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Infection Control Today
161. Balancing Freedom and Safety: When Public Health Mandates
Are Necessary
How we incorporate public health strategies into our society is not
a theoretical discussion but an urgently needed one, necessitated by
the evolving and threatening pathogens looming on the horizon. These
strategies include masking, closures, lockdowns, vaccines, and
improving ventilation. During the initial phases of an outbreak, the
goals of pathogen elimination and delaying causes until therapeutics
are available are of utmost importance. We cannot assume the human
body will naturally ward off an infection with its immune system. We
are part of the natural order, and civilizations, along with entire
species, can be eliminated by infectious diseases. What sets us
apart is our intelligence and understanding of science. This gives
us an advantage in our survival, but it is an advantage that will
only be effective if utilized.
References Infection Control Today. Jan. 9,
2025.
https://www.infectioncontroltoday.com/view/balancing-freedom-safety-when-public-health-mandates-are-necessary
160 Addressing Post-COVID Challenges: The Urgent Need for
Enhanced Hospital Reporting Metrics
We want to encourage CMS to expand their COVID-19 reporting
requirements with the development of the following metrics:
1. Hospital-onset Infections for COVID-19;
2. Total COVID-19 infections in health care workers;
3. Total emergency room visitations and emergency room COVID-19,
influenza, and RSV infections.
The toll COVID-19 has taken on our country is sobering and
necessitate the implementation of mitigation strategies. Masking and
admission testing have been shown to lower the incidence of COVID-19
acquisitions in hospitals. In the same study, a death rate of 8 in
100 randomly selected infected individuals was recorded. This is
consistent with other data showing a 9.5% death rate for
hospital-onset Infections of COVID-19. In Australia, of all COVID-19
deaths, 14% may have acquired their infection in a hospital.
Increasing ventilation and clean air have also decreased the spread
of aerosolized respiratory pathogens. These interventions must be
widely implemented throughout our health care system to protect
patients and medical staff. CMS can drive mitigation strategies by
incorporating COVID-19 metrics into their hospital financial
incentive programs
References Infection Control Today. Dec. 18,
2024.
https://www.infectioncontroltoday.com/view/addressing-post-covid-challenges-urgent-need-enhanced-hospital-reporting-metrics
159. CDC HICPAC Considers New Airborne Pathogen Guidelines
Amid Growing Concerns
Despite the persistence of SARS-CoV-2 and a
looming H5N1 epidemic, most of the Committee, except for one member,
appeared to want to maintain a status quo in our approach to
airborne illnesses. ... Our current approach to reducing the spread
of airborne pathogens must focus on reducing viral dosage. Strong
evidence supports that N95 masks will reduce dosage exposure far
better than surgical masks. However, this reduction may not prevent
infection in all clinical settings. Instead of NOT recommending N95
masks, we must add additional layers to reduce exposure dosage.
These layers include maximizing ventilation, testing, and source
control. All are needed to maintain patient safety and a healthy
health care workforce.
References
Infection Control Today. Nov. 18, 2024.
https://www.infectioncontroltoday.com/view/cdc-hicpac-considers-new-airborne-pathogen-guidelines-amid-growing-concerns
158. Breaking the Cycle: Long COVID's
Impact and the Urgent Need for Preventative Measures
We need to emulate the NIH, which, on
November fourth, initiated a masking requirement at all National
Institutes of Health (NIH) patient care areas. Our nation needs to
come to grips with the fact that the pandemic is NOT over; the virus
is very dangerous and poses risks to everyone. NIH is masking up,
and so should we.... A mask ban enacted in public venues will
increase viral spread. Even outdoors, if you are within 6 feet of an
infected person, large droplet spread can easily occur. Any proposed
or enacted mask ban is anti-public health and will result in
needless cases of long COVID, death, and disability. It will
adversely impact our economy and the mental health of our citizens.
We must break this cycle of infections and disability. Clean indoor
air, the wearing of N95 masks in public places, and vaccinations are
keys to preventing new cases of acute COVID-19 and long COVID.
References Infection Control Today.
Nov. 15, 2024.
https://www.infectioncontroltoday.com/view/breaking-cycle-long-covid-s-impact-urgent-need-preventative-measures
157. Long COVID: Urgent Findings, Including Brain Alterations, Call
for Renewed Public Health Focus.
Over the last month volumes of impactful
scientific research have been published regarding long COVID, which
when taken together clearly describes the precarious state of our
society and the desperate need to change course. We must start to
control our impulses to partake in desirable but risky behavior and
instead prioritize controlling the spread of COVID-19. Most
concerning was a large survey by Shijie Quin and colleagues
involving over 74 thousand participants in China that found the
incidence of long COVID in their country to be between 10% to 30%. A
recent NIH study (RECOVER-Pediatrics cohort STUDY) reported that
“20% of kids (ages 6-11) and 14% of teens met researchers' threshold
for long COVID.” Unfortunately, there is mounting evidence regarding
the role which brain injury plays in long COVID. A picture is
starting to form of an insidious dangerous pathogen which upon
infection can change the behavior of the host to manifest risky
behavior, which in turn can increase the spread of the SARS-CoV-2
virus, repeating the cycle. Acquiring such an ability is an example
of evolutionary pressure to enhance the survival of the virus. We
must prioritize vaccinations, use of N95 masks, clean indoor air,
along with stopping the spread of this virus. Only then will we be
headed in the correct direction.
References Infection Control Today. Oct. 21, 2024.
https://www.infectioncontroltoday.com/view/long-covid-urgent-findings-including-brain-alterations-call-renewed-public-health-focus
156. Commentary: If You Are Immunocompromised, Do Not Despair,
Plan and Prepare for Medical Care
One of the most dangerous challenges
individuals can undertake is climbing Mt Everest; here, one is
pitted against the fury of nature, and many are unable to navigate
the journey and return home safely. But for an immunocompromised
transplant patient, such challenges occur every day and are
unavoidable. One of the highest and most dangerous peaks they must
summit is entering a medical facility and leaving without
experiencing the fury of COVID-19. Wearing N95 masks, keeping up to
date on vaccinations and strategically scheduling appointments are
of utmost importance. In addition, make sure the air you breath
indoors is as safe as possible. Bring a portable CO2 monitor, hand
sanitizer, extra N94 masks and alcohol wipes with you during your
medical appointment. Attending needed medical visits is of the
utmost importance. Instead of postponing, prepare and plan to make
these visits as safe as possible.
References Infection Control Today. Oct. 3,
2024.
https://www.infectioncontroltoday.com/view/if-you-are-immunocompromised-do-not-despair-plan-and-prepare-for-medical-care
155. Urgent Need for a Paradigm Shift in Infectious Disease Control
Amid 2024 Outbreaks
We need a paradigm shift in our approach to infectious diseases. A
recent viewpoint in the journal Medicine discussed 5 areas of
concern.
1. The first and most important area of concern is a siloed feedback
loop.
2. The second area of concern is an overreliance on randomized
controlled trials.
3. The third area of concern is the overreliance on hand hygiene.
We must not normalize
4. The fourth area of concern is the normalization of deviance or
acceptance of the status quo.
5. The fifth area of concern is our views of the burden or
cost-effectiveness of interventions.
Thus, we must extensively revamp our strategies to provide safe
indoor environments and stop the spread of airborne diseases. This
includes measuring CO2 levels to check for proper indoor
ventilation, HEPA filtration, and installing UVC lighting fixtures.
Most importantly, we need to internalize that even breathing and
talking can spread airborne diseases. It does not require an
aerosolizing procedure. AND N95 masks are required to provide
increased protection against contracting airborne diseases. It has
recently been demonstrated in human volunteers that N95 masks reduce
the exhaled viral load of SARS-CoV-2 by 98%. Thus, 2-way masking is
most effective. Infection Control Today.
