Infection Control Today

OCT 2018

ICT delivers to infection preventionists & their colleagues in the operating room, sterile processing/central sterile, environmental services & materials management, timely & relevant news, trends & information impacting the profession & the industry

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disease such as Ebola virus infection safely for 48 hours — that's where efforts must move toward as opposed to every hospital being expected to be able to care for Ebola patients endlessly. It's critical for regional centers to be able to recognize and manage patients with an emerging or re-emerging pathogen. Some hospitals have invested in preparedness and continue to conduct drills and continue to prepare; in many cases, there aren't enough resources or that focus, so I think in many settings, while we are better prepared, there is more work needed to be done. That only happens when hospital leadership is concerned about preparation for pandemics or outbreaks; without resources, that post-Ebola adrenaline and focus is waning, and we are drifting back into relative complacency about these threats — not in all centers, but in many, I think. The challenge is addressing preparedness while still handling competing issues when you don't have unlimited resources; if you have other pressing issues, some of those lessons learned are forgotten or some of those sharpened skills become more and more dull." Retaining capacity is key to preparedness for the future, says Matthew Zahn, MD, a pediatric infectious disease physician with CHOC Children's Hospital in Orange County, California. "We know a great deal of resources were invested into training for Ebola preparedness and boosting infection control capacity, so the million-dollar question is, how do we retain that critical capacity? A few Ebola patients presented in the U.S. as part of the large outbreak that originated in West Africa a few years ago. When it happened, it presented infection control issues beyond what we have dealt with before in this country. Maintaining the capacity to respond to such an event is extremely diffcult for local public health departments and hospitals to work through; there is so much that goes into preparing for just one Ebola patient, as many personnel must be trained on relatively intricate processes including the proper donning and doffng of PPE. That level of training is a huge amount of work. How to maintain that preparedness while not drawing healthcare workers too far from the issues that they see every day is a big concern and it defes a simple answer." Zahn continues, "Engaging staff about something as exotic as Ebola teaches them good practices for infection prevention and control no matter what organisms you encounter every day, so that preparedness emphasis has merit. There is real value to maintaining that institutional level of knowledge because those experiences and those lessons learned are going to pay dividends in the future. Our experience with H1N1 and with Ebola add to our overall knowledge of how to prevent the spread of pathogens and emphasize the need to practice good infection control." Earlier this year, Bill Gates presented a simulation by the Institute for Disease Modeling that found that a new infuenza virus such as the one that caused the 1918 pandemic could kill 30 million people within six months. Gates was the featured speaker for the Shattuck Lecture, held during the annual meeting of the Massachusetts Medical Society and New England Journal of Medicine. Gates' lecture explored the lack of global preparation for a pandemic. To demon- strate the destructive power of an unchecked epidemic, Gates leveraged the modeling expertise of the Institute for Disease Modeling (IDM), which specializes in developing software for the mathematical modeling of infectious disease as well as researching the interventions and methodology necessary for interrupting transmission and eliminating pathogens. For this lecture, Dr. Hao Hu, the senior research manager of IDM's epidemiology section, and Bryan Ressler, a senior software engineer at IDM, worked together to create simulations modeling pandemic scenarios for the spread of an infuenza-like pathogen.

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