Medscape: Hong Kongs public hospital system appears to have successfully protected both patients and staff from SARS-CoV-2, according to a study published online in Infection Control & Hospital Epidemiology.

During the first 42 days of the outbreak, the 43 hospitals in the network tested 1275 suspected cases and treated 42 confirmed patients. However, there are no nosocomial infections or infections among the healthcare personnel.

11 workers out of 413 healthcare workers who are treating patients with confirmed infections have unprotected exposure and were in quarantine for 14 days, but none of them became ill. In comparison, the 2003 SARS outbreak saw almost 60% of nosocomial cases occurring in healthcare workers.

The success story is mainly due to a geared up proactive set of measures that includes improved laboratory examination, early and rapid airborne infection isolation, and fast-turnaround molecular diagnostics.

Other strategies and approach includes staff forums and one-on-one discussions about controlling the infection, employee training in using protective equipment, hand-hygiene compliance enforcement, and get in touch with workers with unprotected exposure.

Moreover, surgical masks are given to all healthcare workers, patients, and even visitors to clinical areas, a practice which was formerly associated with decreased in-hospital transmission during outbreaks of influenza.

Hospitals also has made mandatory to use personal protective equipment (PPE) for aerosol-generating procedures (AGPs) that includes high-flow oxygen use, as AGPs, open suctioning and endotracheal intubation that are related to nosocomial spread to healthcare employees during the 2003 SARS epidemic.

The infection control measures that were a part of a awareness plan was developed after the SARS outbreak and were initiated on 31^st December 2019, when the first reports of a bunch of infections came from Wuhan, China.

As the epidemic progressed, the Hong Kong hospitals hurriedly widened the epidemiologic criteria for screening, from the start which was including only those who had been to a wet market in Wuhan within 14 days of symptom onset, to finally including anyone who had been to Hubei province. The screening was done in a medical facility in mainland China. All the suspected cases were sent to an airborne-infection isolation room (AIIR) or in a ward with at least a meter of space between patients.

Proper awareness in hand hygiene practice, wearing surgical mask in the hospital premises and correct use of PPE in patient care, especially while performing AGPs, are the key infection control measures to prevent nosocomial transmission of SARS-CoV-2 even before the accessibility of effective antiviral agents and vaccine.

The measures taken in Hong Kong are not different from standard infection-control practices, apart from the widespread issue of surgical masks to workers, patients, and even visitors.

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA