Strategies for COVID-19 transmission control and mitigation in a psychiatric hospital in Mexico.

ABSTRACT

In the context of the emerging COVID-19 pandemic, one of the great challenges is to generate effective strategies for the control of nosocomial infections, specifically in psychiatric hospitals with populations considered at risk (older adults or individuals with comorbidities). This article describes the strategies for prevention, containment and treatment of infection transmission implemented during a COVID-19 outbreak that occurred in July 2020 in a psychiatric hospital of the State of Mexico. The population was comprised by women with prolonged hospital stay (mean = 24 years), mostly geriatric (mean = 64 years), with various psychiatric disorders and comorbidities. In total, 19 COVID-19-positive cases were diagnosed, out of which thirteen had mild symptoms and six were asymptomatic. There were no alterations in mental state, psychiatric symptoms or underlying diseases. Algorithms were developed for the management and treatment of suspected/confirmed COVID-19 cases. Finally, the generation of comprehensive strategies, quick and timely actions, as well as adequate management of human resources favoring interdisciplinary work, were deemed to have contributed to contain and mitigate the COVID-19 outbreak, which constitutes a precedent in the psychiatric field with institutionalized patients.

RESUMEN

En el contexto de la emergente pandemia de COVID-19, uno de los grandes desafíos es generar estrategias eficaces de control de infecciones nosocomiales, específicamente en hospitales psiquiátricos con población considerada de riesgo (adultos mayores o con comorbilidades). En el presente artículo se describen las estrategias de prevención, contención y tratamiento de contagio, a partir de un brote de COVID-19 ocurrido en julio de 2020 en un hospital psiquiátrico del Estado de México. La población estuvo constituida por mujeres con estancia hospitalaria prolongada (media = 24 años), en su mayoría geriátricas (media = 64 años), con trastornos psiquiátricos diversos y comorbilidades. En total se diagnosticaron 19 casos positivos de COVID-19, de los cuales 13 cursaron con sintomatología leve y seis resultaron asintomáticos. No se presentaron alteraciones en el estado mental, en la sintomatología psiquiátrica ni en las enfermedades de base. Se realizaron algoritmos para el manejo y tratamiento de los casos sospechosos o confirmados de COVID-19. Finalmente, se consideró que la generación de estrategias integrales, acciones rápidas y oportunas, así como una adecuada gestión de recursos humanos favorecedora del trabajo interdisciplinario contribuyeron a contener y mitigar el brote de COVID-19, constituyéndose en un precedente en el ámbito psiquiátrico con pacientes institucionalizadas.