ABSTRACT
Introduction: Occupational exposures to communicable diseases that are transmitted through droplet or airborne may place healthcare workers (HCW) at risk. Post-exposure interventions such as immunization, prophylactic antibiotics and work restrictions may be indicated. Objectives: We assessed the unprotected exposures of HCW to communicable diseases before and during the COVID-19 pandemic at the American University of Beirut Medical Center (AUBMC). Methods: Policies and procedures for standard and isolation precautions as well as post-exposure management are well defined at AUBMC. Unprotected exposures to suspected or confirmed communicable diseases that are transmitted through droplet or airborne routes are immediately reported to the Infection Prevention and Control Program (ICPP). Investigation of the exposures is conducted through staff interviews, direct observations and review of the surveillance cameras in the Emergency Department (ED) and the critical care units. List of the staff identified with unprotected exposures is then forwarded to the Employee Health Unit (EHU) for post-exposure management. Results: Between 2017 and May 2021, unprotected exposures to communicable diseases such as varicella-zoster virus, pulmonary tuberculosis, pertussis, mumps, measles, Strep group A infections and meningitis caused by Neisseria meningitidis were managed. The highest number of unprotected exposures was identified in 2019 with 400 HCW exposed to 23 communicable diseases. A dramatic decrease in exposures was noted in 2020 and 2021 with 13 and 0 staff, respectively. Conclusion: Immediate identification of patients with potential communicable diseases as well as application of standard and transmission- based precautions are essential in halting the transmission of infections among patients and HCW. The mandatory masking policy for patients, visitors and HCW during the COVID-19 pandemic as the well as ongoing educational and training activities including increased awareness about Hand Hygiene practices and environmental decontamination played a vital role in decreasing the occupational exposures at our center. (Figure Presented).
ABSTRACT
Introduction: Lebanon received its first batch of Pfizer-BioNTech vaccines on February 13, 2021 to launch a free nationwide vaccination campaign led by the Ministry of Public Health. The country has suffered an increase in cases and fatalities after the Beirut explosion in August 4, 2021. Objectives: We analyzed the efficacy of vaccination on preventing COVID-19 among staff at the American University of Beirut Medical Center (AUBMC). Methods: The COVID-19 vaccination campaign started in different centers including AUBMC on February 14, 2021. Two doses of vaccine were administered at 3 weeks interval. Infection Control (IC) Program and Employee Health Unit (EHU) continued to raise awareness and investigate COVID-19 infections among staff. Positivity of cases is confirmed by antigen and/or PCR testing. Results: Till May 26, 2021, Lebanon reported 538,991 COVID cases (8% of population) and 7,690 deaths. While at AUBMC, a total of 1,133 (29%) staff developed COVID-19. To date, 8.6% of the population received the first dose of the vaccine, and 4.5% received the second dose. Eighty five percent of the hospital staff received the first dose and 80% received the second dose. The trend depicting COVID-19 cases at AUBMC followed the one observed in Lebanon. Following the end of year's celebrations an increase of cases was observed at AUBMC and in Lebanon during January. Inversely, we observed a decrease in the number of positive cases in May 2021 nationwide and at AUBMC. Conclusion: The trend in COVID-19 cases declined at the national level starting April 2021 similar to our trend. The decline at AUBMC was more pronounced most likely because of the rapidity of the immunization as most of the workforce was vaccinated within 4 weeks. The spread of the virus in Lebanon decreased due to vaccination and the natural immunization secondary to the infection. IC practices, mandatory masking, hand hygiene, and physical distancing, remain instrumental in halting COVID- 19 transmissions in the community in view of the slow vaccination rollout in Lebanon. (Figure Presented).
