A hospital stay can be a source of anxiety, and for many, the thought of acquiring an infection during their visit is a significant concern. Hospital-acquired COVID-19, sometimes called nosocomial COVID-19, refers to an infection that a patient contracts while receiving care in a healthcare facility for a different reason. This means the individual was not infected with the virus upon admission but developed it during their stay. Understanding that facilities have robust systems in place to manage and mitigate this risk is important for patients and their families.
Transmission Pathways in Healthcare Settings
The spread of the virus in a hospital setting occurs through several interconnected pathways, amplified by the unique nature of the environment. The primary route is through the air, when an infected person exhales virus-containing droplets and smaller particles called aerosols. These can be dispersed throughout enclosed spaces, such as patient rooms or treatment areas, and can be generated in higher concentrations during certain medical procedures.
Direct and indirect contact represents another significant pathway for transmission. Surfaces in a patient’s room, from bed rails to doorknobs, can become contaminated with the virus. Shared medical equipment, if not properly disinfected between uses, can also transfer the virus from one person to another.
Person-to-person spread remains a constant factor, given the close proximity required for patient care. Transmission can occur between patients, particularly if they share a room, from a healthcare worker to a patient, or even from a visitor. Healthcare workers themselves can be exposed, sometimes from colleagues in non-patient areas like break rooms. The concentration of individuals, many of whom are medically vulnerable, combined with the hands-on nature of healthcare, creates a complex environment where transmission can occur more readily than in the general community.
Identifying At-Risk Patients and Environments
Certain individuals are more susceptible to developing a severe infection if they contract COVID-19 in a hospital. Patient-related factors include being immunocompromised, having a weakened immune system due to underlying conditions or treatments like chemotherapy. Advanced age and the presence of significant pre-existing health issues, known as comorbidities, also increase a person’s vulnerability.
Beyond individual patient health, specific environmental factors within the hospital can elevate risk. Intensive Care Units (ICUs), for example, house critically ill patients and often require aerosol-generating procedures, increasing the potential for airborne transmission. Long-term care wards, where patients have extended stays, also present a heightened risk due to the prolonged period of potential exposure. The duration of a hospital stay is also a factor, as a longer stay increases the opportunity for exposure.
Hospital Prevention and Control Protocols
To counter the risks of transmission, hospitals employ a multi-layered strategy focused on prevention and control. A foundational element is screening patients upon admission for any symptoms of respiratory illness. This is often paired with rapid and routine testing of both patients and staff to quickly identify positive cases, including those who may be asymptomatic. This allows for the swift implementation of cohorting, which is the practice of placing patients who have tested positive for COVID-19 in dedicated, separate wards or single-patient rooms to prevent them from sharing spaces with non-infected individuals.
Strict adherence to the use of personal protective equipment (PPE) is another fundamental practice. Healthcare staff wear masks, such as N95 respirators, along with gowns, gloves, and eye protection, especially when caring for patients with confirmed or suspected COVID-19. This is complemented by an intense focus on hand hygiene, with staff required to clean their hands thoroughly between every patient interaction to prevent cross-contamination.
Hospitals also engineer the physical environment to minimize spread. This includes investing in advanced air filtration and ventilation systems, such as HVAC upgrades and the use of high-efficiency particulate air (HEPA) filters, to clean the air and remove viral particles. Furthermore, facilities follow rigorous and frequent disinfection schedules for patient rooms, common areas, and all medical equipment.
Patient and Visitor Safety Measures
Patients and their visitors also have a role in maintaining a safe environment during a hospital stay. Practicing meticulous and frequent hand hygiene, using either soap and water or an alcohol-based hand sanitizer, is a simple yet effective measure. This is particularly important after touching surfaces in the room and before eating. Wearing a high-quality, well-fitting mask correctly throughout the hospital is another important step in personal protection.
To minimize the risk of introducing or spreading germs, it is wise to limit the number of personal items brought into the hospital room. Adhering strictly to the facility’s visitor policies, which may include limits on the number of visitors or specific visiting hours, helps reduce overall traffic and potential exposures. Patients should feel empowered to ask their doctors or nurses about the specific infection control measures in place, fostering a collaborative approach to safety.