References
Aug. 26, 2024.
https://www.infectioncontroltoday.com/view/urgent-need-paradigm-shift-infectious-disease-control-amid-2024-outbreaks
154. Reevaluating the 6-Foot Rule: Efficacy and Challenges in
COVID-19 Prevention
"During the June 3, 2024, House Oversight
Committee regarding the Coronavirus Pandemic, the six-foot rule was
again thrown into the spotlight, and questions about its
appropriateness and effectiveness were raised. One of the
Representatives questioned the continuation of advocating for six
feet of social distancing after it was known the virus was
aerosolized. This question exemplifies one of the underlying
problems in our pandemic response—dividing the spread of respiratory
pathogens into aerosols and large droplets.....Although the 6-foot
rule will protect against large non-aerosolized particles, it will
not afford the needed protection if one is exposed to a highly
infectious airborne virus that spreads through the air. Because
aerosols float in the air, ventilation is a key factor in their
elimination. In highly ventilated indoor settings or outdoor venues,
aerosolized particles will dissipate, but large particles will not.
Thus, the 6-foot rule adds substantial protection if you do not have
a mask and are outdoors. In highly ventilated indoor settings, the
same may be true. This is why a CO2 monitor is handy for measuring
indoor ventilation. However, the safest option indoors or in crowded
outdoor settings is wearing an N95 mask."
References
Infection Control Today. July 22, 2024.
https://www.infectioncontroltoday.com/view/reevaluating-6-foot-rule-efficacy-challenges-covid-19-prevention
153. Rethinking Airborne Pathogens: WHO Proposes New Terminology for
Disease Spread
"Recently, the World Health Organization (WHO)
initiated a paradigm shift in preventing pathogens from spreading
through the air. If that phrasing seems non-scientific and does not
use the jargon of “airborne pathogens” or “aerosolized pathogens”,
it is by design... Too many healthcare experts believe that an
“airborne” pathogen will only spread under certain circumstances or
unusual conditions, such as during an aerosolizing procedure...
Infection disease professionals must not only advocate but also act.
A good first step is to carry a portable CO2 monitor to help
evaluate indoor air quality at your health care workplace. One
should advocate for continuous CO2 monitoring in your facility and
make sure HEPA filtration is used with adequate ventilation."
Infection Control Today.
References
May 15, 2024.
https://www.infectioncontroltoday.com/view/rethinking-airborne-pathogens-who-proposes-new-terminology-disease-spread
152. Understanding the Impact of COVID-19 on Personality and Brain
Function: A Grim Reality or a Wake-Up Call?
Opinion: A summary of studies on how COVID-19
may damage the brain's frontal lobes, alter personality traits and
cognitive functions, and potentially reshape society's dynamics. A
nightmare scenario would be if mankind were targeted by a pathogen
that attacks our frontal lobes and changes our personalities, making
us less likely to get along, reach a consensus, and understand
others' points of view. Such a pathogen could bring an end to
society as we know it. Unfortunately, the nightmare may be real and
taking shape in SARS-CoV-2, the virus that causes COVID-19.
References Infection
Control Today. April 30, 2024.
https://www.infectioncontroltoday.com/view/understanding-impact-covid-19-personality-brain-function-grim-reality-wake-up-call-
151. COVID-19 Harmonization: Balancing Risks and Benefits of CDC's
Latest Move
"The CDC's recent decision to align
recommendations for respiratory viruses, particularly COVID-19, has
garnered support from the public and infectious disease
societies....the Infectious Diseases Society of America (IDSA) lends
its backing to the CDC's harmonization efforts, concerns persist
regarding the implications of this shift, especially considering the
Omicron variant's unique characteristics and the ongoing challenges
posed by COVID-19's multi-system impacts. Currently, IDSA is
supporting the CDC in dropping the isolation time to 0 days for
asymptomatic carriers. In view of protracted viral shedding in
patients who have become symptom-free after infection (11% had
positive cultures at 10 days) and a 40 to 50% rate of asymptomatic
infections, some have concerns regarding this decision. COVID-19 is
still ravaging our society, with over 200 deaths each week and over
20,000 individuals in the hospital each day. And the tolls of long
COVID may be mounting, not decreasing. During the first week of
February 2024, 6.8% of all adults are experiencing long COVID
symptoms, up from 5.3% during the week of October 18 to 30, 2023. In
Sweden, a country that had very few COVID-19 interventions, a major
insurance company, If, reported that after the pandemic, 1 in 3
young adults are experiencing brain fog. A better prevention
harmonization may well be with the measles and polio viruses."
References Infection Control Today. Mar. 11, 2024.
https://www.infectioncontroltoday.com/view/covid-19-harmonization-balancing-risks-benefits-cdc-s-latest-move
150. COVID-19 Realities: Beyond a Respiratory Virus, Addressing
Optimism in Pandemic Management
The CDC needs to give an unambiguous message about the urgent
need for COVID-19 vaccinations and not one minimizing the disease by
green-lighting the safety of asymptomatic spreaders mingling in our
community.
We should not be minimizing COVID by comparing it to RSV and flu.
Not all airborne viruses are primarily respiratory. There is
disagreement with this contention in the scientific community as to
whether SARS-CoV-2 should be considered a respiratory virus since it
affects every organ system of the body, and COVID-19 may be more of
a neurological and cardiovascular disease than respiratory. The
United Kingdom's workforce has been crippled with chronic illnesses,
with 2.8 million of UK’s citizens being inactive due to chronic
illness. This figure has increased by 700,000 since the pandemic
first started and corresponds to an equivalent decrease in workforce
participation. We need to strengthen isolation requirements along
with protecting the vulnerable. And we need to prepare for the next
pandemic through increasing standards for ventilation and the use of
N95 masks for all airborne pathogens.
References Infection Control Today.
Feb. 28, 2024.
https://www.infectioncontroltoday.com/view/covid-19-realities-beyond-a-respiratory-virus-addressing-optimism-in-pandemic-management
149. CDC Sends Back Proposals to HICPAC on Pathogen Spread in
Health Care for Revision
On January 23, 2023, the CDC announced it is
sending back its 2023 proposals regarding the spread of dangerous
pathogens in health care to the Healthcare Infection Control
Practices Advisory Committee (HICPAC) for revision. Infection
Control Today® (ICT®) has published 2 articles sounding the alarm
regarding the potential harm these recommendations could potentially
cause and the need to revise the 2023 proposed guidelines. The
narrative that the use of N-95 masks, negative pressure rooms, and
effective source control is too burdensome needs to be weighed
against the Federal estimate of the cost of $9.6 million per life
lost. But even more concerning is the newly posted preprint from
Beijing China which describes a cell-cultured mutated SARS-CoV-2
related virus which has a 100% fatality rate in human
ACE2-transgenic mice. Disease “X” may have been found, and we must
be fully prepared for the next pandemic.
References
Infection Control Today. Jan. 24, 2023.
https://www.infectioncontroltoday.com/view/cdc-sends-back-proposals-hicpac-pathogen-spread-health-care-revision
139. COVID-19 vs Seasonal Influenza: A Comparative Analysis
Reveals Alarming Trends
There were 2.87 times as many SARS-CoV-2
(5,572,366 cases) as seasonal influenza cases (1,772,602 cases and 5
times more new hospitalizations with COVID-19 than seasonal
influenza. Importantly, the impact on society is not just determined
by the case fatality or disability rate for those infected with a
dangerous pathogen. Infectivity is also of utmost importance,
especially for SARS-CoV-2, an immunoevasive mutating virus that all
too commonly causes reinfections. The high rates of death and
disability from SARS-CoV-2, compared to seasonal influenza, along
with its increased infectivity, makes slowing viral spread and
development of next-generation vaccines imperative.