ABSTRACT
Introduction: Lebanon suffers from a seasonal increase in severe acute respiratory infections caused by Influenza viruses each year. Patients present with mild to severe symptoms which may require hospitalization. The increase in morbidity and mortality is usually noted in elderly and in patients with comorbidities. Objectives: We studied the Influenza activity at the American University of Beirut Medical Center (AUBMC) before and during the COVID-19 pandemic. Methods: In Lebanon, the Influenza season extends from September to May with a noted peak during winter. Close monitoring of the Influenza activity is performed at our center by the Infection Control team. Patients with suspected or confirmed Influenza are placed in a single room under droplet precautions. Influenza infections are confirmed by either Rapid Influenza Diagnostic test or Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. During COVID-19 pandemic, public health measures such as lockdown, mandatory masking and physical distancing were implemented in the country with discrepancy in compliance between geographical regions. Results: Since September 2020, all the respiratory specimens that were tested for Influenza at AUBMC came back negative. While positive results reached 27% in 2019-2020 season and 20% in 2018-2019 Influenza season. The number of specimens tested during season 20-21 was 150 compared to 4592 and 4457 samples tested during the last 2 seasons, respectively. Conclusion: The exceptional zero Influenza cases encountered during the 2020-2021 Influenza season at our center in comparison to the previous 2 seasons is reasonably explained. The dramatic decrease in Influenza cases, hospitalization, morbidities, and mortalities is the result of the public health measures that were imposed by the authorities to control the spread of COVID- 19 in the country. A similar decline in Influenza cases is similarly observed in the United States where the positivity rate is reported at 0.1% during the same season. (Figure Presented).
ABSTRACT
Introduction: The outbreak of COVID-19 in Lebanon created substantial demand for hospital beds. Hospitals were bound to equip units to admit such patients. A national vaccine rollout was planned by the Ministry of Public Health (MOPH). Objectives: We evaluated the impact of a COVID-19 vaccination campaign and governmental measures on reducing hospitalization and mortality among COVID-19 patients at a tertiary care center in Lebanon. Methods: Nationwide lockdown measures were imposed following a rise in COVID-19 cases. Our facility, a tertiary care center, designated a building in March 2020 to accommodate COVID-19 patients (regular and critical). During the second week of February 2021, the COVID-19 vaccination rollout started. Two doses of Pfizer-BioNTech vaccine were administered at 3 weeks interval. Other vaccines such as Oxford-Astra- Zeneca and Sputnik V were administered by the private sector. Results: In Lebanon, the daily number of COVID-19 cases showed a rapid increase in January 2021. The highest percentages were recorded during the first quarter of 2021 with 7% infections and 6% mortality. At AUBMC, 100% bed occupancy with increased mortality were noted in the COVID-19 dedicated units during the same period. The drop in cases started to appear when the country reached 4% to 7% vaccinated persons with first and second dose, respectively. In May 2021, bed occupancy continued to drop and the pattern was comparable to the decrease in new COVID-19 cases and deaths at the national level. Conclusion: The trends illustrating occupied beds and mortality rates in Lebanon were similar to our trends at AUBMC. The decline in cases and in deaths is primarily related to offering the vaccines based on occupation, age and medical condition. Improving the preparedness at our center is a lesson learnt in the event of another threat. Despite the decline in cases, hospital staff are at risk. The continued importance of masking is mandatory and indispensable in poorly ventilated areas or crowded places. (Figure Presented).
ABSTRACT
Background: The rapidly spreading COVID-19 pandemic was associated with significant nosocomial transmissions and poses a risk to healthcare workers and hospitalized patients. We assessed intensive care units (ICU) resources, COVID-19 preparedness and the availability of personal protective equipment (PPE) to ICU practitioners in Lebanon.
ABSTRACT
Background: The rapidly spreading COVID-19 pandemic was associated with significant nosocomial transmissions and poses a risk to healthcare workers and hospitalized patients. We assessed intensive care units (ICU) resources, COVID-19 preparedness and the availability of personal protective equipment (PPE) to ICU practitioners in Lebanon. Methods: Between March 23 and 31, 2020, 250 ICU physicians working in Lebanon were surveyed on COVID-19 preparedness at their local hospitals, the availability of ICU resources, and adequate PPE. The survey was developed and administered by the Lebanese Society of Critical Care Medicine in collaboration with the Lebanese Pulmonary Society and the Lebanese Society of Anesthesiologists. Results: Eighty-nine ICU physicians working at 51 hospitals in all Lebanese regions completed the survey. The recommended PPE for ICU physicians (N95 masks, face shields and impermeable body-gowns) and the needed fitting and doning/doffing training were available to 34% of respondents. Dedicated wards and ICU for COVID-19 patients, negative pressure ICU rooms, video-laryngoscopes and COVID-19 testing were available on-site at 17% of respondents' hospitals. Conclusions: At the onset of the COVID-19 epidemic in Lebanon, the availability of recommended PPE to the surveyed ICU physicians in Lebanon and the available ICU resources and COVID-19 preparedness at their hospitals were limited.