Infection prevention and control in nursing severe coronavirus disease (COVID-19) patients during the pandemic

The novel coronavirus disease 2019 (COVID-19) is now worldwide publicity. Five to 20% of the total COVID-19 positive cases required admission to an intensive care unit (ICU) and the mortality rate was approximately 50% among critically ill patients who developed acute respiratory distress syndrome [1–5]. Deeply concerned by the spread and severity, the World Health Organization (WHO) characterized COVID-19 as a pandemic in March 2020. In February, Wuhan was facing a sudden shortage of health workers induced by the COVID-19 pandemic. The Chinese health authorities reported that 3019 Chinese health workers were infected with COVID-19, of which 10 died [6]. Front-line health workers are at high risk of infection. Inadequate awareness and precautionary measures, patient overload, and staff burnout are considered as relevant reasons for health worker infections. As an emergency measure, the China government dispatched 189 national medical teams comprising more than twenty-thousand health workers from all over the country who volunteered to combat COVID-19 in Hubei. They had been working together with local health workers and successfully controlled the development of the epidemic. The goal of “Zero” COVID-19 infection among health workers was achieved. Actually, from February 12 to April 9, 9282 health worker COVID-19 cases were reported by the US Center for Disease Control and Prevention, and contacts with COVID-19 patients in health care, household, and community settings were all detected [7]. COVID-19 infections among health workers are common and fatal to the health system. Infection among health workers may cause widespread transmission within the system and even lead to the collapse of the whole services. And this was what exactly happened in Harbin in the past weeks; a persisting cluster centered on an 87-year-old inpatient infected more than eighty people, including 8 health workers. The affected hospital urgently suspended routine medical services as a result. Based on Wuhan’s experience, it is critical to develop tailored infection prevention and control (IPC) protocols for both workplace and non-occupational settings and to conduct effective IPC training. Thus, the following suggestions were summarized based on the first-hand experience of a national medical team from Zhejiang, to facilitate the development of IPC protocols in critical care settings.