References
Infection Control Today. Jan. 2, 2023.
https://www.infectioncontroltoday.com/view/covid-19-vs-seasonal-influenza-comparative-analysis-reveals-alarming-trends
138. How Artificial Intelligence Is Revolutionizing Diagnosis in
Health Care
Diagnostic errors are a long-standing,
pervasive problem. A recent study published in the British Medical
Journal, Quality & Safety, estimates that in the United States,
795,000 patients suffer serious harm each year from diagnostic
errors. The big 3 categories of diseases where these errors occurred
were vascular events, infectious diseases, and cancers. There was an
average medical error occurrence of 11% and a rate of patient harm
of 4.4%. There is little doubt that AIs will be widely used to aid
physicians in making diagnoses and nurses in making patient intake
and triage decisions. Implementing AI promises to increase patient
safety, accuracy, and efficiency. The latter, however, will mean
fewer medical jobs for humans, but with the potential of patients
having greater access to more affordable health care.
References
Infection Control Today. Dec. 22, 2023.
https://www.infectioncontroltoday.com/view/how-artificial-intelligence-is-revolutionizing-diagnosis-health-care
137. CDC's HICPAC Update: Impact on COVID-19, Pathogen Control, and
Immunocompromised Safety in Health care Settings
Recent CDC HICPAC revisions regarding
SARS-CoV-2 control face criticism from the World Health Network and
others due to alleged breaches in committee structure and erroneous
infection control guidance, potentially impacting COVID-19
management and immunocompromised individuals in health care. As
stated in an action letter sent to the CDC, for the immunocompromised the
status quo is unacceptable, and weakening current regulations will
result in a “direct threat” to their safety and well-being and does
not maintain accessible features for safe and adequate access to a
facility. This concern was further underscored by the findings of
the INFORM and EPOCH research initiatives. The CDC be “mindful of
the provisions of the ADA and the impact recommendations will have
regarding vulnerable individuals who both work in health care
settings or are experiencing reduced access to healthcare because of
unsafe healthcare environments.”
References
Infection Control Today. Nov. 8, 2023.
https://www.infectioncontroltoday.com/view/cdc-s-hicpac-update-impact-covid-19-pathogen-control-immunocompromised-safety-health-care-settings
136. A Keynote Speaker's Journey: Strategies to Maximize
Respiratory Safety During Air Travel Amid a Pandemic
A high-risk for severe COVID-19 keynote
speaker, Kevin
Kavanagh, MD, shares strategies for safe air travel during the
COVID-19 pandemic, emphasizing mask usage, vaccinations, and air
quality monitoring, with mixed observations throughout the journey.
On the return, Logan airport had carbon dioxide levels consistently
around 600 (549 to 690), making my wait much safer, but I kept my
mask on. There was no downside to doing so. I flew on the exact same
plane, and carbon dioxide levels were around 2000 ppm. Again, I
stayed masked. When I landed, I hurried out of the airport with the
stagnant and probably aerosol-ridden air, and then made it back
home. The one thing that was very evident was the United States has
a long way to go in providing clean indoor air. But for me, so far,
so good, I have not developed a respiratory infection.
References Infection Control Today. Oct. 16, 2023.
https://www.infectioncontroltoday.com/view/a-keynote-speaker-s-journey-strategies-maximize-respiratory-safety-during-air-travel
135. How to Prepare For Possible “Tripledemic” of RSV,
Influenza, and SARS-CoV-2
The interaction between the respiratory
viruses SARS-CoV-2, influenza, and RSV, poses ongoing challenges.
Personal protective measures, testing, and vaccination are critical
components of our strategy to mitigate the impact of these viruses.
New research focuses on real-time SARS-CoV-2, RSV, and influenza
detection. A proof-of-concept portable monitor has been developed to
detect SARS-CoV-2 within 5 minutes.18 This technology could also be
applied to RSV and influenza. Thus, we must not abandon public
health and only rely on personal protection. This is a recipe which
may force us to endure another tripledemic. Instead, we should
prevent all respiratory illnesses to the highest degree possible,
with strategies which are adopted and supported by society.
References
Infection Control Today. Sept. 25, 2023.
https://www.infectioncontroltoday.com/view/how-prepare-possible-tripledemic-rsv-influenza-sars-cov-2
134. Organized Disinformation Fanning the COVID-19 Flames of Vaccine
Hesitancy
"Our pandemic response has undoubtedly been
stymied, largely due to the divisive effects of organized
disinformation. Many disseminators of disinformation downplay the
idea of a multi-layer approach and proclaim that if you can still
catch COVID-19 while wearing a mask, they do not work, ignoring that
seldom is a single intervention 100% effective. Everything from
treating a cold to cancer involves multilayer approaches, as does
automobile and airline safety. Why should COVID-19 be any different?
.... As COVID-19 cases and hospitalizations increase, do not fall
prey to disinformation. It is wise to be vaccine-boosted, wear a
mask in high-risk settings, and carry a CO2 monitor to determine
safe indoor ventilation. These steps will help us all avoid the
disabilities caused by long COVID and help to maintain the health of
our families and the nation’s workforce."
References
Infection Control Today. Sept. 18, 2023.
https://www.infectioncontroltoday.com/view/organized-disinformation-fanning-covid-19-flames-vaccine-hesitancy
133. As COVID-19 Hospitalizations Increase Alarmingly, Workers and
Patients Call for Better Standards
"After almost 4 years of COVID with over
10,000 patients currently hospitalized, a 22% increase over last
week, one must ask, what has the CDC been doing? According to many
people, the CDC has been trying to roll back our protections and
ability to fight the spread of disease when experts are strongly
advising those at high-risk to mask up in indoor settings." During
an ongoing pandemic, credibility is of utmost importance. As one
commentator stated, “We need consistent messaging to educate the
public about the true dangers of COVID and being disabled by long
COVID.” If the public cannot rely on the agency to communicate safe
and effective recommendations on masking and ventilation, how then
can they be expected to rely on the CDC’s advice on vaccine uptake?
And if we minimize the dangers of SARS-CoV-2, how then can we expect
the public to see the urgency in obtaining the updated booster?
References
Aug. 28, 2023. Infection Control Today.
https://www.infectioncontroltoday.com/view/as-covid-19-hospitalizations-increase-alarmingly-workers-patients-call-better-standards
132. Flying Blind as COVID-19 Rates Increase: The Eris Variant
Few people doubt COVID-19 will stay around,
and it is starting to increase again in August 2023. Daily hospital
admissions are on the rise, up over 70% from mid-June. Currently,
there are 1500 COVID-19 admissions daily in the United States and
projected to increase to over 1800 admissions by the end of August.
The Walgreens COVID-19 test positivity rate is at 44.7%, the highest
it has ever been. COVID-19 infections will not go away and will have
a lasting impact on our resources. We must be able to accurately
calculate and project the societal and workforce impact of COVID-19.
We should have the data to calculate the percentage of the
population disabled by COVID-19 and project this into the future.
But at this point, we appear to still have our heads in the sand,
hoping that if we do not measure and report the virus one day, like
a miracle, will disappear.
References
Infection Control Today. Aug. 17, 2023.
https://www.infectioncontroltoday.com/view/flying-blind-as-covid-19-rates-increase
131. One Step Forward, 2 Back: CDC's Proposals for Infection
Control in Health Care Facilities
"During the CDC’s June 2023 Healthcare
Infection Control Practices Advisory Committee (HICPAC) meeting,
concerns were expressed regarding proposed updates to existing
infection control guidance for health care facilities which would
place patients, health care workers, and nursing home residents at
risk.... The United States’ post-emergency infection control
strategy involves scaling back data collection, weakening guidance,
not effectively reporting health care worker or patient
acquisitions, and not setting firm and effective standards for
control. HICPAC/CDC is on the verge of weakening contact precautions
(by adopting EBPs) and weakening airborne precautions, thereby
ignoring decades of occupational health research."
