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Open Forum Infectious Diseases ; 8(SUPPL 1):S572-S573, 2021.
Article in English | EMBASE | ID: covidwho-1746343


Background. Accurate and rapid dissemination of clinical information is vital during pandemics, particularly with novel pathogens. To respond to the high volume and constantly evolving knowledge during the COVID-19 pandemic, the Infectious Diseases Society of America (IDSA) created an online educational COVID-19 Resource Center for frontline clinicians. Methods. In February 2020, IDSA launched an online resource center for COVID-19, which housed relevant clinical guidance, institutional protocols, and clinical trials. Then, in September 2020, IDSA leveraged a CDC grant to transform the resource center into the COVID-19 Real Time Learning Network (RTLN), a user-friendly, up-to-date microsite that contains clinically focused original content, guidelines, resources, and multimedia (Figure 1). The RTLN is supported by a team consisting of a Medical Editor, Associate Editors, an Online Editor, and IDSA staff. As of June 2021, the RTLN housed 12 sections, 7 of which are comprised of original content;these 7 sections contain a total of 37 subsections. A Twitter account (@RealTimeCOVID19) was also created in October 2020 to share information from RTLN in real-time. Results. As of June 2021, the most visited page of the RTLN was the Moderna Vaccine page, with 486,969 page views (Figure 2). Peak monthly page views are displayed in Figure 3. Between October 2020 and June 2021, the RTLN Twitter account had 2,911 followers, 2,135,783 impressions, and 41,793 engagements. The account had also hosted 2 Twitter Chats on COVID-19 vaccines;these chats resulted in 19 million and 5.3 million impressions, respectively. Twitter engagements by month are displayed in Figure 4. Conclusion. A comprehensive educational microsite housing clinically relevant COVID-19 information had high uptake, and an accompanying Twitter account had significant engagement. Rapid curation is labor-intensive and required expansion of our editorial team. To ensure we continue to serve the needs of our users a qualitative survey is planned. Our experience launching the RTLN can serve as a roadmap for the development of accessible and nimble educational resources during future pandemics.

Open Forum Infectious Diseases ; 7(SUPPL 1):S167-S168, 2020.
Article in English | EMBASE | ID: covidwho-1185706


Background: Antibiotic therapy has no known benefit against COVID-19, but is often initiated out of concern for concomitant bacterial infection. We sought to determine how common early empiric antibiotic therapy and community-onset bacterial co-infections are in hospitalized patients with COVID-19. Methods: In this multi-center cohort study of hospitalized patients with COVID-19 discharged from 32 Michigan hospitals during the COVID-19 Michigan surge, we describe the use of early empiric antibiotic therapy (within the first two days) and prevalence of community-onset bacterial co-infection. Additionally, we assessed patient and hospital predictors of early empiric antibiotic using poison generalized estimating equation models. Results: Between 3/10/2020 and 5/10/2020, data were collected on 951 COVID-19 PCR positive patients. Patient characteristics are described in Table 1. Nearly two thirds (62.4%, 593/951) of COVID-19 positive patients were prescribed early empiric antibiotic therapy, most of which (66.2%, 393/593) was directed at community-acquired pathogens. Across hospitals, the proportion of COVID-19 patients prescribed early empiric antibiotics varied from 40% to 90% (Figure 1). On multivariable analysis, patients were more likely to receive early empiric antibiotic therapy if they were older (adjusted rate ratio [ARR]: 1.01 [1.00-1.01] per year), required respiratory support (e.g., low flow oxygen, ARR: 1.16 [1.04-1.29]), had signs of a bacterial infection (e.g., lobar infiltrate, ARR: 1.17 [1.02-1.34]), or were admitted to a for-profit hospital (ARR: 1.27 [1.11-1.45]);patients admitted later were less likely to receive empiric antibiotics (April vs. March, ARR: 0.72 [0.62-0.84], Table 2). Community-onset bacterial co-infections were identified in 4.5% (43/951) of COVID-19 positive patients (2.4% [23/951] positive blood culture;1.9% [18/951] positive respiratory culture). Conclusion: Despite low prevalence of community-onset bacterial co-infections, patients hospitalized with COVID-19 often received early empiric antibiotic therapy. Given the potential harms from unnecessary antibiotic use, including additional personal protective equipment to administer antibiotics, judicious antibiotic use is key in hospitalized patients with COVID-19. (Figure Presented).

