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Title: Fending off Delta - hospital measures to reduce nosocomial transmission of COVID-19
Authors: Lim, Rachel Hui Fen
Htun, Htet Lin
Li, Anthony Lianjie
Guo, Huiling
Kyaw, Win Mar
Hein, Aung Aung
Ang, Brenda
Chow, Angela
Keywords: Science::Medicine
Issue Date: 2022
Source: Lim, R. H. F., Htun, H. L., Li, A. L., Guo, H., Kyaw, W. M., Hein, A. A., Ang, B. & Chow, A. (2022). Fending off Delta - hospital measures to reduce nosocomial transmission of COVID-19. International Journal of Infectious Diseases, 117, 139-145.
Journal: International Journal of Infectious Diseases 
Abstract: Objectives: Following the emergence of the Delta variant of SARS-CoV-2 in Singapore, our hospital experienced a Delta-linked ward cluster. In this study, we review the enhanced strategies in preventing nosocomial transmission of COVID-19 following widespread community transmission of the Delta variant. Methods: We conducted a cohort study on exposures to unexpected COVID-19 cases for which contact tracing was initiated from June 2021 to October 2021. Strategies evaluated included upgraded personal protective equipment (PPE) and rostered routine testing (RRT) for staff and patients, surveillance of staff with acute respiratory illness (ARI), and expanded quarantining and testing for contacts of identified cases. Results: From 193 unexpected COVID-19 exposures, 2,573 staff, 542 patients, and 128 visitor contacts were traced. Four staff contacts subsequently had SARS-CoV-2 infection. Two were likely from exposure in community settings, whereas 2 had exposure to the same COVID-19 positive staff in the hospital, forming the only hospital cluster. One inpatient had a nosocomial infection, possibly from visitors. The SARS-CoV-2 detection rate among staff was 0.3% (of 11,200 staff) from biweekly RRT and 2.5% (of 3,675 staff) from ARI surveillance. Conclusion: Enhanced hospital measures, including upgraded PPE and RRT for staff and patients, staff sickness surveillance, and more rigorous management of contacts of COVID-19 cases, were likely to have reduced nosocomial transmission amid the Delta variant.
ISSN: 1201-9712
DOI: 10.1016/j.ijid.2022.01.069
Schools: Lee Kong Chian School of Medicine (LKCMedicine) 
Organisations: Tan Tock Seng Hospital
Saw Swee Hock School of Public Health, National University of Singapore
Rights: © 2022 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (
Fulltext Permission: open
Fulltext Availability: With Fulltext
Appears in Collections:LKCMedicine Journal Articles

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