" On April 11th, 2020, four patients hospitalized for more than 7 days developed fever some of them respiratory symptoms compatible with Covid-19 infection and were detected positive for SARS-CoV2. A 5th patient was also detected positive , had minor symptoms and was admitted 2 days earlier for collecting PBSC As a consequence of this mini-outbreak a screening of healthcare workers at this Unit revealed 2 staff members positive for SARS-CoV2. Severe acute respiratory distress syndrome Coronavirus 2(SARS-CoV2), causing Covid19 pandemic is rapidly spreading from person-to-person, via respiratory droplets, direct contact with mucous membranes or indirect contact through touching infected surfaces and then touching own eyes, nose or mouth. Airborne transmission after generated aerosols (intubation, bronchoscopy, tracheal aspiration,…) have been previously reported for other Coronaviruses(SARS-CoV1, MERS) and has been postulated for SARS-Cov2. In critical units such as the Sterile Unit where haematopoietic stem cells transplantation and intensive chemotherapy for leukemic patients are performed, and immunocompromised patients are at high risk of complications from Covid-19 such as respiratory failure, shock or multiorgan failure and death. Despite all protective measures taken in hospital care, healthcare associated transmission of SARS-CoV2 has occurred in many instances, with severe consequences for patient care and infection control. Closing of wards and patient transfer to Covid-19 units, screening of healthcare workers and all patients on wards, environmental decontamination of all available surfaces are the main action undertaken in this context. For all these reasons, we believe that screening of healthcare workers for Covid-19 would help in reducing the risk of nosocomial transmission of the infection. Extreme precautions are mandatory in order to avoid acquisition. "
Publication References: Mc Michael TM et al. COVID-19 in a Long-Term Care Facility - King County, Washington, February 27-March 9, 2020; MMWR Morb Mortal Wkly Rep. 2020;69(12):339. Epub 2020 Mar 27 Wang D et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA 2020 Guan WJ et al. Clinical characteristics of coronavirus Disease 2019 in China. N Engl J Med. 2020 Feb 28. doi: 10.1056/NEJMoa2002032. Ai T et al. Correlation of Chest CT and RT-PCR Testing in Coronavirus Disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology 2020. Bai HX et al. Performance of radiologists in differentiating COVID-19 from viral pneumonia on chest CT. Radiology 2020. Bahl P et al. Airborne or droplet precautions for health workers treating COVID-19? J Infect Dis. 2020 Kampf D et al. Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. J Hosp Infect. 2020;104(3):246. Epub 2020 Feb 6.
Mickael Aoun, Infectiologist