References
Infection Control Today. July 24, 2023.
https://www.infectioncontroltoday.com/view/one-step-forward-2-back-cdc-s-proposals-infection-control-health-care-facilities
130. Opinion: Post Pandemic Strategies Are Inadequate To Assure
Public Safety
Many COVID-19 experts place the odds at 20% in
the next two years of experiencing an outbreak comparable to that
caused by the Omicron variant. Unfortunately, SARS-CoV-2 is not the
only disease on the rise. The lack of publicly available data
regarding the incidence of MRSA, COVID-19, and other pathogens in
the United States is concerning. This data should be readily and
publicly available for community and facility-onset infections. For
now, patients can only guard against exposure to aerosolized
pathogens by wearing a well-fitted N95 mask in healthcare settings
and using CO2 monitors to screen for adequate air ventilation. What
is needed to control an organism is what is required to be
implemented. The pathogen does not care where it is. The same
interventions are needed in nursing homes as are needed in
hospitals. And workers need to be protected from all, not some
aerosolizing pathogens. No one wishes to be sick for days or weeks
at a time. Just because it does not kill you is not an excuse to
only provide a worker with a surgical mask or to not take necessary
preventative strategies to limit airborne spread.
References
Infection
Control Today. July 13, 2023.
https://www.infectioncontroltoday.com/view/opinion-the-latest-on-covid-19-where-are-we-now-
129. 70% of COVID-19 Cases Transmitted By Children
COVID-19, schools, and children are sensitive topics.
Some worry about transmission in schools,
while others don't see it as a concern. Which is it? "One of the
lessons of the COVID-19 pandemic is that schools can be opened
safely if proper mitigation strategies are in place. However, during
the pandemic, we witnessed a vicious cycle of concerned and loving
parents wanting in-person learning for their children but justifying
their position by asserting that COVID-19 in children was “not a
thing.” This often led to mitigation strategies not being
implemented and teachers being reluctant to return to school.
Schools remained closed for a period much longer than would have
been necessary. We must start planning for the next infectious
disease surge and build an effective school infrastructure,
including upgrading ventilation and upper room UV-C germicidal
lighting."
References
Infection Control Today. June 5, 2023.
https://www.infectioncontroltoday.com/view/70-covid-19-cases-transmitted-by-children
128. Endemic SARS-CoV-2 Demonstrating Workforce/Health Consequences
The rate of unemployment, long COVID, and
immune system issues are still causing problems globally. . Several
countries are reporting workforce shortfalls. China is now short 41
million workers, and in the United Kingdom, for every 13 individuals
working, one person is not working because of long-term sickness.
The WHO is taking a leadership position, calling for a monovalent
XBB booster that targets XBB.1.5 and XBB.1.16. Concerns of immune
imprinting and the rapid waning of vaccine and infection-induced
immunity make it clear that additional mitigation strategies are
needed to mitigate transmission. Unspent COVID-19 funds are
available, which should be used to expand infectious disease
reporting, testing upgrade facility ventilation and air quality, and
use upper room UV-C germicidal lighting.
References Infection Control Today.
May 22, 2023.
https://www.infectioncontroltoday.com/view/endemic-sars-cov-2-demonstrating-workforce-health-consequences
127. The End of the COVID-19 Public Health Emergency?
Although the public health emergency for COVID-19 is officially over,
infection rates, precautions, and safety measures for communities
around the United States still need to be addressed. Even though the
PHE has ended, numerous workplaces need to implement preventive
strategies and upgrade their infrastructure. Adequate ventilation is
still lacking in far too many venues, including our dilapidated
school infrastructure. There is clearly a critical missed
opportunity for engagement of electronic medical records to collect
needed data for public health. It may be time to discontinue the
Pandemic Health Emergency, but many have concerns regarding this
action when the United States appears to be unprepared for another
SARS-CoV-2 surge, let alone a new pandemic. As a nation, we can and
must do better.
References Infection
Control Today. May 11, 2023.
https://www.infectioncontroltoday.com/view/the-end-of-the-covid-19-public-health-emergency-
126. Opinion: COVID-19 Expanded Reporting Systems Should Continue
One of the most concerning outcomes of the
COVID-19 pandemic is that the CDC and other governmental agencies
appear to be dismantling our newly expanded reporting systems rather
than expanding and maintaining them for the next pandemic, a
pandemic which many experts feel has a 15% to 20% chance of
occurring in the next 2 years... We need not only to have a
permanent system for monitoring the persistence and emergence of
dangerous pathogens but also to determine the composition of
patients’ microbiomes. Everyone should be tested every year and upon
admission to acute and long-term care facilities. This would
identify pathogens and provide new insights into diabetes, obesity,
cancer, and even COVID-19 and long COVID... Control and prevention
of infections are of paramount importance. We need to back away from
blame. Regardless of who is at “fault” or even if any “fault”
exists, if you need an internal prosthesis placed, you may not want
to have this procedure in a hospital or a community with high rates
of MRSA carriage or infections. Knowing and mitigating the actual
numbers are important. Infection Control Today.
References
May 10, 2023.
https://www.infectioncontroltoday.com/view/opinion-covid-19-expanded-reporting-systems-should-continue
125. COVID-19 Masking: Hundreds of Thousands of Russian Social
Media Bots Have Tricked the Public
"Fake news and disinformation may
significantly inhibit the adoption of masking by the public. The
Washington Post reports that recently leaked national security
documents indicate the Russians “boasted” that “less than 1%” of
their sham social media profiles and bots have been caught. One of
their propaganda campaigns spread the conspiracy theory that the
United States was hiding the side effects of vaccines. A “network of
hundreds of thousands of social media bots emulate(ed) users” and
was intended to divide the West, and apparently was very successful.
One could argue that this has led to a loss of confidence in public
health authorities, adversely impacting adopting of COVID-19
mitigation strategies. As a hyper-traveling world society has
emerged, dangerous pathogens spread almost instantaneously. The
United States needs to adapt. As a first step, health care
facilities should require universal masking to protect patients and
staff."
References Infection Control Today.
Apr. 19, 2023.
https://www.infectioncontroltoday.com/view/covid-19-masking-hundreds-thousands-russian-social-media-bots-have-tricked-public
124. The Health of US Citizens Is Declining—But Why?
Some policymakers have blamed the infection
increase on time-tested public health strategies, such as the few
weeks of lockdowns 3 years ago. However, this phenomenon is also
seen in Sweden, a country that implemented limited mandates and
shunned masking. There is mounting research evidence that infection
with SARS-CoV-2 causes immunological damage in at least a subset of
patients, a subset which may progressively enlarge as reinfections
occur. Unfortunately, many interventions have fallen by the wayside
in the United States, explaining our marked decrease in life
expectancy. We can declare the pandemic has ended, but the virus is
an unrelenting adversary that does not respond to political
pressure.
References
Infection Control Today.
Apr. 5, 2023.
https://www.infectioncontroltoday.com/view/the-health-of-us-citizens-is-declining-but-why-
123. COVID-19: Study Suggests Long-term Damage to Immune
System
NIH News Release: "...findings suggest that
SARS-CoV-2 infection damages the CD8+ T cell response, an effect
akin to that observed in earlier studies showing long-term damage to
the immune system after infection with viruses such as hepatitis C
or HIV." These findings mirror those reported by Jacob Files, PhD,
et al who stated, “Overall, expression of these activation and
exhaustion markers indicated more severe immune dysregulation of
CD8+ T cells in the hospitalized group.” And they found that “CD8 T
cell expression of exhaustion markers increased in nonhospitalized
individuals over time….” We can choose to declare the pandemic over,
but SARS-CoV-2 is deaf to these pronouncements. Hopefully, the
dysfunction will be temporary and progressive in most individuals.
However, just the possibility makes avoiding COVID-19 infections
paramount, and we must keep our immunity as high as possible.
References
Infection Control
Today. March 21, 2023.
https://www.infectioncontroltoday.com/view/covid-19-study-suggests-long-term-damage-immune-system
122. Addressing COVID-19 Misinformation: What the Experts Got
Right—and Wrong
Information presented at this week's
Congressional Committee needs a much deeper evaluation and
consideration. The Cochrane Masking study may even vindicate the
federal government's initial COVID-19 response.
Natural Immunity Is Superior to Vaccinated Immunity.
This is a self-fulfilling prophecy. Early on, it was stated
that if the virus continued to spread, it would mutate, and the
vaccine would become less effective. This has happened with the help
of many individuals who discouraged adopting public health
strategies.
