Nosocomial Infection Control: COVID-19 & Ventilator Associated Pneumonia

The recent pandemic outbreak of the infection Coronavirus Disease 2019 (COVID-19), also known as the Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2), reminds us once again about the ongoing challenge of emerging and re-emerging of contagious respiratory pathogens. 

Given the high number of ICU admissions requiring mechanical ventilation, hospitals dealing with the current COVID-19 virus are ringing the alarm bell as they are running out of ICU capacity. Therefore, slowing the spread of this virus transmission (‘flattening the coronavirus curve’) by performing infection control and contamination reduction is nearly as important as stopping it.

Most frequently, infection diseases cause symptoms of the common cold (type 1-2 patients: fever, cough, and shortness of breath). However, they can also lead to Acute Respiratory Distress Syndrome (ARDS), Acute Hypoxemic Respiratory Failure (AHRF) and severe lower respiratory tract infections like pneumonia, primarily in infants, older people, and the immunocompromised.¹ These patients with acute breathing difficulties (type 3 patients) need lifesaving, adequate intensive care.

Healthcare facilities are crucial in containing and preventing the spread of infectious diseases like the current novel coronavirus. Still, these Healthcare-Associated-Infections (HCAI), also known as Hospital Acquired Infections or nosocomial infections, pose significant risk to patients as well as medical personnel.

NICE already reported in 2014 that around 1.5% of hospital inpatients will have a hospital-acquired respiratory infection, for instance Ventilator Associated Pneumonia (VAP), at any given time². Acquisition of Hospital-Acquired Infections in Intensive Care Units (ICUs) predispose patients to higher mortality rates and additional adverse events³. Also, it remains significant, and there is now soft COVID-19 evidence from both China and Italy, that healthcare workers who are infected have a higher rate of severe and critical illness than the normal population, plausibly because of exposure to a higher viral load.⁴

Ensuring the safety of healthcare workers is not only to safeguard continuous patient care but also to ensure they do not transmit the virus. Anaesthetists’ and intensivists’ involvement in the coronavirus containment is high since airway management, including tracheal intubation, is associated with some of the highest risks of transmission of infection.⁴  

Collaboration in planning and delivery of critical care services, as well as the protection of hospital staff safety, are essential. Therefore, the emergence and rapid increase of these kinds of respiratory infection diseases like COVID-19 require constant surveillance, early detection and prompt diagnosis in the hospital. 

Moniek Haan is a Marketing Manager Respiratory & Monitoring Solutions EMEA