State of the Pandemic: SHEA Board Commentaries

These commentaries, written by the SHEA Board of Trustees to respond to the rapidly changing COVID-19 crisis, give timely perspectives on issues concerning the current state of the pandemic.

• Service, science, and fortitude: Our thanks and salute to Dr. Anthony S. Fauci (Oct. 2020) 
  As national leaders in infection prevention and healthcare epidemiology, the work of NIAID directly affects our own. Our society would like to publicly thank Dr. Fauci for his calm, consistent reliance on science and for his national leadership during this pandemic. Dr. Fauci is a trusted public health expert who has decades of service.  He is a brilliant scientist and is an unwavering leader during our COVID-19 pandemic response.
• Preparing Nursing Homes for a Second Wave of COVID-19 (Oct. 2020)
  Forty percent of COVID-19 related deaths in the United States have been linked to nursing homes. NHs commonly have limited access to infection prevention and control experts, and are set up so that IPC duties are performed by a NH staff member or an infection preventionist (IP) with other responsibilities and little protected time. This report outlines suggested models for collaboration, configuration, and controls to facilitate optimal preparedness and response for NHs during this pandemic and beyond.
• Organizational strategies for managing COVID-19 survivors who return for care (Sept. 2020) 
  For hospitals that routinely test all admissions, should patients who have recovered from COVID-19 be included? And how should these patients be managed when it comes to pre-procedure testing?
• Whither Immunity? The Search for Effective, Durable Immunity to Coronavirus Disease 2019 (COVID-19) (Sept. 2020)
  One of the most important and challenging questions facing medicine today concerns the extent to which immunity develops and persists following coronavirus disease 2019 (COVID-19), that is, infection with severe acute respiratory coronavirus virus 2 (SARS-CoV-2), or for that matter, following immunization with a candidate SARS-CoV-2 vaccine. This report reviews what is known to-date about nonspecific immunity, humoral immunity, and cellular immunity, as well as animal studies and clinical experience.
• Universal pandemic precautions: An idea ripe for the times (Jul. 2020)
  Increasing evidence has provided a roadmap for protecting HCP from the acquisition of COVID-19. Systematic reviews and meta-analyses have demonstrated the effectiveness of masks and eye protection to protect HCP. As with HIV and HBV in the 1980s, multiple measures need to be implemented in healthcare facilities to prevent SARS-CoV-2 transmission, including (1) screening of patients, visitors, and HCP for symptoms of COVID-19 prior to entry; (2) routine use of source control masks by patients, visitors, and HCP 6 ; (3) frequent hand hygiene and surface disinfection of shared equipment and devices; (4) enhanced personal protective equipment for HCP performing aerosol-generating procedures and during care of known or suspected patients with COVID-19; and (5) prompt testing of persons with signs or symptoms of COVID-19 and institution of appropriate isolation precautions.
• The perplexing problem of persistently PCR-positive personnel (Jul. 2020)
  As a result of using the test-based strategy, many institutions now have significant numbers of staff whose nasopharyngeal swabs remain RT-PCR positive for COVID-19, despite the fact that they have recovered from their episodes of illnesses and have been asymptomatic for weeks or, in some instances, months. This report suggests approaches to managing recovered HCP who continue to receive positive PCR test results.
• Shifting sands: Molecular coronavirus testing during a time of inconsistent resources(Jun. 2020)
  The purpose of this short paper is to emphasize a few principles that SHEA members are following during these extremely challenging times for healthcare epidemiology, for healthcare in general, and for our nation as a whole. Our intent is to inform epidemiologists, clinicians, and other health professionals about our approach to these complex issues.