Prior to the Delta variant, the vaccine had the edge; afterward, the
vaccine’s efficacy diminished. However, neither type of immunity is
adequate, and whether infected or vaccinated, your immunity will
wane, and a booster is beneficial to obtain hybrid immunity.
Masks Prevent COVID-19 Transmission.
One of the main problems is that the study relies heavily on
research evaluating the seasonal flu, a virus that is NOT felt to
spread primarily by the airborne route. For the season flu, masking
will not stop its major route of transmission. For SARS-CoV-2, which
is airborne, cloth masks and even surgical masks will not provide
optimal protection. Well-fitted N95 masks will provide the greatest
protection.
School Closures Reduce COVID-19 Transmission
Abundant evidence exists that children can spread COVID-19. The
Public Health Agency of Sweden Weekly Report #50 states:
“(translated) among the environments for the public (excluding
health care) was primary school, the environment from which the most
outbreaks were reported in week 50…” (Total outbreaks 199, Nursery
Schools 39, Elementary Schools 90, Grammar Schools 23, Workplace 39,
High Schools were closed.)
References
Infection Control Today.
March 3, 2023.
Read the full article for an expanded analysis and other areas
of misinformation:
https://www.infectioncontroltoday.com/view/addressing-covid-19-misinformation-what-experts-got-right-wrong
121. How Soon Is Another Booster Needed? Durability of
Vaccine-Induced Immunity
Specifically for older individuals and
immunocompromised individuals, a year could be too long. "Is the
(bivalent) booster worth taking? Yes, definitely. However, this
differs from the booster or vaccine we need to navigate this
pandemic. At the conclusion of the CDC Committee meeting, my primary
impression was that we senior citizens might be viewed as
expendable. Policy makers need to make the hard decisions that must
be made to assure our safety during this pandemic. After looking at
the data, I will consult my physician about receiving a booster on
an accelerated schedule, possibly at 6 months.
References
Infection Control Today. Feb. 26, 2023.
https://www.infectioncontroltoday.com/view/how-soon-is-another-booster-needed-durability-vaccine-induced-immunity
120. Is the Rise in RSV Infections Associated With Immune Debt or
SARS-CoV-2 Immune Dysfunction?
Post-COVID-19 immune dysfunction is supported
by epidemiological, clinical, and laboratory evidence. Attributing,
with little to no evidence, that masking and lack of exposure is the
primary driver of increases in bacterial and viral infections
discourages critical interventions needed to stop the spread of
disease.
References
Infection Control Today. Feb. 24, 2023.
https://www.infectioncontroltoday.com/view/is-rise-rsv-infections-associated-immune-debt-sars-cov-2-immune-dysfunction-
119. COVID-19 Immunity: Catching a Disease to Prevent a
Disease?
I had to stop and read the Seattle Times news
article "UW study: Catching COVID gives protection from its worst
effects." The article’s first sentence states: "A past COVID-19
infection offers ‘durable,’ temporary protection against getting
severely sick with the coronavirus." Can you please tell me what
'durable - temporary protection' is? Unfortunately, neither
vaccination nor infection provides durable protection. Hybrid
immunity is best, but becoming infected to achieve immunity is a
perilous strategy. At 40 weeks, the study in question, reported that
pooled data found only a 36.1% effectiveness against reinfection. This protection
would be expected to be even less effective with the highly
immune-invasive XBB.1.5 and BQ.1 variants. Herd immunity is not
achievable and has not been achieved in Sweden, a country whose
results have been discouraging. There is minimal downside to
boosting your immunity to help avoid long COVID. Our goal as a
nation must not be to become reinfected yearly; this is not a viable
option.
References
Infection Control Today. Feb. 20, 2023.
https://www.infectioncontroltoday.com/view/covid-19-immunity-catching-disease-prevent-disease-
118. FDA VRBPAC Meeting: Bivalent Vaccines, Natural Immunity,
Imprinting and COVID-19 Hospitalization Rates
The FDA's Vaccines and Related Biological
Products Advisory Committee laid out a simpler direction for
SARS-CoV-2 development and deployment. In individuals without a
previous infection, the better the original vaccination matches the
current viral strain, the better the immunological response will
match future viral sublineages and the less of an impact any
potential imprinting will have. In addition, during a discussion
regarding natural immunity, it was stated: “Major issue is, the
concept was that if you had COVID-19 or had been vaccinated
previously, you would just need one dose versus others who might
have multiple doses.” Thus, the new vaccine strategy may bring
natural immunity on par with initial vaccination, and require
frequent updating of vaccines and boosters to minimize the impact,
if any, of immune imprinting and maximize the immunological response
to SARS-CoV-2.
References
Infection Control Today. Jan. 29, 2023.
https://www.infectioncontroltoday.com/view/fda-vrbpac-meeting-bivalent-vaccines-natural-immunity-imprinting-covid-19-hospitalization-rates
117. Bird Flu Warning: Its Spreading, Mutating, and Infecting
Mammals
I’m starting to experience déjà Vu.
Gain-of-Function experiments performed on a hazardous virus, viral
spread from birds to mammals, spread between mammals, and mutations
beginning to arise, which may be the first step in conferring the
ability to transmit in humans. I do not want to go through this
again, especially since our current pandemic is not under control.
We need to aggressively contain the spread of bird flu and increase
our genomic surveillance for this disease.
References
Infection Control Today. Jan.
23, 2023.
https://www.infectioncontroltoday.com/view/bird-flu-warning-its-spreading-mutating-infecting-mammals
116. Immunodysfunction: A Cause of Stealth COVID-19 Illness
and Death
The concept of immune dysfunction caused by
COVID-19 is rapidly changing from a theoretical construct to a
significant adverse outcome of COVID-19. One which may have the
potential to collapse our health care system and impact patients
long after they become COVID-19-negative. Along with heart disease,
immune dysfunction and severe infections are becoming another cause
of stealth COVID-19 deaths. The public needs a paradigm shift from
believing that COVID-19 is a respiratory disease to understanding
that COVID-19 impacts every organ of the body, causing delayed
manifestations such as strokes, heart attacks, and infections which
can present long after one becomes COVID-19-negative.
References
Infection Control Today. Jan.
17, 2023.
https://www.infectioncontroltoday.com/view/immunodysfunction-a-cause-of-stealth-covid-19-illness-death
115. Future Directions for Vaccine Development with
considerations of immune imprinting and prevention of spread
"The commentary discusses the continued
concerns about COVID-19 vaccine efficacy reduction and what he
believes should be done to protect against the further spread." We
need a warp speed on new vaccine development. Why this is not being
done is one of the most significant failings of our pandemic
response. Until we have a vaccine that stops spread, we need to use
N95 masks, avoid crowded indoor venues, and markedly increase indoor
ventilation and air sanitization (with upper room UV-C units).
Because of immune imprinting, we need to consider the administration
of a bivalent or monovalent BA.5 (or current variant) vaccine to
COVID-19-naive individuals, especially young children, as opposed to
the monovalent vaccine with the spike protein from the wild-type
virus. Finally, we a new Warp Speed initiative designed to develop
mucosal vaccines. Infection Control Today.
References Dec. 27, 2022.
https://www.infectioncontroltoday.com/view/immune-imprinting-prevention-spread
114. COVID-19 and Traffic Accidents: Is a COVID-19 Personality
Disorder Caused by Viral Damage to the Prefrontal Cortex?
A study from Canada suggests that not being
vaccinated for COVID-19 could mean an individual is at higher risk
for an automobile accident. What if it is from brain damage from
contracting COVID-19? Right-wing media have ridiculed the American
Journal of Medicine article. But this observation may be based in
reality with a sound explanation. Suppose COVID-19 produces a
lasting COVID-19 personality disorder due to anatomical damage of
the orbitofrontal cortex created by SARS-CoV-2 infection. In that
case, those segments of the population that shun public health
interventions and aggressively seek to stop general health measures
may be entering into a vicious cycle of decline. As repeated
infections occur, damage to the brain increases, resulting in
decreased emotional control and increased aggression. All of this
makes it imperative that we slow the spread of this disease and have
clear and consistent messaging regarding the risks of COVID-19 and
what mitigation procedures can be implemented.
