Post COVID-19, do elevated decontamination protocols return to pre-pandemic levels?

Aug. 26, 2021

Once the lingering pandemic – engulfed by COVID-19 and the delta variants – finally comes under control or leaves via medication and protocol enhancements, what happens to all of the heightened, intensified and “onerous as defined by COVID fatigue” cleaning, decontaminating, disinfecting and sterilizing procedures put in place?

Everyone ambles to return to “normal” as in like it was during pre-pandemic 2019 but should all or some of the preventive measures adopted and enacted to combat COVID-19’s spread also return to 2019? 

Infection prevention and environmental services experts share their perspectives about the inherent dangers in regressing and not continuing the more acute room decontamination/infection prevention protocols. 

“The role of housekeeping is key to keeping everyone in the facility safe. This pandemic especially has demonstrated that at any time a highly infectious novel pathogen can emerge that can spread by air, direct and/or indirect contact. A recently published study found the COVID 19 virus was found on many objects throughout a hospital but particularly in COVID units – mainly because droplets with the virus are heavier than air and fall to the surfaces.  If ventilation in patient care areas can be improved by meeting CDC guidelines using UVGI adjuncts like the Vidashield UV24 then everyone on the unit is better protected from pathogen exposure. Experts agree SARS-COV-2 is not going away, and there are many other pathogens of concern including the many other viral, fungal and multi-drug resistant organisms that continual to plague healthcare facilities.”

Karen Hoffman, R.N., CIC, FSHEA, FAPIC, Epidemiologist and Infection Prevention Consultant for NUVO Surgical and Vidashield, clinical instructor in the Division of Infectious Diseases at the University of North Carolina’s School of Medicine in Chapel Hill and immediate past president of the Association for Professionals in Infection Control and Epidemiology (APIC). 

“During the pandemic, facilities increased the frequency and caliber of their disinfection efforts. As the world returns to a more ‘normal’ state, it is critical to keep in mind the effect that increased disinfection measures had on other infections. For instance, studies have shown that clostridium difficile infections (CDIs) significantly dropped in 2020 when enhanced disinfection practices were put into place as compared to 2019. Today, as hospital census for non-COVID patients increases, cases of C. diff and C. auris, a deadly fungal infection, are on the rise once again.”

David St. Clair, Executive Chairman, Halosil International Inc. 

“Preventing the spread of germs will always be important, especially in healthcare settings. While personal protective equipment (PPE) is essential to protecting against COVID-19, there are many other diseases that live on surfaces or spread through hand contact. That’s why it’s imperative to maintain strict cleaning protocols, as it could be instrumental in preventing a similar health crisis down the road.”

Deborah Chung, North America Marketing Manager – Healthcare,
Essity Professional Hygiene
 

“Quite simply, we’re not out of the woods yet! We’re still learning and experiencing new developments in the COVID-19 pandemic seemingly every day, such as new emerging variants. To deescalate environmental cleaning and infection prevention protocols now may be premature. An abundance of pre-pandemic evidence shows cleaning and disinfection practices have been predominately subpar across the healthcare spectrum. It is more likely that the increased vigilance in environmental cleaning and disinfection is more on target for what we should have been routinely doing, regardless of a pandemic.”

Deva Rea, R.N., CIC, Clinical Science Liaison, PDI 

“While the immediate need for improved infection control during the pandemic was focused on limiting the spread of the virus, we should also be ensuring that we are better prepared for the next one. COVID-19 has been devastating, but it could have been much worse. Though rate of infection was high, what if mortality rates matched those seen in much more serious infections such as Ebola or measles? In many ways our response to the pandemic was impressive. But it was also a warning shot that highlighted the need to be much more prepared going forward. Modernizing infection control teams with new disinfection technologies will address both the immediate need for limiting the spread of COVID-19 as well as the need to be better prepared for the future.”   

Ernest Cunningham, President, Nevoa Inc. 

“There are many inherent dangers that could stem from not continuing newly enhanced room decontamination/infection prevention protocols over and above pre-pandemic procedures. The pandemic has provided us with an awareness that most facility protocols were lax in their terms of disinfection and that many employed cleaning methods were either outdated or insufficient. If we were to go back to the ‘norm’ of disinfection and decontamination, the spread of viruses will continue to happen and will develop and grow stronger, placing everyone at risk.” 

Halden Shane, DPM, Chairman & CEO, TOMI Environmental Solutions Inc. 

