ICCS Infection Prevention & Infection Control Newsletter: January 2021

This issue covers some of the most significant news from January. Topics include nursing home surveys, President Biden's focus on infection prevention, infection control lapses, state legislation, hand sanitizers from Mexico, and a California outbreak.

* * *

ICYMI: Check out our Special Edition: 2020 Year in Review newsletter.

Infection Preventionists Can Help the Non–Health Care Sector Thrive — This Infection Control Today article features insight from ICCS President Phenelle Segal, RN, CIC, FAPIC.

Nursing Homes: CMS Adds New Triggering Factors for Focused Infection Control Surveys — CMS expanded the criteria that will trigger a focused infection control survey at nursing homes.

Biden Wants More Infection Control Regulations, COVID Relief Funding for Long-Term Care — President Joe Biden's pandemic response plan calls for a significant focus on infection control and prevention, including new policies and guidance.

New Five-Star Ratings Ding Providers for Infection Control Lapses — More than 12,000 infection control-related citations have been given to nursing homes during the pandemic.

Sweeney-Vitale Bill Requiring Infection Prevention Plans for Nursing Homes Advances — New Jersey will develop an infection prevention and control plan for nursing homes if new legislation passes.

AG Lambasts Drastic Undercounting of COVID Nursing Home Deaths, Infection Control Compliance — Reports like this one out of New York and the previous report out of New Jersey lead us to believe that we're going to see significant state and federal activity around infection control compliance in 2021.

Cameras in Nursing Home Rooms, Additional Supplies of Protective Gear Recommended as Legislative Changes This Year — Connecticut is also on the growing list of states considering infection control reforms for long-term care.

Infection Prevention and Control Guidance for Long-Term Care Facilities in the Context of COVID-19 Update — WHO issued interim infection prevention and control guidance for long-term care facilities concerning COVID-19.

Emergence of SARS-CoV-2 B.1.1.7 Lineage — CDC emphasized the importance of universal and increased compliance with mitigation strategies as the U.S. confronts more highly transmissible variants of the coronavirus.

FDA Takes Action to Place All Alcohol-Based Hand Sanitizers from Mexico on Import Alert — FDA placed all alcohol-based hand sanitizers from Mexico on a countrywide import alert to help stop products that appear to be in violation from entering the U.S. until the agency is able to review the products' safety.

Kaiser Employee Dies After San Jose ER Outbreak Possibly Tied To Christmas Costume — Airborne transmission of the coronavirus, possibly linked to an inflatable Christmas costume, was the likely cause of a 44-person outbreak at Kaiser Permanente San Jose.

Infectious Diseases Society of America Guidelines on the Treatment and Management of Patients with COVID-19 — IDSA released new recommendations on the use of baricitinib in hospitalized patients with COVID-19 and an updated literature review on hydroxychloroquine for patients with COVID-19.

Virginia Adopts First Permanent Workplace Virus Rule in U.S. — Virginia was the first state to enact a temporary COVID-19 emergency workplace rule last year, sparking a trend of states taking similar action in the absence of such a move by OSHA. We expect other states to follow suit on Virginia's decision to enact a permanent rule.

ICCS Infection Prevention & Infection Control Newsletter: 2020 Year in Review

Another year is behind us, and what a year it was. Let's look back at what happened with infection prevention and control during 2020 in this special edition of the ICCS Infection Prevention & Control Newsletter, beginning with a section dedicated to the biggest development of the year.

* * *

WHO Statement Regarding Cluster of Pneumonia Cases in Wuhan, China — On January 9, WHO issued its first statement concerning what would become the COVID-19 pandemic.

First Travel-Related Case of 2019 Novel Coronavirus Detected in United States — On January 21, CDC confirmed that a Washington resident was the first person in the US with a confirmed case of the novel coronavirus.

Secretary Azar Declares Public Health Emergency for United States for 2019 Novel Coronavirus — At the end of January, HHS declared a public health emergency for the entire US. The announcement came around the same time that WHO declared a global health emergency, among many other developments.

CMS: Review Infection Prevention and Control Policies and Practices Now — In mid-February, CMS issued a memo reminding healthcare facilities about the importance of compliance with infection control practices as the spread of COVID-19 continued.

WHO Declares COVID-19 a Pandemic — On March 11, WHO declared COVID-19 a pandemic. Two days later, the novel coronavirus was declared a US national emergency. This was occurring as dangerous myths about prevention of and treatment for the COVID-19 were circulating and increasing in intensity.

California Becomes First to Issue Statewide Stay-at-Home Order — On March 19, California became the first state to issue a stay-at-home order and direct healthcare systems to prioritize services to the sickest patients.

United States COVID-19 Death Toll Surpasses 100,000 — On March 28, CDC announced that the number of people in the US who had died from COVID-19 surpassed 100,000.

States Rolling Out Mandates for Long-Term Care Facilities — In the summer, we began to see states rolling out COVID-19 mandates for long-term care facilities as CMS began resuming inspections, indicated plans for its own expansion of requirements, and increased noncompliance penalties.

FDA Issues EUA for First COVID-19 Vaccine — On December 11, FDA issued the first emergency use authorization to the Pfizer/BioNTech COVID-19 vaccine. A few days later, the FDA issued its second EUA to the Moderna COVID-19 vaccine.