References Infection Control
Today. Dec. 20, 2022.
https://www.infectioncontroltoday.com/view/covid-19-traffic-accidents-covid-19-personality-disorder-caused-viral-damage-prefrontal-cortex-
113. COVID-19: How to Reduce Spread Without Vaccines and
Monoclonal Treatments
With many of the new COVID-19 vaccines not as
effective against the new variants, reducing their spread without
pharmaceuticals is even more critical. Vaccines are losing their
effectiveness. Although their ability to substantially prevent
hospitalizations and death has remained intact, the degree of
prevention with current variants cannot be determined until we are
well into the COVID-19 wave. Now, more than ever, we need to take a
layered approach and add non-pharmaceutical strategies to mitigate
disease from and spread to SARS-CoV-2. Combined with the risks of
long COVID-19, all of this means we need to reemphasize
non-pharmaceutical strategies to reduce the spread of SARS-CoV-2.
Three recent articles have placed renewed emphasis on ventilation,
spread by fomites, and outdoor precautions. Dec. 13, 2022.
References Infection
Control Today.
https://www.infectioncontroltoday.com/view/covid-19-how-to-reduce-spread-without-vaccines-monoclonal-treatments
112. Sweden’s Pandemic Experiment: A Book Review
Currently, the United States’ rates of
COVID-19 hospitalizations are increasing, and its response is muted,
even paralyzed, with a lack of public consensus. Much of the
public’s confusion can be traced back to Sweden’s “experience,” one
which is shrouded in misinformation and the “massaging of data.” Of
particular interest was the chapter dealing with “Children at the
front line of the Covid-19 pandemic” by Johanna Hoog. This chapter
delved into the push to keep schools open. The policy appeared to be
based upon a misinterpretation of a World Health Organization study
where a lack of analysis (“not possible to determine”) was reported
by the lay press as strong evidence that children do not spread
disease. In addition, there was inadequate testing and reporting of
cases which masked the outbreaks that did occur. And finally,
questions arose regarding how data was presented, data which
appeared to mitigate the impact of SARS-CoV-2 on children. Infection
Control Today. Dec. 12, 2022.
https://www.infectioncontroltoday.com/view/sweden-s-pandemic-experiment-book-review
111. As Holidays Approach, COVID-19 Remains a Major Concern
As the festive holidays begin, even with
vaccinations and boosters, COVID-19 still remains a concern for Long
COVID and other severe long-term effects. Al Roker’s, cohost of the
Today Show, recent hospitalization for blood clots in his leg, which
embolized to his lungs, is a sobering illustration of the long-term
risks imposed by even a mild case of COVID-19, along with the reason
why those who survive the acute infection should not be considered
recovered. Remember, many relatives are elderly and at a very high
risk for severe COVID-19 and Long COVID. All who are able should
receive the bivalent BA.5 booster. Right before family gatherings,
perform a rapid antigen test on all attendees. Ask visiting
relatives to follow safe practices (wearing masks and avoiding
crowded indoor settings) several days before the holiday events.
References
Infection Control Today. Nov. 23, 2022
https://www.infectioncontroltoday.com/view/as-holidays-approach-covid-19-remains-major-concern
110. Nov. 8, 2022. Respiratory Spread and the Flawed
Concept of Immunological Debt: A New Understanding
The recent CDC discussion of potential
redefinition of spread, uniform application of guidelines across
different types of facilities and the recommended use of N95 masks
to stop the spread of SARS-CoV-2, if adopted, could provide
revolutionary and needed changes in our approach to infectious
disease, along potentially transforming our approach to the
SARS-CoV-2 pandemic.
Social media is filled with the discussion of “immunity debt” and a
cause of the increase in RSV infections. I feel there is not a
well-established scientific basis for this concept. One hypothesis
to explain the increase in RSV hospitalizations is the possibility
that SARS-CoV-2 causes a persistent immunological dysfunction in
infected individuals.
References
Infection Control Today. Nov. 8, 2022.
https://www.infectioncontroltoday.com/view/respiratory-spread-flawed-concept-immunological-debt-new-understanding
109. Nov. 1, 2022. Is the Current Bivalent Booster the
Correct One? Studies Suggest it Isn't
The United States may be on the precipice of a
rude awakening regarding the persistence and devastation of
COVID-19. A perfect storm is brewing with the convergence of 3
untoward outcomes: The bivalent booster may primarily elicit
imprinted immunity, a deadly brew of a plethora of immune escape
variants is forming, and our public has thrown safety to the wind
with few—if any—masking or bothering to optimize their immunity. All
of this is in the background of new and disturbing data regarding
the dangers of long COVID-19.ReferencesInfection
Control Today. Nov. 1, 2022.
https://www.infectioncontroltoday.com/view/is-the-current-bivalent-booster-correct-one-studies-suggest-it-isn-t
108. Oct. 14, 2022 Have you recovered from COVID-19, or
Just Survived?
A recent controlled study from the Institute
of Health and Wellbeing and the Public Health of Scotland found that
almost half of COVID-19 patients have persistent symptoms at 6
months; and that the percentage of patients with symptoms did not
change over an 18 month period. The additive effects of Long COVID
with repeat infections, combined with the long-term persistence of
Long COVID systems, does not bode well for the United States’
workforce. N95 masks, vaccines, boosters and improvements in
ventilation are keys to prevention. Currently, the Brookings
Institute estimates that 2 to 4 million workers, or approximately 2%
of the United States Workforce is not working because of Long COVID.
Vaccines and boosters offer a degree of protection. The young have
been observed to have a greater incidence of Long COVID than the
elderly. This is not necessarily because they have a propensity to
develop the disease, but because they are less likely to be
vaccinated and boosted. Infection preventionists need to educate our
population regarding the dangers of long COVID and repeated
infections, encourage the wearing of N95 masks in indoor venues, monitor facility ventilation with CO2 levels as a surrogate for
adequate ventilation, and have MERV-13 filters installed in central
HVAC systems. Finally, to prevent the spread of highly infectious
airborne pathogens, upper room germicidal UV-C lighting should be
installed.
References
Infection Control Today. Oct. 14, 2022.
https://www.infectioncontroltoday.com/view/have-you-recovered-covid-19-just-survived-
107. Sept. 2, 2022. The Autumn COVID-19 Booster Is Here:
Is it Safe and Effective?
On Sept. 1st the first autumn boosters will
begin to be available, but individuals may be concerned about their
efficacy and safety. Ample safety data and immunological response
data indicates the reformulated boosters to the BA.4/5 Variant will
provide an improvement in efficacy. The magnitude of this
improvement is not known, and the mitigation of this augmentation
due to “antigenic sin” is also not known. In the beginning of the
pandemic, mRNA vaccines were heralded as a major breakthrough
allowing rapid adaptation and distribution of a reformulated
vaccine. To accomplish this feat in 2 months is just remarkable and
validates the initial optimism for this technology. I feel a
monovalent vaccine booster for BA.4/5 may have been better. However,
the current authorized BA.4/5 bivalent booster promises to give much
better protection to the BA.4/5 variant than the original booster. I
will be first in line to receive the newly reformulated version.
References Infection
Control Today. Sept. 2, 2022.
https://www.infectioncontroltoday.com/view/the-autumn-covid-19-booster-is-here-is-it-safe-and-effective-
106. Aug. 17, 2022. Viewpoint: We Cannot Afford to
Surrender to COVID-19 Now
Last week the Centers for Disease Control and
Prevention (CDC) relaxed recommendations which neither control or
prevent a rapidly evolving and disabling disease, COVID-19. However,
we must maintain effective efforts to control the spread of the
virus. Many of the relaxations appeared to be timed with the opening
of schools, ignoring the high rate of COVID-19 related
hospitalizations, national deaths hovering just under 500 per day,
and the urgent need for a reformulated vaccine, whose delivery is
expected in the fall of this year.
