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Consequences of inadequate infection prevention

Hospitals and other healthcare settings are important sites of transmission for many infectious diseases.  In 2002-3 healthcare workers accounted for 37%–63% of suspected SARS cases (a 2002-3 novel coronavirus disease), and were also a source of community transmission.   Unlike today's COVID-19, however, SARS transmissibility began simultaneously with symptoms, and symptoms were often severe.  Thus healthcare workers were particularly vulnerable to transmission from patients seeking care.  However, in that context, screening for patient and healthcare workers symptoms successfully controlled the SARS global outbreak.

In contrast, COVID-19 transmission may occur before symptoms, and from patients who never have symptoms.  Therefore, although healthcare-acquired cases and outbreaks are common, they are not the major drivers of community transmission.  CDC states "In the context of COVID-19, the IPC goal is to support the maintenance of essential healthcare services by containing and preventing COVID-19 transmission within healthcare facilities to keep patients and healthcare workers healthy and safe."  In other words, healthcare settings are not the key to introducing COVID-19 to their communities.  Instead, healthcare organizations must protect themselves from continuous introduction of SARS-CoV2 into their facilities from the community.  

Nevertheless, unless and until COVID-19 infection (including asymptomatic infection) is recognized and rapidly controlled inside healthcare settings, they face a dual risk: reduced workforce (through illness, isolation and quarantine) and increased demand for services (as patients susceptible to severe COVID-19 are exposed in healthcare settings).

Healthcare facilities are also subject to COVID-19 emergency regulations and waivers affecting ICP.  Furthermore, those facilities determined by public health authorities to be experiencing a COVID-19 outbreak may be subject to additional orders including mandated screening and testing, cleaning, distancing and other measures, temporary site closure and public notifications.  

Together these may affect employee relations, public reputation, costs and revenue.   A proactive program of administrative controls; environmental mitigation; staff education; inventory management of PPE and other materiel; assessment of patients, visitors, staff and contractors; early case detection; and prompt and appropriate isolation and quarantine can prevent some of these potential consequences, while also buttressing an organization's licensure and certification.