Public Health Reviews (Feb 2022)

Mitigating SARS-CoV-2 Transmission in Hospitals: A Systematic Literature Review

  • Chester Yan Hao Ng,
  • Nicole-Ann Lim,
  • Lena X. Y. Bao,
  • Amy M. L. Quek,
  • Raymond C. S. Seet,
  • Raymond C. S. Seet

DOI
https://doi.org/10.3389/phrs.2022.1604572
Journal volume & issue
Vol. 43

Abstract

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Objectives: Hospital outbreaks of SARS-CoV-2 infection are dreaded but preventable catastrophes. We review the literature to examine the pattern of SARS-CoV-2 transmission in hospitals and identify potential vulnerabilities to mitigate the risk of infection.Methods: Three electronic databases (PubMed, Embase and Scopus) were searched from inception to July 27, 2021 for publications reporting SARS-CoV-2 outbreaks in hospital. Relevant articles and grey literature reports were hand-searched.Results: Twenty-seven articles that described 35 SARS-CoV-2 outbreaks were included. Despite epidemiological investigations, the primary case could not be identified in 37% of outbreaks. Healthcare workers accounted for 40% of primary cases (doctors 17%, followed by ancillary staff 11%). Mortality among infected patients was approximately 15%. By contrast, none of the infected HCWs died. Several concerning patterns were identified, including infections involving ancillary staff and healthcare worker infections from the community and household contacts.Conclusion: Continuous efforts to train-retrain and enforce correct personal protective equipment use and regular routine screening tests (especially among ancillary staff) are necessary to stem future hospital outbreaks of SARS-CoV-2.

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