References
Infection Control Today. Aug. 17, 2022.
https://www.infectioncontroltoday.com/view/viewpoint-we-cannot-afford-surrender-covid-19-now
105. A Call for Action: The Triple Threat of Polio, Monkeypox, and
SARS-CoV-2
The US is at substantial risk of having a
reemergence of polio, the largest outbreak of monkeypox in the world
and is enduring repeated surges of SARS-CoV-2 variants. Rapid and
aggressive public health interventions are needed. If the resistance
we have seen in attempting to stop SARS-CoV-2 becomes commonplace
with other pathogens, we will be no better off dealing with disease
than in the Middle Ages.
It is apparent we cannot simply vaccinate our way back to normal. We
must also encourage the public to adopt public health strategies,
including the wearing of N95 masks, avoiding close contact with
strangers, and improved indoor ventilation. Now, more than ever,
infection preventionists are needed to turn this tide around.
References Infection Control Today. Aug. 8, 2022.
https://www.infectioncontroltoday.com/view/a-call-action-triple-threat-polio-monkeypox-sars-cov-2
104. The Public Ignores Warnings from Infection
Preventionists, but at What Cost?
Preventing infections hides an infection’s
true threat and firmly places IPs into the category of unsung
heroes. The inability of some leaders to focus on preventing
infections has placed our nation in peril, resulting in an
ineffective COVID-19 response, fueled an exponential growth in
monkeypox infections, along with a rise in antibiotic-resistant
bacteria, and has allowed all but conquered diseases, such as polio,
to start to reemerge. Scientists early on warned of exponential
growth (of SARS-C0V-2), while politicians declared the epidemic
gone, then under control. Only when the barn has burned down did
elected officials become concerned about the once avoidable
epidemic.
References
Infection Control Today. July 25, 2022.
https://www.infectioncontroltoday.com/view/public-ignores-warnings-infection-preventionists-what-cost-
103. Long COVID-19 and New Variants: Sounding a Continuing
Alarm.
It is easy to become complacent, but the
SARS-CoV-2 pandemic is not over, and long COVID-19 and the new
variants are causing rising concern. published in the New England
Journal of Medicine which found that '…data show that the BA.2.12.1,
BA.4, and BA.5 subvariants substantially escape neutralizing
antibodies induced by both vaccination and infection.' In addition,
the BA.4 and BA.5 variants may be the most infectious variants to
date. Long COVID-19 has been found to occur in 30% of patients
treated for COVID-19, and up to 70% have symptoms of brain fog,
memory, or other cognitive problems. It also can have a profound
impact on the heart and other organs.
References
Infection Control Today. June 27, 2022.
https://www.infectioncontroltoday.com/view/long-covid-19-new-variants-sounding-continuing-alarm
102.
Viewpoint: Battling COVID-19 Disinformation
Much of the denial comes from a lack of
understanding of the importance of infectivity and how it increases
your chances of getting a severe infection. The best example of this
is the high infectivity of the Omicron variant, which resulted in a
large number of deaths and hospitalizations. Attending an event in
the United States, your chances of dying of Omicron was greater than
Delta, but once infected, the opposite is true. Advocating for herd
immunity, downplaying the usefulness of masks; along with denying
the severe impact of long-COVID and acute infections from SARS-CoV-2
makes little sense. One may choose to ignore disinformation, writing
it off to a few uninformed individuals, but unfortunately, there are
many. To make matters worse, disinformation can be highly organized,
fanning flames that not only have the potential of placing health
care workers in jeopardy but also weakening our nation. Hence, I
would encourage all to engage in respectful conversations with those
who spread disinformation to at least provide an opposing point of
view. References Infection Control Today. June 17, 2022.
https://www.infectioncontroltoday.com/view/viewpoint-battling-covid-19-disinformation
101. Monkeypox: CDC Raises Travel Alert, But How Much Threat
Is it Really?
Many are wondering should we be concerned
about Monkeypox or is it just a disease of the week, soon to pass
and be forgotten. Current data indicates the former. Cases in the
United States have quickly risen, now at 25 confirmed cases and many
more are expected to have occurred but not been detected. Worldwide,
the number of confirmed and suspected cases has risen to nearly
1000, and spread is continuing. The virus is currently in 29
countries. Where this disease came from will probably be a mystery.
Already, there are theories of biolabs and germ warfare circulating
on social media. However, the history of this disease shows an
increasing incidence in Africa, presumably from waning immunity. At
this point, we must be vigilant but so far human-to-human spread of
this virus appears to be related to risky behavior and very close
physical contact. There are both vaccines and antiviral medications
which are effective against Orthopoxviruses. In addition,
epidemiological case tracking and public education are expected to
bring this outbreak under control.
References
Infection Control Today. June 6 2022.
https://www.infectioncontroltoday.com/view/monkeypox-cdc-raises-travel-alert-but-how-much-threat-is-it-really-
100. A Pandemic Paradigm Shift in Our Understanding of
Transmission
The bugs are winning, but only because we are
letting them. Modern day epidemiology has divided the spread of
respiratory diseases into categories of airborne and droplet
transmission. We were not facing a dichotomy in methods of spread;
we were facing a continuum. There is no doubt that infection
preventionists have a herculean task before them. The first step
must be to educate hospital administration regarding the resources
required to reverse the increasing rates of antibiotic resistance
and to improve infection prevention by implementing the knowledge
learned during the pandemic. Only then will an optimal safe
workplace be created and the safest possible care be provided to
patients.
References
Infection Control Today. May 25, 2022.
https://www.infectioncontroltoday.com/view/a-pandemic-paradigm-shift-our-understanding-transmission
99. AB.4 and BA.5 Variants, Pandemic Fatigue, and Waning
Immunity: A Toxic Mix
With new variants emerging, cases rising and a
more complete understanding of the dangers of long COVID-19, one can
make a strong case for resuming public health measures intended to
control spread and infections from this disease. Unfortunately, even
in the face of waning immunity, few individuals in the United States
are currently wearing masks, and many are continuing to engage in
risky behavior. This may well be a toxic mix, and healthcare
facilities, and infection preventionists need to prepare for another
possible surge in cases.
References
Infection Control Today. May 9, 2022.
https://www.infectioncontroltoday.com/view/ab-4-ba-5-variants-pandemic-fatigue-waning-immunity-toxic-mix
98. Viewpoint: New UK Data Show BA.2 Variant Produces More
Frequent Hospitalizations Than Omicron
New data is beginning to emerge for the BA.2
variant, and the results do not look good. Data from the United
Kingdom show the BA.2 surge to be about half that of the Omicron
surge. However, the number of hospitalizations are the same and
those caused by BA.2 may eventually surpass Omicron. This evidence
indicates that BA.2 is not only more infectious but also more
virulent than the Omicron variant.
References Infection
Control Today. Apr. 6, 2022. Read Full Article:
https://www.infectioncontroltoday.com/view/viewpoint-new-uk-data-show-ba-2-variant-produces-more-frequent-hospitalizations-than-omicron

97. How Does the US Response
to COVID-19 Compare With the Rest of the World?
Among high-income nations, the United States has one
of the highest rates of COVID-19 excess deaths per capita. Despite
the implementation of many strategies and high population adherence
in Sweden, this country has one of the highest rates of COVID-19
excess deaths among Nordic Nations. Only Denmark is higher. The
United States has not performed the worst during the pandemic, but
it has performed below average among the worlds' nations. Even our
completeness of reporting actual cases is below that of the United
Kingdom and Southern South America Nations. This poor performance
makes it imperative that we learn the lessons of this pandemic,
reform our healthcare system, and improve messaging along with
public acceptance of mitigation strategies. The United States can
and must do better.
