Hospitals Struggle to Contain Covid-19 Spread Inside Their Walls

U.S. medical centers have reported 5,000-plus cases of patients likely catching the coronavirus once admitted for other conditions, adding to the strain of the pandemic itself

By Russell Gold and Melanie Evans of The WSJ. Excerpts:

"At many medical centers, including University of Illinois Hospital, the strategy from the pandemic’s outset was to cleave into two parts, one for Covid-19 patients and one for everyone else.
The CDC recommended physical separation and also having a dedicated coronavirus staff. That has proved harder to do.

University of Illinois Hospital, while separating Covid-19 patients from others, allows physicians, nurses, technicians and custodial staff to float in and out of Covid-care zones, employees said. Nurses from both sections of the hospital change in shared locker rooms before and after shifts. A spokeswoman for the hospital said it tried to have a dedicated staff for Covid units but didn’t dispute that some personnel floated from a Covid unit to a non-Covid one.

Dr. Bleasdale told others as early as the end of March that the virus seemed to be spreading inside University of Illinois Hospital. In an email to infection-control doctors around the country, she wrote: “We have gone to universal masking and not due to pressure but due to nosocomial transmission”—meaning spread inside a hospital. 

The hospital’s small infection-control staff, whose job is to determine the route of disease transmission and trace contacts, was quickly overwhelmed by the number of employees who got sick. Although the CDC said hospitals stretched thin should forgo this time-consuming task, Dr. Bleasdale added temporary staff members to do contract tracing.

The need to scan paper case records into computers hobbled the effort. New software eventually helped, but the push to trace viral exposure in employees didn’t fully get going until around April 20, according to employees. By then, several staff members were infected with the coronavirus and potentially spreading it inside the facility."

"didn’t hear about infected and hospitalized coworkers from hospital administration. Word passed on social media and the work floor, they said."

"Some hospitals have made extensive efforts to trace viral exposure among their employees. Others say infections are so widespread it doesn’t make sense to commit the resources."

"Pinning down hospital-acquired infections is difficult because of the time the virus can incubate before symptoms appear. To be certain an infection occurred in a hospital, the federal government asks hospitals to report only infections appearing in patients who had been hospitalized for two weeks or more.

Such a standard means “you’re going to miss a vast majority of hospital-acquired infections,” said Ashish Jha, director of the Harvard Global Health Institute."