Open Forum Infectious Diseases ; 7(SUPPL 1):S164-S165, 2020.
Article in English | EMBASE | ID: covidwho-1185698


Background: Nursing home (NH) populations are at higher risk for morbidity and mortality due to COVID-19. A March 2020 NH survey indicated improvements in pandemic planning when compared to a similar survey in 2007. We surveyed NHs to evaluate how well pandemic preparedness plans and infection prevention strategies met the reality of COVID-19. Methods: The first COVID-19 case in Michigan was reported March 10, 2020. In the setting of 46,088 cases and 4,327 deaths statewide as of May 1, we disseminated an online survey to state department-registered NHs to describe their experience of the initial pandemic wave. Responses were collected May 1-12, during which the state averaged 585 cases/day. We were particularly interested in NH preparedness, challenges, testing capacity, and adaptations made. Results: Of 452 NHs contacted, 145 opened the survey and 143 (32%) responded. A majority (68%) indicated that their facility's pandemic response plan addressed > 90% of issues they experienced;29% reported their plan addressed most but not all anticipated concerns (Table 1). As the pandemic evolved, all facilities (100%) provided additional staff education on proper personal protective equipment (PPE) use. 66% reported experiencing shortages of PPE and other supplies. Half of all facilities (50%) lacked sufficient resources to test asymptomatic residents or staff;only 36% were able to test all residents and staff with suspected COVID-19 infection. Half (52%) considered their communication regarding COVID-19 with nearby hospitals “very good.” The majority of facilities (55%) experienced staffing shortages, often relying on remaining staff to work additional hours and/or contracted staff to fill deficits (Table 2). NH staff resignations increased, with 63% of NHs experiencing resignations;staff with greater bedside contact were more likely to leave, including nurses and nurse assistants. Conclusion: While most NHs had a plan to respond to COVID-19 pandemic in March 2020, many facilities experienced a lack of available resources, less than ideal communication lines with local hospitals, lack of testing capacity and insufficient staff. These shortcomings indicate potential high-yield areas of improvement in pandemic preparedness in the NH setting. (Table Presented).

Oman Medical Journal ; 35 (1):7, 2020.
Article in English | EMBASE | ID: covidwho-820306


Objectives: The first confirmed case of Middle East respiratory syndrome (MERS) in Oman was in 2013. This report describes the nosocomial spread of MERS-coronavirus (CoV) in two regional hospitals in Oman (2019) and highlights opportunities for rapid containment in the future. Method(s): An outbreak epidemiological description and analysis of contributing factors was undertaken, with infection prevention and control challenges highlighted. A transmission map was created to trace hospital contacts and symptomatic contacts were screened using RT-PCR. Environment decontamination was carried out. Awareness programmes including training and education were augmented and infection prevention and control guidelines were revised, especially those related to the implementation of risk assessment for contact screenings. Result(s): Between 23 January and 16 February 2019, 13 confirmed cases were reported from two hospitals. Seven out of 13 were secondary transmitted cases, including two healthcare workers. Symptoms included fever in six (46%) patients, respiratory symptoms in six (46%), and gastrointestinal symptoms in four (31%). Four out of 13 patients died. High traffic in affected wards, poor adherence to infection control measures, lack of awareness, delay in the diagnosis of primary cases, and inadequate terminal cleaning were identified as contributory factors to the outbreak. Both affected healthcare workers and two secondary patients were missed during contact screenings. Conclusion(s): Lapses in the implementation of infection control measures within a facility can facilitate nosocomial transmission of MERS-CoV. There is a need to revise risk assessment tools for contacts within hospitals so that positive cases can be detected earlier.