TY - JOUR
T1 - Investigation of nosocomial SARS-CoV-2 transmission from two patients to healthcare workers identifies close contact but not airborne transmission events
AU - Bays, Derek J.
AU - Nguyen, Minh Vu H.
AU - Cohen, Stuart H.
AU - Waldman, Sarah
AU - Martin, Carla S.
AU - Thompson, George R.
AU - Sandrock, Christian
AU - Tourtellotte, Joel
AU - Pugashetti, Janelle Vu
AU - Phan, Chinh
AU - Nguyen, Hien H.
AU - Warner, Gregory Y.
AU - Penn, Bennett H.
N1 - Funding Information:
Financial support. No financial support was provided relevant to this article.
Publisher Copyright:
© 2021 Authors
PY - 2021/9/3
Y1 - 2021/9/3
N2 - Objective: To describe the pattern of transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) during 2 nosocomial outbreaks of coronavirus disease 2019 (COVID-19) with regard to the possibility of airborne transmission. Design: Contact investigations with active case finding were used to assess the pattern of spread from 2 COVID-19 index patients. Setting: A community hospital and university medical center in the United States, in February and March, 2020, early in the COVID-19 pandemic. Patients: Two index patients and 421 exposed healthcare workers. Methods: Exposed healthcare workers (HCWs) were identified by analyzing the electronic medical record (EMR) and conducting active case finding in combination with structured interviews. Healthcare coworkers (HCWs) were tested for COVID-19 by obtaining oropharyngeal/nasopharyngeal specimens, and RT-PCR testing was used to detect SARS-CoV-2. Results: Two separate index patients were admitted in February and March 2020, without initial suspicion for COVID-19 and without contact or droplet precautions in place; both patients underwent several aerosol-generating procedures in this context. In total, 421 HCWs were exposed in total, and the results of the case contact investigations identified 8 secondary infections in HCWs. In all 8 cases, the HCWs had close contact with the index patients without sufficient personal protective equipment. Importantly, despite multiple aerosol-generating procedures, there was no evidence of airborne transmission. Conclusion: These observations suggest that, at least in a healthcare setting, most SARS-CoV-2 transmission is likely to take place during close contact with infected patients through respiratory droplets, rather than by long-distance airborne transmission.
AB - Objective: To describe the pattern of transmission of severe acute respiratory coronavirus virus 2 (SARS-CoV-2) during 2 nosocomial outbreaks of coronavirus disease 2019 (COVID-19) with regard to the possibility of airborne transmission. Design: Contact investigations with active case finding were used to assess the pattern of spread from 2 COVID-19 index patients. Setting: A community hospital and university medical center in the United States, in February and March, 2020, early in the COVID-19 pandemic. Patients: Two index patients and 421 exposed healthcare workers. Methods: Exposed healthcare workers (HCWs) were identified by analyzing the electronic medical record (EMR) and conducting active case finding in combination with structured interviews. Healthcare coworkers (HCWs) were tested for COVID-19 by obtaining oropharyngeal/nasopharyngeal specimens, and RT-PCR testing was used to detect SARS-CoV-2. Results: Two separate index patients were admitted in February and March 2020, without initial suspicion for COVID-19 and without contact or droplet precautions in place; both patients underwent several aerosol-generating procedures in this context. In total, 421 HCWs were exposed in total, and the results of the case contact investigations identified 8 secondary infections in HCWs. In all 8 cases, the HCWs had close contact with the index patients without sufficient personal protective equipment. Importantly, despite multiple aerosol-generating procedures, there was no evidence of airborne transmission. Conclusion: These observations suggest that, at least in a healthcare setting, most SARS-CoV-2 transmission is likely to take place during close contact with infected patients through respiratory droplets, rather than by long-distance airborne transmission.
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U2 - 10.1017/ice.2020.321
DO - 10.1017/ice.2020.321
M3 - Article
C2 - 32618530
AN - SCOPUS:85088515091
VL - 42
SP - 1046
EP - 1052
JO - Infection Control and Hospital Epidemiology
JF - Infection Control and Hospital Epidemiology
SN - 0899-823X
IS - 9
ER -