First Coronavirus Vaccine Shots Given Outside Trials In U.S. — In between the issuing of the EUAs, Sandra Lindsay became the first American to receive the coronavirus vaccine outside a clinical trial.

---

Note: The stories shared above represent a fraction of 2020's most significant developments concerning the COVID-19 pandemic. AJMC and NBC News are among the publications and organizations maintaining timelines about the pandemic that identify other substantial announcements and developments. While COVID-19 was undoubtedly the defining story of 2020, there were a number of unrelated, yet still significant infection prevention and control developments from 2020 to know.

---

Future of Infection Prevention: Q&A With Consultant Phenelle Segal — ICCS Founder Phenelle Segal answered 10 questions concerning the future of infection prevention in the COVID-19 era.

FDA: Stop Using Certain Cardinal Health Surgical Gowns, Packs — Early in the year, the FDA advised providers to discontinue use of certain Cardinal Health surgical gowns and PreSource procedural packs that included the surgical gowns because of possible contamination. Cardinal initiated a recall around the same time. While the company sought to address its shortages, the recall was further magnified by the PPE shortages that surged during the pandemic.

WHO Urgent Challenges List Includes Infectious Diseases, Anti-Microbial Resistance — WHO issued its "urgent health challenges for the next decade" list. Included on the list: "stopping infectious diseases" and "protecting the medicines that protect us," which focuses on anti-microbial resistance.

KHN: Nursing Homes Struggling With 'Basic Infection Prevention Protocols' — A Kaiser Health News report highlighted the struggles of many nursing homes around the country with following "basic infection prevention protocols," with a federal records analysis revealing that about 61% of all such facilities were cited for one or more infection-control deficiencies since the beginning of 2017.

Infection Prevention Standards Challenge AAAHC-Accredited Facilities — Infection prevention and safe injection practice standards continued to be among those with high deficiency percentages for organizations accredited by the Accreditation Association for Ambulatory Health Care.

Joint Commission Infection Control Standards: Most Challenging for Accredited Ambulatory Healthcare Organizations — The Joint Commission identified its most challenging standards for accredited ambulatory healthcare organizations in 2019, with infection control standards as the most and second most challenging for the year.

ECRI: Sterile Processing, Antimicrobial Stewardship Top Patient Safety Concerns — Challenges concerning sterile processing and antimicrobial stewardship appeared on the ECRI Institute's "Top 10 Patient Safety Concerns for Healthcare Organizations 2020" report.

High Infection, Injury Rates Lead to Medicare Penalties for Several U.S. News' 'Best Hospitals' — As this report showed, every facility — no matter how many awards or recognitions its earned — has room for improvement concerning infection prevention and control.

Unsafe Injection Practices Endanger Thousands of Patients — A study revealed that nearly 67,000 patients were notified about potential exposure to unsafe injection practices by healthcare personnel between 2012 and 2018.

New S. aureus Guidelines for NICU — CDC issued new recommendations for the prevention and control of Staphylococcus aureus, including MRSA and MSSA, in infants in neonatal intensive care units.

Study: Doctors’ Phones Too Often Contaminated by MRSA — This study served as a helpful reminder about the importance of cleaning and disinfecting our mobile technology.

10 of the Scariest Healthcare Infections and Threats (2020 Edition) — ICCS produced its second annual list of scariest healthcare infections and threats to coincide with Halloween.

Special Report: What to Know About Standard Precautions — Early in the year, the ICCS team issued a special report that took a deep dive into the concept of "standard precautions."

Nursing Homes: CMS Adds New Triggering Factors for Focused Infection Control Surveys

The Centers for Medicare & Medicaid Services (CMS) has expanded the criteria that will trigger a focused infection control survey at a nursing home, according to a revised CMS memo.

The new criteria are as follows:

• multiple weeks with new COVID-19 cases;

• low staffing;

• selection as a "special focus facility" per the Social Security Act;

• concerns related to conducting outbreak testing per CMS requirements; or

• allegations or complaints which pose a risk for harm or immediate jeopardy to the health or safety of residents which are related to certain areas, such as abuse or quality of care (e.g., pressure ulcers, weight loss, depression, decline in functioning).

The revisions come now that there is the increased availability of resources for the testing of residents and staff and factors related to the quality of care, CMS notes.

CMS indicated that it is working with state survey agencies to identify facilities that meet the above criteria. The focused infection control survey, which will be performed by the state agencies, are to start within 3-5 days of identification. CMS noted that facilities which meet the criteria to trigger a survey will not need to be resurveyed if a focused survey was conducted within the previous three weeks.

The updated memo also notes that surveyors performing the focused infection control surveys should keep an eye out for and then investigate concerns related to residents who have experienced a significant decline in their condition during the public health emergency.

As McKnight's Long-Term Care News reports, the memo builds upon requirements issued in the middle of 2020. "Since June, CMS has required states to perform onsite infection control-focused surveys by the end July at nursing homes with previous COVID-19 outbreaks, or within three to five days of any nursing home with three or more new confirmed cases since their last report to the National Health Care Safety Network."

Infection Control Consulting Services (ICCS) is actively assisting many nursing homes working to comply with survey requirements and continuing to implement COVID-19 prevention practices. To learn more ICCS's COVID-19-related services, click here.