From Cambridge Press:
In a coronavirus disease 2019 (COVID-19) ward in 2020, preventing a catheter-associated urinary tract infection was probably not always the foremost consideration for healthcare staff. Nurses and doctors were trying to save the lives of surges of critically ill infectious patients while juggling shortages of respirators and, at times, shortages of gowns, gloves, and disinfectant wipes as well. Infection control staff were working around the clock to ensure that their healthcare colleagues were wearing proper protective gear and that patients and visitors were screened for symptoms, were tested for severe acute respiratory coronavirus virus 2 (SARS-CoV-2), and were wearing masks. All available resources were directed at minimizing the risk of SARS-CoV-2 transmission in the hospital.
Sometimes these efforts went terribly wrong. Infection control practices in COVID-19 wards often adapted to shortages of personal protective equipment (PPE), responded to the fears of healthcare personnel, and did not always lend themselves to better infection prevention. Examples include reuse of PPE and use of double gowning or gloving. Some specific practices have been implicated in transmission of multidrug-resistant organisms. 1,2 Because of limited capacity and staffing shortages, some hospitals suspended their infection prevention activities altogether or redirected them entirely toward the prevention of SARS-CoV-2 transmission, which resulted in spikes in multidrug-resistant organism activity. 2 These focused views from the COVID-19 trenches provide clear insights into the challenges and complexities that have faced healthcare epidemiologists during the pandemic.
A broader view, however, contributes additional perspective. The COVID-19 pandemic has taken an enormous toll on our society. The health impact is obvious, with >615,000 lives lost in the United States alone. The economic impact has been severe: many businesses have closed, millions of people are out of work, and families are struggling to stay afloat. The mental health aspects of the pandemic cannot be overstated. Quarantine, self-isolation, physical distancing, separation from families and loved ones, stress, and uncertainty have been constant companions for most citizens. The concept of ‘business as usual’ has virtually disappeared. Perhaps no venue has been more affected than health care. Hospitals throughout the nation have dramatically altered their business and operational practices, precluding elective surgeries and admissions, barring visitors, and creating COVID-19 clinical and intensive care units. Some hospitals have struggled to remain solvent. Emergency rooms have been flooded with COVID-19 patients. During surges, acute-care hospitals have been overwhelmed to overflowing. Hospital staffs have been stressed, often to the breaking point, while trying to provide the best possible clinical and critical care to numerous patients, many of whom succumb to the disease in isolation with no family members present. The impact of this cataclysmic pandemic on traditional health care has been profound. (more…)