Abstract
ObjectivesTo compile current published reports on nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evaluate the role of healthcare workers (HCWs) in transmission, and evaluate outbreak management practices.MethodsNarrative literature review.Short conclusionThe coronavirus disease 2019 (COVID-19) pandemic has placed a large burden on hospitals and healthcare providers worldwide, which increases the risk of nosocomial transmission and outbreaks to “non-COVID” patients or residents, who represent the highest-risk population in terms of mortality, as well as HCWs. To date, there are several reports on nosocomial outbreaks of SARS-CoV-2, and although the attack rate is variable, it can be as high as 60%, with high mortality. There is currently little evidence on transmission dynamics, particularly using genomic sequencing, and the role of HCWs in initiating or amplifying nosocomial outbreaks is not elucidated. There has been a paradigm shift in management practices of viral respiratory outbreaks, that includes widespread testing of patients (or residents) and HCWs, including asymptomatic individuals. These expanded testing criteria appear to be crucial in identifying and controlling outbreaks.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), first described in December 2019, causes coronavirus disease 2019 (COVID-19), and has been declared as a Public Health Emergency of International Concern by World Health Organization (WHO) on 30 January 2020
Hospitals admitting COVID-19 patients have practised cohorting in accordance with recommendations from infection prevention and control (IPC) professional societies [6–9]
Risk of nosocomial transmission to and from healthcare workers HCWs are at increased risk of SARS-CoV-2 exposure while caring for COVID-19 patients
Summary
Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), first described in December 2019, causes coronavirus disease 2019 (COVID-19), and has been declared as a Public Health Emergency of International Concern by World Health Organization (WHO) on 30 January 2020. Because HCWs are at the interface between healthcare settings and the community, where there is significant transmission, combined with the fact that as essential workers they are not confined, they may play a role in initiating or amplifying outbreaks in settings such as hospitals [10, 11] and long-term care facilities (LTCFs) [12]. The aim of this narrative review is to provide an overview of the existing literature regarding SARS-CoV-2 transmission and outbreaks in healthcare settings, to evaluate the role of HCWs in these outbreaks, and to highlight key IPC practices in outbreak management and prevention
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