Infection prevention and control in healthcare settings (COVID-19)

Standard measures of infection control in healthcare facilities include:

• administrative measures such as triage, testing and isolation/placement of patients;
• hygiene precautions and source control measures such as hand washing, respiratory hygiene, and face masks;
• environmental measures such as ventilation, cleaning, disinfection, and safe waste management; and
• transmission-based precautions and personal protective equipment (PPE).

Infection prevention and control (IPC) measures aim at mitigating the spread of pathogens in healthcare settings, decreasing the risk of outbreaks, and further reducing the burden on personnel and resources.

Universal screening of all patients for SARS-CoV-2 on admission to hospital irrespective of symptoms appears to have only limited additional benefit, but may be considered when there is high community transmission of SARS-CoV-2 or emerging variants with high impact.

The assessment of patients with respiratory symptoms should preferably be carried out in a separate area of the emergency or entry area, including testing with rapid antigen detection tests (RADTs) or point-of-care/near-patient tests to support decisions on further clinical management, such as isolation or early initiation on antiviral treatment.

Patients with confirmed respiratory viral infection or probable respiratory viral infection with testing results pending should be placed in a single room and wear a medical mask when not in the room. If single room placement is not possible, several patients with the same viral infection can be placed in the same room (cohorting).

Medical and non-medical staff, patients, and visitors need to be informed about standard precautions, and have access to adequate resources, e.g. easy access to hand hygiene.

Decisions on the implementation of stricter additional IPC measures, such as universal masking or restriction of visitors, will depend on an assessment of the risk considering the situation in the community and healthcare facility and balancing expected benefits, as well as the burden on resources, staff, patients, and visitors [54].