Doctor in face mask is looking away through window with tiredness while having a break

A new study of geriatric acute care wards highlights how gaps in infection control practices may help spread COVID-19 between healthcare workers and patients.

There is still some uncertainty about the chain of SARS-CoV-2 transmission in nursing homes and hospitals, according to the investigators, from Switzerland and the United Kingdom. To better pinpoint the role that healthcare professionals and patients play in spreading the virus, they reconstructed transmission dynamics during several hospital COVID-19 outbreaks in the Swiss University-affiliated Hospital of Geriatrics.

The hospital has 196 acute-care beds, many of which became part of COVID-19 isolation wards, and 100 rehabilitation beds. In the COVID-19 isolation wards, the researchers found less transmission of the virus than they expected between patients and healthcare workers. Instead, the main source of new hospital-acquired infections was healthcare professionals working on other wards when an outbreak occurred, they reported. 

Healthcare workers had double the odds of infection by another healthcare professional working on a ward that had an outbreak than from one of the COVID-19 wards. And most patient-to-patient transmission was among patients who had shared a ward, rather than a room.

The differences in transmission suggest that COVID-19 ward workers were more rigorously employing infection control and prevention measures, “whereas those working on non-COVID wards may have underestimated the risk of transmission,” said study author Stephan Harbarth, of Geneva University Hospitals. 

Strategies to prevent SARS-CoV-2 transmission in geriatric settings should take into account not only the potential for patient-to-patient transmission, but the transmission and infection control dynamics between healthcare workers in non-COVID-19 wards, “which may differ considerably from those in dedicated COVID-19 wards,” he and his colleagues concluded.

Full findings were published in the journal eLife.

Related articles:

Building design affects long-term care COVID-19 infection control: study

A long time coming’: LTC infection preventionists get new certification option