Abstract
With the global spreading of Coronavirus disease (COVID-19), many primary care medical workers have been infected, particularly in the early stages of this pandemic. Although extensive studies have explored the COVID-19 transmission patterns and (non-) pharmaceutical intervention to protect the general public, limited research has analysed the measures to prevent nosocomial transmission based upon detailed interpersonal contacts between medical staff and patients. This paper aims to develop and evaluate proactive prevention measures to contain the nosocomial transmission of COVID-19. The specific objectives are (1) to understand the virus transmission via interpersonal contacts among medical staff and patients; (2) to define proactive measures to reduce the risk of infection of medical staff and (3) evaluate the effectiveness of these measures to control the COVID-19 epidemic in hospitals. We observed the operation of a typical primary hospital in China to understand the interpersonal contacts among medical staff and patients. We defined effective distance as the indicator for risk of transmission. Then three proactive measures were proposed based upon the observations, including a medical staff rotation system, the establishment of a separate fever clinic and medical staff working alone. Finally, the impacts of these measures are evaluated with a modified Susceptible-Exposure-Infected-Removed model accommodating the situation of hospitals and asymptomatic and latent infection of COVID-19. The case study was conducted with the hospital observed in December 2019 and February 2020. The implementation of the medical staff rotation system has the most significant impact on containing the epidemic. The establishment of a separate fever clinic and medical staff working alone also benefits from inhibiting the epidemic outbreak. The simulation finds that if effective prevention and control measures are not taken in time, it will lead to a surge of infection cases in all asymptomatic probabilities and incubation periods.
Highlights
The world has been experiencing an unprecedented public health emergency, a pneumonia pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that is, the Coronavirus disease (COVID-19) (WHO, 2020c)
A heatmap is generated based on the matrix D (Figure 3), showing the pairwise effective distance between all medical staff
The effective distances between the medical staff show that the staff members in outpatient departments have more contact with patients, especially those working in the pharmacy
Summary
The world has been experiencing an unprecedented public health emergency, a pneumonia pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that is, the Coronavirus disease (COVID-19) (WHO, 2020c). This infectious disease spreads rapidly within a brief period of time to more than 190 countries or regions worldwide, resulting in acute morbidities and mortalities. Pharmaceutical intervention to protect the general public, limited research has analysed the measures to prevent nosocomial transmission based upon detailed interpersonal contacts between medical staff and patients. The specific objectives are (1) to understand the virus transmission via interpersonal contacts among medical staff and patients; (2) to define proactive measures to reduce the risk of infection of medical staff and (3) evaluate the effectiveness of these measures to control the COVID-19 epidemic in hospitals
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