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Review
. 2021 Jan 6;10(1):7.
doi: 10.1186/s13756-020-00875-7.

Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers

Mohamed Abbas  1   2 , Tomás Robalo Nunes  3   4 , Romain Martischang  3 , Walter Zingg  3   4   5 , Anne Iten  3 , Didier Pittet  3   4   5 , Stephan Harbarth  3   4   5
Affiliations
Review

Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers

Mohamed Abbas et al. Antimicrob Resist Infect Control. .

Abstract

Objectives: To 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.

Methods: Narrative literature review.

Short conclusion: The 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.

Keywords: COVID-19; Healthcare-associated infection; Infection prevention and control; Nosocomial outbreaks; SARS-CoV-2.

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Conflict of interest statement

All authors have no competing interests to declare.

Figures

Fig. 1
Fig. 1
Transmission pathways of SARS-CoV-2. a Likely modes of SARS-CoV-2 transmission to HCWs in healthcare environments (both direct patient care and non-clinical settings) and in the community. b Likely modes of SARS-CoV-2 transmission to patients in healthcare settings. c Unlikely modes of SARS-CoV-2 transmission to HCWs in healthcare environments
See this image and copyright information in PMC

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