During a 12-week peak in the COVID-19 crisis, an 800-bed academic hospital in a frenetic American city admitted more than 9,000 inpatients—including almost 700 with COVID—while letting only two infections sneak in unchecked.
And of those two exceptions, one traced to a patient’s infected spouse who visited before developing symptoms and before the hospital enacted restrictions.
The other got sick four days after being discharged and had no known in-hospital exposures.
Brigham and Women’s Hospital (BWH) in Boston relays its infection-control success story in a study posted Sept. 9 in JAMA Network Open.
Corresponding author Chanu Rhee, MD, MPH, describe their work rolling out increasingly strict germ-busting measures from March 7, when BWH took in its first COVID patient, to May 30.
Along with mandating 24/7 PPE in patient rooms with suspected COVID in late February—before the first case showed up—the steps included:
- March 13: Opened first dedicated COVID ward.
- March 18: Went live with a 12-hour in-house COVID lab test.
- March 25: Began requiring face masks for all healthcare workers.
- March 28: Mandated daily symptom attestation for all healthcare workers.
- April 3: Restricted visitors to those accompanying pediatric patients, pregnant women and patients near the end of life.
- April 6: Required masks for the restricted visitors and for inpatients during all in-person interactions.
- April 10: Shifted to N95 masks for routine COVID care (enacted when the hospital’s N95 inventory improved).
- April 17: Required nurses to screen patients with possible start of symptoms.
- April 26: Implemented lab testing of all patients upon admission.
- May 8: Mandated enhanced eye protection for healthcare workers treating patients unable to wear masks.
In their discussion section, the authors suggest their chronicle and its results show “robust and rigorous infection control practices may be associated with minimized risk of nosocomial spread of COVID-19 to hospitalized patients.”
In a BWH press release, Rhee adds that the preventative steps, if adopted at other hospitals in the U.S., “should provide reassurance to patients as some healthcare systems reopen services and others continue to face COVID-19 surges.”
The study is available in full for free.