relaxed-visiting-rules
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.
References
https://www.infectioncontroltoday.com/view/viewpoint-nursing-home-guidance-endangers-elderly
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 https://www.infectioncontroltoday.com/view/rush-to-reopen-buys-covid-19-more-time
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
https://www.infectioncontroltoday.com/view/viewpoint-cdc-s-school-reopening-plan-gets-an-f-
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.
https://www.infectioncontroltoday.com/view/beginning-of-the-end-some-hopeful-covid-developments
Kentucky Health
News. Feb. 3, 2021.
http://kyhealthnews.blogspot.com/2021/02/as-virus-mutations-pop-up-around-world.html
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
https://www.infectioncontroltoday.com/view/problem-covid-19-hospital-acquired-infections
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:
https://combatcovid.hhs.gov/ Then click on the "Find
Infusion Locations" screen button.
Infection Control Today. Jan. 17, 2021.
References
https://www.infectioncontroltoday.com/view/as-vaccine-rollout-stalls-move-monoclonal-antibodies-into-covid-fight
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
https://www.infectioncontroltoday.com/view/covid-19-variants-make-infection-prevention-harder
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
https://www.infectioncontroltoday.com/view/vaccines-should-work-against-new-covid-19-strain
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.
https://www.infectioncontroltoday.com/view/viewpoint-monitoring-systems-track-covid-vaccine-reactions
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 https://www.infectioncontroltoday.com/view/covid-19-vaccine-hurry-up-and-wait
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.
https://www.infectioncontroltoday.com/view/healthcare-workers-stricken-by-covid-need-workers-comp
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 https://www.infectioncontroltoday.com/view/viewpoint-healthcare-workers-not-being-protected-from-covid
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
https://www.infectioncontroltoday.com/view/viewpoint-quackery-might-stall-progress-against-covid-19
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.
https://www.infectioncontroltoday.com/view/covid-vaccine-what-infection-preventionists-need-to-know
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.
https://www.infectioncontroltoday.com/view/fda-panel-reviews-many-challenges-facing-a-covid-vaccine
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.
https://www.infectioncontroltoday.com/view/viewpoint-the-not-so-great-barrington-declaration
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.
https://www.infectioncontroltoday.com/view/q-a-are-infection-preventionists-being-misinformed-
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)
https://cdn.sanity.io/files/0vv8moc6/infenctioncontrol/
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.
https://www.infectioncontroltoday.com/view/trick-or-treat-or-covid-19-
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.
https://www.infectioncontroltoday.com/view/taking-aim-at-antibiotic-resistant-bacteria-during-covid
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.
https://www.infectioncontroltoday.com/view/is-covid-19-primarily-a-heart-and-vascular-diseases
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.
https://www.infectioncontroltoday.com/view/viewpoint-infection-preventionist-guide-to-dealing-with-covid-misinformation
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.
https://www.infectioncontroltoday.com/view/q-and-a-flu-data-show-potency-of-anti-covid-tactics-like-masking-hand-hygiene
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.
https://www.infectioncontroltoday.com/view/the-2020-flu-dud-or-devastation-it-is-up-to-you
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.
https://www.infectioncontroltoday.com/view/new-study-hydroxychloroquine-works-in-monkeys-not-humans
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.
https://www.infectioncontroltoday.com/view/covid-19-experience-suggests-need-for-national-reporting-system-for-dangerous-pathogens
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.
https://www.infectioncontroltoday.com/view/viewpoint-despite-happy-talk-we-re-far-from-out-of-the-covid-woods
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.
https://www.infectioncontroltoday.com/view/covid-19-experience-suggests-need-national-reporting-system-dangerous-pathogens
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.
https://www.infectioncontroltoday.com/view/qa-reopening-after-covid-19-proceed-caution
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.
https://www.infectioncontroltoday.com/view/why-public-should-wear-masks-during-covid-19-pandemic
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.
https://www.infectioncontroltoday.com/view/when-covid-19-knocks-nursing-homes-doors-systemic-problems-welcome-it
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.
https://www.infectioncontroltoday.com/view/
viewpoint-covid-19-modeling-lies-damn-lies-and-statistics
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.
https://www.infectioncontroltoday.com/view/viewpoint-have-you-heard-about-herd-its-covid-19-fallacy
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.
https://www.infectioncontroltoday.com/view/lessons-hydroxychloroquine-debacle-solid-covid-19-research-matters
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.
https://www.infectioncontroltoday.com/view/viewpoint-cdcs-changing-guidance-underscores-how-covid-19-keeps-winning
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: https://www.infectioncontroltoday.com/view/viewpoint-covid-19-spreads-where%E2%80%99s-all-money-hospitals-have-made
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.
https://www.infectioncontroltoday.com/view/viewpoint-what-do-about-ace-inhibitors-during-covid-19-pandemic
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.
https://www.infectioncontroltoday.com/view/churches-could-be-deadliest-places-covid-19-pandemic
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.
https://www.infectioncontroltoday.com/view/evidence-continues-link-ace-inhibitors-severe-covid-19-symptoms
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).
https://www.infectioncontroltoday.com/view/well-know-weve-won-war-against-covid-19-when
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).
https://www.infectioncontroltoday.com/view/covid-19-ips-other-healthcare-workers-greater-jeopardy-thought
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).
https://www.infectioncontroltoday.com/view/viewpoint-us-woefully-unprepared-covid-19-pandemic
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).
https://www.infectioncontroltoday.com/view/viewpoint-were-losing-fight-against-covid-19-so-far
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.
https://www.infectioncontroltoday.com/view/infection-preventionists-hospital-administrators-will-be-frontlines-coming-covid-19-epidemic
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