Frontline physical care personnel are engaged in a hot confrontation with many infection specialists and hospital directors about how the new coronavirus spreads and, therefore, what point of the protective device is appropriate.
The question is the extent to which the virus is suspended in the air, capable of spreading through tiny and persistent traces of aerosols in the air, or basically transmitted through giant drops that fall faster, for example, a sneeze or cough. has a real effect on the type of safety measures that fitness companies will have to take to protect their patients and workers.
The Centers for Disease Control and Prevention confused Friday’s debate with a recommendation on airborne transmission, claiming that tiny aerosol particles, as well as larger droplets, are “the primary means of spreading the virus. ” website, and the firm said it had published a “preliminary edit of the proposed changes” in error and that experts were still working to update the “airborne recommendations. “
Dr. Anthony Fauci, America’s leading infectious disease specialist, addressed the front-face discussion in a September 10 webcast for Harvard Medical School, pointing to aerosol scientists who said the CDC “has actually existed for many, many years. “
“At the end of the day, there are a lot more aerosols [transmission] than we thought,” Fauci said.
The factor has been deeply divisive within hospitals, largely due to the question of whether a disease spreads through drops or spray effects on two other sets of protective practices, affecting everything from airflow in hospital wards to patient isolation and selection of protective equipment. Improved protections would be costly and harmful to a number of industries, but especially hospitals, which have struggled to obtain protections opposed to lower-level “droplets. “
Hospital directors and epidemiologists who argue that the virus spreads mainly through droplets cite studies showing it spreads to a small number of people, such as people without blood or flu. for patients with COVID-19, these officials say.
The debate has reached its climax in hospitals from coast to coast, as studies have emerged that suggest that the live virus is suspended in the hospital rooms of patients with COVID-19 even in the absence of “aerosol generator” procedures (such as intubations or breathing treatments) and has contributed to outbreaks in a nursing home, a back and going and a choir.
KHN and The Guardian U. S. read about more than 1,200 deaths of physical care personnel due to COVID-19, many of whom their families or colleagues reported running under-protection equipment.
However, some managers and frontline managers disagree on how and why fitness services get sick.
Hospital infection and epidemiology officials cite studies suggesting that many health professionals get the virus outdoors and at rates that reflect what is happening in their communities.
An organization of Epidemiologists at Penn Medicine called last July studies on aerosol transmission unconvincing and cited “numerous evidence published around the world” that seems to indicate that “the vast majority” of coronavirus spread occurs “through giant droplets that breathe. “
However, trade unions, occupational fitness researchers, and aerosol scientists refer to a series of studies that indicate that health care personnel have been much more affected than the average hospital room. These debris can remain suspended in the air for up to 3 hours.
In support of their concerns, a letter of 6 July signed through 239 scientists suggested to the medical network and the World Health Organization recognize “the possibility of air propagation of Covid-19”.
The letter highlighted studies that say that speaking, exhaling and coughing emit small debris that is suspended in the air for much longer than droplets and “poses a threat of exposure. “
At a branch of a Dutch retirement home with air recirculation, researchers found that 81% of citizens had been diagnosed with COVID-19. Virus.
Although researchers may simply not rule out transmission through the method, the “almost simultaneous detection” of the virus among almost all citizens highlighted the spread of aerosols.
The concept that the virus spreads through droplets or aerosols is an overssimplified, said Dr. Shruti Gohil, associate director of epidemiology and infection prevention at the University of California, Irvine School of Medicine.
Gohil said it had more than one spectrum, as the virus was also transmitted through a few drops and giant aerosol particles.
However, the number of other people inflamed by a poorly ill user is a metric in which other people focus on the scope of infection in hospitals. For COVID-19, studies have shown that the number is approximately two, similar to an Unequivocal air transmission disease such as measles, the number is closer to 12 to 18.
Measles is “what aerial transmission looks like,” Gohil said. “If it were a number one disease transmitted through aerosols, we would be in a world of suffering. “
Hospital epidemiologists are also focusing on the rate of home spread of the new coronavirus. With measles, the threat of an unvaccinated family member being in poor health is 85%, said Dr. Rachael Lee, a hospital epidemiologist. and an assistant professor at the University of Alabama-Birmingham. For COVID-19, he said, the threat is closer to 10%.