References Infection
Control Today. . Mar. 22, 2022.
https://www.infectioncontroltoday.com/view/how-does-us-response-covid-19-compare-rest-world-
96. Evidence Shows Students Need to Wear Masks in
Schools Despite Disinformation
Multiple studies and reports show that masks
in schools are effective, safe, and necessary because COVID-19 is
not going away. Above all, as pointed out by the “Getting to and
Sustaining the Next Normal” report, we need clear guidance on when
school mitigation recommendations (“including masking, social
distancing, quarantining, reduced class sizes, and outdoor
learning”) are to be triggered to enable communities to provide the
safest environment possible for the education of our children.
References Infection Control Today. Mar. 14, 2022.
https://www.infectioncontroltoday.com/view/evidence-shows-students-need-wear-masks-schools-despite-disinformation
95. COVID-19 Brain Changes: New Evidence Details Long-Term
Effects of Infection
A new study supports the conclusion that the
“brain fog” reported by many who have recovered from mild COVID-19
infection is real and has an anatomical basis. The United States has
all but declared victory and followed the United Kingdom’s example
by rapidly relaxing public health strategies, including masking. The
BA.2 (Stealth) variant could prove more infectious than Omicron
(BA.1) and is ravaging Denmark and Hong Kong. This variant is also
increasing in our country. A finding that, combined with the
increased concerns over the impact of long COVID, dictates that a
more careful approach to relaxation of mitigation strategies may be
warranted.
References Infection Control Today. Mar. 9, 2021.
https://www.infectioncontroltoday.com/view/covid-19-brain-changes-new-evidence-details-long-term-effects-infection
94. Preventing the Spread of COVID-19 While Keeping Kids in
School: A Case Study
Amanda Mulcahy: Swampscott’s overall goal was
to keep students and staff safe with significant consideration to
minimize the disruption to learning for students and their families.
This was accomplished with layers of mitigation strategies that were
applied in the district. With every added layer, another barrier was
created to protect both students and staff, keeping them safe in the
district’s buildings and allowing the prioritization of in-person
learning. Interventions included, attention to air filtration and
circulation, use of masks, robust testing, case tracking and
promotion of vaccinations. Infection Control Today. Mar. 3,
2022.
https://www.infectioncontroltoday.com/view/preventing-spread-covid-19-while-keeping-kids-school-case-study
Health Watch USA Meeting Video Presentation
https://youtu.be/JVYKWhW0ffk
93. Mutated SARS-CoV-2 Detected in White-Tailed Deer in
Ontario
Mounting evidence is supporting the spread of
SARS-CoV-2 in animals. The latest report is from Ontario, Canada,
and has added to the evidence that white-tailed deer can become
infected with SARS-CoV-2. Above all, the report by Bradley Pickering
et al underscores the importance of One Health, the idea that
animals and mankind live in the same biosphere and you cannot
optimally promote health in mankind without also addressing the
health and spread of disease in animals. It is unlikely we can stop
the emergence of future dangerous variants by vaccinating all of
mankind. We must also address the health of animals and modify how
we interact with domesticated and wild species.
References Infection Control Today. Mar. 1, 2022.
https://www.infectioncontroltoday.com/view/mutated-sars-cov-2-detected-white-tailed-deer-ontario
92. Perspective: Relaxing Mask Guidance Must Be Done
'Carefully'
The Centers for Disease Control and Prevention
(CDC) is expected to relax mask guidelines on indoor mask
requirements Friday. Reports have indicated the new guidelines will
be based, at least in part, on hospitalizations and hospital
capacity. First, the metric for hospitalizations is a lagging
indicator, and basing action on increasing hospitalizations will
make our actions reactive and not proactive. Second, there are data
that indicate we may not yet be in an endemic phase of the pandemic.
During the month of February, deaths spiked in South Africa. In
Denmark, a country whose cases are almost totally comprised of the
BA.2 variant. Deaths are at an all-time high. For me, this is reason
enough to continue masking.
References Infection Control Today. Feb. 25,
2022.
https://www.infectioncontroltoday.com/view/perspective-relaxing-mask-guidance-must-be-done-carefully
91. COVID-19 Boosters: New MMWR Report Explores Waning
Immunity
The research found vaccine efficacy in the
prevention of visits to urgent treatment centers and emergency rooms
fell from 87% at 2 months, to 66% at 4 months, to 31% at ≥ 5 months.
A WHO Variant of Concern, the Stealth Omicron (BA.2), may pose even
new challenges and has been reported to be more severe and
infectious than Omicron (BA.1). In addition, it is being initially
reported that it may “largely” escape current vaccines and could be
resistant to many monoclonal antibody products, including the GSK
antibody, sotrovimab. However, a vaccination booster appears to
restore immunity with a 74% protection against illness.
References Infection Control Today. Feb. 18, 2022.
https://www.infectioncontroltoday.com/view/covid-19-boosters-new-mmwr-report-explores-waning-immunity
90. Viewpoint: How to Improve U.S. Dismal COVID-19 Response
Former President Trump’s Presidential Federal
Advisory Committee for COVID-19 needs to be reestablished under
President Biden. The United States Senate HELP Committee will hold a
hearing tomorrow to officially begin the process of formulating
legislation to strengthen our pandemic preparation and response. All
of the provisions focus on acronyms of the CDC, FDA, BARDA, ASPR,
NIAID and the GAO. What is missing is OSHA and frontline worker
protection, this includes infection preventionists.
References Infection
Control Today. Feb. 7, 2022.
https://www.infectioncontroltoday.com/view/viewpoint-how-to-improve-u-s-dismal-covid-19-response
89. Those Who Believe in Herd Immunity Cannot Do the Math
COVID-19 mutations are evading our immunity
and at the same time our immunity is waning. Herd immunity to
disease and the eradication of SARS-CoV-2 is no longer possible.
According to the United Kingdom’s Imperial College COVID-19 response
team, a two-dose vaccine (AstraZeneca and Pfizer) provides a vaccine
effectiveness in the prevention of symptomatic disease between 0%
and 20% with the Omicron Variant, and a previous infection gave a
protection of 19%. However, unlike infections, you can safely
receive a booster with an mRNA vaccine. Three-dose vaccinations
provide a vaccine effectiveness for the prevention of symptomatic
disease from Omicron of between 55% and 80%. Current data are
placing the final nails in the coffin of herd immunity.
References
Infection Control Today. Jan. 26, 2022.
https://www.infectioncontroltoday.com/view/those-who-believe-in-herd-immunity-cannot-do-the-math
88. Viewpoint: COVID-19 Forever Cancels the Old Normal
Contrary to the “vaccinate and all will be
well” narrative, “mild” does not mean just avoiding hospitalization,
nor does surviving a COVID-19 acute illness means you have
recovered. Vaccines are an important layer of armor but they, in
themselves, will not stop COVID-19. Public health is focused on the
community, not one’s own health. In public health, as vaccine
efficacy falls, it is even more imperative that all who can, become
vaccinated. We must slow down the spread of this virus. It is easy
to advocate for personal freedom and act irresponsibly when someone
else is funding your safety net.
References Infection
Control Today. Jan. 24, 2022.
https://www.infectioncontroltoday.com/view/viewpoint-covid-19-forever-cancels-the-old-normal
87. Animal Farms: COVID-19 Doesn’t Need Humans to Survive.
Animal infection sets the stage for an
independent evolution of SARS-CoV-2 which, after an extended
evolutionary period, can jump back to humans causing disease with an
unpredictable infectivity and case fatality rate. This is what
appears to have happened with the Omicron variant. In other words,
we all need to start taking this virus more seriously and uniformly
enact effective control measures.
References Infection Control Today. Jan. 20, 2022.
https://www.infectioncontroltoday.com/view/animal-farm-covid-19-doesn-t-need-humans-to-grow
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.
https://www.infectioncontroltoday.com/view/infection-preventionists-might-be-needed-in-schools
Detailed YouTube presentation:.
https://www.youtube.com/embed/6Z3mh-TmMJs
YouTube Interview
and Transcript:
https://www.infectioncontroltoday.com/view/and-a-
infection-preventionists-should-head-back-to-school
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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