ICCS COVID-19 Update: Shortage of Face Protection

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Infection Control Consulting Services (ICCS) continues to update clients as this highly fluid pandemic evolves. This week's update includes caring for COVID-19 patients in your facility (now and future) with the main focus on critical issues related to the shortage of face protection.

ICCS recommends reviewing the following resources:

  • Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings — Access resource >

  • Strategies for Optimizing the Supply of Facemasks — Access resource >

  • Duke Starts Innovative Decontamination of N95 Masks to Help Relieve Shortages — Access resource >

  • What Healthcare Personnel Should Know about Caring for Patients with Confirmed or Possible COVID-19 Infection — Access resource >

  • Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings — Access resource >

  • Aerosol Generating Procedures — See chart below

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COVID-19: Debunking Potentially Dangerous Myths

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Many myths as to prevention of and treatment for the novel coronavirus (COVID-19) infection are circulating and increasing in intensity. They serve no purpose except to cause confusion, potential injuries and even death.

The origins of these myths include a combination of old wives tales, self-made ideas due to lack of understanding of the virus itself, cultural beliefs and profit. The copycat syndrome is included in the spread of non-scientific information.

In addition to a list of myths released by the World Health Organization, which we strongly encourage you to review, the Infection Control Consulting Services (ICCS) team has been asked to comment on the following six myths.

1. Drinking alcohol can kill the virus. This is a myth and a potentially dangerous at that. The amount of alcohol ingested that would be needed for such a study is lethal and not a scientifically viable option.

2. Zinc lozenges can prevent the coronavirus and most other virus from multiplying in your throat and nasopharynx. The myth claims that it is "best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx." This is a myth introduced by a pathologist and has no basis for prevention of any viruses, according to scientists. It is particularly concerning that anyone would advocate for sucking on a lozenge while laying down and running the risk of choking, besides the lack of evidence that zinc prevents any viruses from replicating.

3. COVID-19 causes a productive cough and drinking hot water will loosen the phlegm. This is a myth as hot water does not affect COVID-19. If the water is hot enough, it can burn a person. In addition, COVID-19 typically presents as a dry cough and not a productive cough.

4. Blowing a hairdryer up your nose will kill the viruses in your nose. This is a ridiculous claim and has no basis. Furthermore, an individual taking such an action runs the risk of burning themselves from the hot hairdryer.

5. Certain medications have been approved in the United States for treating COVID-19. This is a myth as, at the time of publication of this piece, there are no Food and Drug Administration (FDA)-approved medicinal treatments for this illness. Several trials are underway with a few medications. Unfortunately, information was released by the White House that has caused a nationwide shortage in an autoimmune condition medication, placing people with rheumatoid arthritis and lupus in jeopardy if they cannot obtain their medication. In addition, one person has died and their spouse hospitalized after they ingested large doses of a medication in a different form.

6. Silver kills the coronavirus within 12 hours. This is a myth peddled by at least one televangelist who also claimed that his "Silver Solution" strengthened the immune system. As the Mayo Clinic notes, "Colloidal silver isn't considered safe or effective for any of the health claims manufacturers make. Silver has no known purpose in the body. Nor is it an essential mineral, as some sellers of silver products claim." While rare, excessive doses of silver can cause serious health issues. 

Reputable Sources of COVID-19 Information

ICCS stresses the importance of relying upon only healthcare-related updates, including those concerning COVID-19, issued by reputable organizations, including the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), Federal Drug Administration (FDA) and National Institutes of Health (NIH).

COVID-19 Pandemic: Update on Accreditation Surveying

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Over the past few weeks, national accreditation organizations have issued statements concerning whether and how they plan to proceed with surveys during the coronavirus pandemic. The following includes highlights from these plans and provides links to each organization's latest official statement on the matter or articles with information about plans if no official statement could be found at this time. Note: Organizations are listed in alphabetical order.

Accreditation Association for Ambulatory Health Care (AAAHC)

On March 17, AAAHC announced, "AAAHC has postponed non-emergency surveys for all Medicare deemed status accreditation (MDS) and non-MDS programs scheduled for a survey with a begin date of March 18 through May 1. … AAAHC will do our best to complete high priority emergency surveys for all MDS and non-MDS programs."

Read the AAAHC statement.

American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF)

On March 18, AAAASF announced that it was "… suspending routine on-site ​resurvey activities. ​However, due to the national call to increase healthcare capacity, AAAASF will continue to conduct initial on-site surveys for all of its programs. We will be working directly with these facilities ​that require surveys as needed​, in many cases to provide modified services in response to the emergency situation. In addition, ​AAAASF will continue to provide certain surveys at the discretion of the AAAASF Board, including in response to complaints related to infection control or patient abuse."

Read the AAAASF statement.  

Center for Improvement in Healthcare Quality (CIHQ)

At this time, it does not appear that CIHQ has issued an official statement concerning its plans for managing healthcare accreditation surveys during the pandemic. An article in Patient Safety & Quality Healthcare (PSQH) included a statement from the accreditation organization's CEO. His comments included the following: "At this time, CIHQ has suspended routine reaccreditation surveys for at least the month of April 2020. … We will continue to perform initial surveys for new hospitals, and surveys if needed to address infection prevention and control issues in our accredited facilities."

Read the PSQH article.

Det Norske Veritas (DNV) National Integrated Accreditation for Health Care Organizations

At this time, it does not appear that DNV has issued an official statement concerning its plans for managing healthcare accreditation surveys during the pandemic. An article from Hall Render attorneys noted that they expect DNV to issue an advisory notice explaining management plans and then provided a summary of what they understand to be DNV's survey plans, including the following: "DNV does not intend to cancel all accreditation surveys but will be flexible with hospitals that wish to push back their survey dates. Many hospitals have requested a postponement and DNV has agreed to such postponements." and "DNV is not conducting routine surveys in Washington, New York or California at this time."

Read the Hall Render article.

Healthcare Facilities Accreditation Program (HFAP)

On March 5, HFAP announced that it was suspending most survey activities, but noted that some surveying will go forward, including:

  • incoming immediate jeopardy complaints alleging infection control breaches or abuse and neglect;

  • complaint surveys alleging infection control breaches;

  • initial surveys (for organizations without a CMS certification number);

  • CLIA laboratory surveys; and

  • surveys of facilities with an immediate jeopardy-level infection control deficiency in the last three years.

Surveys that may go forward include those of facilities with a history of infection control deficiencies and certification surveys for which the facility and the surveyor have agreed to proceed.

Read the HFAP statement.

The Joint Commission

On March 16, The Joint Commission stated that it was "… suspending all regular surveying beginning Monday, March 16, 2020. In some cases, there may be a small number of surveys that will need to continue, such as high-risk situations."            

Read The Joint Commission statement.