“As we emerge from the pandemic, the ongoing challenge of healthcare-associated infections continues, and particularly the threat of multi-drug resistant organisms is very concerning as recent Candida auris outbreaks demonstrate. The evidence indicates that fewer than 50% of hospital room surfaces are compliantly cleaned and disinfected with manual cleaners and disinfectants, so enhanced protection with proven UV-C room disinfection technology is important to drive better patient outcomes.”

Richard Hayes, President, UVDI 

The pandemic is not over, especially for healthcare providers who are caring for people in the hospital. As of July 2021, we're seeing infections on the rise in 50 states and globally. Taking a step back from enhanced room decontamination protocols elevates the risk for healthcare providers and patients being treated in the hospital. When unvaccinated people enter the ER, they are contaminating surfaces. The CDC said that high-level disinfection should take place when a room has been inhabited by someone with COVID, so it's imperative that healthcare facilities have the technology available to accomplish this. That's what sets our LightStrike UV disinfection technology apart – the robots are proven to deactivate SARS-CoV-2 on surfaces in two minutes, and don't require warm-up or cool-down time. Hospitals are disinfecting dozens of rooms per day per robot with intense bursts of UV light generated by our patented pulsed xenon technology that doesn’t damage materials in the room.”

Mark Stibich, Ph.D., FIDSA, Co-Founder & Chief Scientific Officer,
 Xenex Healthcare Services
 

“Microbes are evolving faster than we are evolving at treating them, especially with 50-year-old chemical formulas. Novel solutions are delayed and discarded due to contracts, costs or lack of belief (regardless of studies). Insert Newton’s rule: Unless a new force can knock an item at rest or in motion, nothing really changes. 

“The return on investment must be addressed. If a $100,000 machine can avoid two infections, a facility breaks even and a patient’s life improves. Combine technology with better supplies, training and education, and accountability for those trusted to clean, disinfect and protect, and we are on a good path. Eliminate incentives to investing in these, and we are in danger of more and more costly infections.   

“We may see a pendulum effect, or we may see a new growth industry. I personally was amazed at how little traction we had during the pandemic – it was due to COVID stay-at-home policy and ransomware, which all caused 10 times the amount of emails, which caused more stress and work and so on. Lack of access to key decision maker in a position to make an informed decision stalled acute-care room decontamination [efforts]. With elective procedures stopping and then restarting with a vengeance, it led to a blind spot in room decontamination with a focus on revenues and backlog.  With the ebbs and flows of the pandemic, we must continue to educate the industry, lest we continue to fight these new variants with one hand tied behind our back.”

Brian Donahue, Director, Sales & Corporate Accounts, Finsen Technologies Ltd. 

“Relaxing advanced adjunct disinfection procedures, including the use of UVC systems, will allow the environmental pool of pathogens to rise, thereby returning the incidence of disease and infection back to pre-COVID levels, or worse.”

Sam Trapani, CEO, Steriliz LLC 

“All too often, healthcare facilities revert to their baseline efforts of infection prevention and control as soon as the threat ‘clears.’ This has been repeatedly observed with recent outbreaks such as SARS, Novel Bird Flu, Ebola, and the current SARS-CoV-2 pandemic. Infection control, as a practice, requires a consistent and pragmatic approach to make sustainable reductions in healthcare-associated infections (HAIs). Healthcare facilities should not quickly forget the impacts of the ongoing pandemic, but rather take this opportunity to hardwire these infection control best practices throughout their healthcare systems to benefit all patients. Pandemic preparedness is an ongoing process that requires collaboration across all healthcare professional disciplines. 

“It is also important for healthcare facilities to adopt a ‘think-outside-the-box’ mentality and approach traditional practices, such as room disinfection, in different ways to allow for maximum impact. During pandemics and beyond, a tiered approach to room disinfection is recommended to allow for needed flexibility to address disinfection requirements of daily/terminal cleaning, small and large room applications, inpatient and outpatient settings, as well as pathogen-specific demands of high-risk patients or care settings. This tiered approach can consist of ready-to-use wipes and sprays, electrostatic whole-room disinfection, and the use of other technologies as appropriate.”

J. Hudson Garrett Jr., Ph.D., MSN, MPH, MBA, FNP-BC, IP-BC, PLNC, CFER, AS-BC, VA-BC, BC-MSLcert, NREMT, MSL-BC, DICO-C, TR-C, CPPS, CPHQ, FACDONA, FAAPM, FNAP, Adjunct Assistant Professor of Medicine, Faculty, Center for Education and Training in Infection Prevention (CETIP), Division of Infectious Diseases, Department of Medicine, University of Louisville School of Medicine; President & CEO, Community Health Associates LLC, which serves as a consultant to Clorox Healthcare

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