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Nowhere is safe: record number of patients contracted Covid in hospital in January

A record 4,734 patients were recorded as having caught Covid-19 internally on January 19.

During the January Covid-19 surge a year ago, hospitals reported that around 2,000 patients each week on average contracted Covid while there, compared to around 3,000 this year.

The total number of people who contract Covid-19 in hospital remains uncertain as these figures only count patients who have been in hospital for at least 14 consecutive days and do not take into account people who test positive after their departure. The government figures are probably only a fraction of the total.

Nosocomial infections have long been one of the most serious risks for patients, especially those who stay for weeks or months. But recent data shows that more than two years into the pandemic, hospitals still have a long way to go to prevent transmission within their walls.

Michael Osterholm, an epidemiologist at the University of Minnesota, expressed concern about the rise in infections. “Using standard infection control, this should not occur where there is transmission, whether patient-to-patient, visitor-to-patient or worker-to-patient,” he said.

He said hospitals were not doing enough to prevent transmission, allowing visitors and staff to wear surgical masks rather than the more protective N-95 masks. The Centers for Disease Control and Prevention has not recommended that all healthcare workers and visitors wear N-95s at all times.

Despite the Omicron-related spike, US health officials have not moved to suggest hospitals revamp their infection control measures, three officials told POLITICO. The numbers are preliminary and CDC officials are investigating the causes of the increase, said two of the officials, who were granted anonymity because they were not authorized to speak publicly about the internal discussions.

One potential factor, several public health experts said, is the CDC’s decision in December to allow health workers who had tested positive for Covid to return without first isolating or testing to ensure they don’t. were more infectious. However, several public health experts also said the move likely had minimal impact because workers are wearing masks and ideally higher-grade N-95s.

A CDC spokesperson declined to say whether the agency’s decision played a role.
It’s unclear what other factors, if any, could have influenced the increase, though some public health experts aren’t surprised.

“A hospital is a subset of the population,” said Kathleen Gallagher, epidemiologist at the National Patient Advocate Foundation. “You expect to see this increase.”

“At the time, home testing was rare, lines were hours long for in-office testing, and other changes were afoot, like CDC changes to quarantine procedures for workers in the health,” she added. “Patient visitors were potentially not required to present proof of vaccination and may not have worn the correct masks or worn them incorrectly.”

The number of patients catching Covid in hospitals tracks community infection rates nationwide, according to analysis of the data by POLITICO. Last summer, for example, when cases across the country were much lower, so were hospital transmission cases.

Despite the spike in January, the odds of catching Covid-19 in a hospital are relatively low, federal and state health officials said.

For example, in North Carolina, 1.6% of patients were infected with Covid-19 in a hospital in December last year, according to a state health department spokesperson. This percentage rose to 2.2% in January. An average of 25 patients contracted infections in hospital each day in December, compared with 96 in January, on average, the spokesperson said.

Shama Cash-Goldwasser, senior technical adviser at Resolve to Save Lives, a group led by former CDC director Tom Frieden that aims to prevent outbreaks, said it’s impossible for hospitals to bring transmission to zero, especially when facilities are overcrowded and staff are overwhelmed as they have been during the Covid-19 surges. “It’s unfortunate,” she said. “I’m not saying all is well… Immunocompromised patients and very sick people are at very high risk of poor outcomes, so transmission inside a hospital can really be devastating.”

The figures do not say which hospitals accounted for the most transmission. The Department of Health and Human Services, which compiles the data, does not release figures by hospital. The figures are compiled as part of a daily survey of hospitals showing how the pandemic is affecting their operations, from case numbers to equipment supplies.

US health officials are considering changes to how hospitals report the number of patients who contract Covid-19 internally, POLITICO reporteda change that could raise concerns among hospital lobbyists and associations who say such transmission is rare.

But the change would make it easier to spot how many patients in any given day are suspected of having contracted Covid-19 in hospitals, POLITICO reported. The discussions, which involved CDC and HHS officials, may not result in changes.

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