Although the idea is for the virus to spread more through droplets than through aerosol particles, Lee said, UAB University Hospital staff use an N95 respirator for an additional layer of coverage and because patients want so many respiratory remedies or procedures to generate aerosols. “
These practices are not universal. At the University of Iowa Hospital, physical care personnel use N95 and facials for procedures that generate aerosols, but in a different way use surgical masks and facial protectors for the treatment of regimens for COVID patients, said Dr. Daniel Diekema, director of the Infectious Division. Diseases in college.
He said those “enhanced precautions against drops” work. Places where staff wear medical masks and face shields do not see any significant spread of the disease among staff, although one such report has focused on the spread of a single patient.
Elsewhere, patients have also been on floors where COVID-19 and virus-free patients have been placed in adjacent rooms, a practice other people involved in spreading aerosols do not condone.
“The contribution of small breathable particles, called aerosols or droplet nuclei, to transmission nearby is lately uncertain. However, person-to-person transmission into the air over long distances is unlikely,” according to guidelines.
The California Hospital Association sent a letter to the state congressional delegation requesting that the review be permanent.
“We want CDC to pass clearly and conditionally precautions against droplets for patients and fitness workers,” the letter says. This would allow hospitals to retain PPE materials and restrict the use of special isolation rooms for COVID patients.
A spokesman for the agreement told KHN that the organization did influence science, but that he only insisted that the regulations be clear.
Christopher Friese, professor of nursing, administration and fitness policies at the University of Michigan, is one of the experts in whom regulations put fitness personnel at risk.
“We spend a lot of time and, frankly, live because the first recommendation is to use the N95 only for those express procedures,” Friese said.
Family members and union leaders from Missouri to Michigan and California have raised considerations about the deaths of COVID-19 nurses after treating inflamed patients with N95 virus respirators In such cases, hospitals have stated that they are following CDC guidelines.
Friese echoed some office security experts who warned that the CDC’s strictest rules at the beginning of the call for suspended illness in the air may have had an effect, perhaps pressuring President Donald Trump to invoke the Defense Production Act to build an N95 source so that “we may have the source we want anywhere we want. “Friese said.
Surveys across the country show that there is still a shortage of non-public devices in many fitness facilities.
The CDC rules published Friday reportedly emphasized some hospitals’s protective measures, which they would have resisted, and said the virus can spread when a user sings, speaks, or breathes.
“These wastes can be inhaled through the nose, mouth, airlines and lungs and cause an infection,” he says. “It is believed to be the main direction of spread of the virus. “
On Monday morning, the online page had returned to say that the virus was basically spread through droplets, noting that the draft text had been published by mistake.
The University of Nebraska Medical Center has taken so-called airborne precautions from the start. There, Dr. James Lawler, a physician and director of the university’s Global Center for Health Safety, said his colleagues had documented that the virus could simply be in the air. and live on surfaces away from patients.
He said the hospital was examining all patients admitted to the virus and keeping patients with COVID-19 out of the general population. He said they were paying particular attention to cleaning shared spaces and tracking airflow in the limited unit. respirators, which are hoods supplied with filtered air pumped.
All of this has resulted in a “very low” of fitness workers’ infections.
Amid uncertainty about the virus, and as an unprecedented number of physical care personnel die, adopting the “highest possible” coverage bureaucracy is the solution, said Betsy Marville, nurse organizer of the 1199SEIU United Healthcare Workers East union in Florida.
This would mean a deviation from CDC rules that now say physical care personnel want an N95 respirator for “aerosol-generating” procedures, such as intubations or other respiratory remedies. protective apparatus – or unprotected – when patients urgently want such remedies.
“He doesn’t leave his patient in misery and doesn’t look for a mask,” he says. I said, “It’s crazy. “
Kaiser Health News is a national fitness policy data service it is an editorially independent program of Henry J. Kaiser Family Foundation, which is affiliated with Kaiser Permanente.
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