Infrastructure Guidance for COVID-19/COVID-19 Infection Prevention and Control
Contents
Infection prevention and control for COVID-19
Infection prevention and control in the context of Covid-19 should focus on three pillars: exposure reduction by workflow, cleaning disinfection and decontamination, and use of personal protective equipment.
General Concern:
Contact and droplet spread
Transmission of SARS-CoV-2 virus occurs via contact and droplet spread. The virus has been shown to persist on surfaces for extended periods of time and is known to be efficient at infecting people. Waste products: As SARS-CoV-02 is carried in body fluids and fecal matter, disposal of contaminated items (tissues) and cleaning regimes (spaces, garments, linen) should be accommodated carefully in the workflow design and infrastructure provision.
Limited Concern:
Water and Sewerage Contamination
The International Water Association (Link to Report) concluded that water and sewerage contamination is not considered to be a key risk factor for Covid-19. The panel expressed concern for how waste and specifically wastewater (medical) would be handled by places (e.g., hostels, hotels) that are used to serve as interim Covid-19 quarantine or testing facilities or accommodation. These are places other than hospitals that are used in the interim for such purposes and do not usually handle medical wastewater. Such facilities should be monitored carefully.
Airborne Transmission
Under exceptional circumstances, where the risk of airborne transmission arises the following should be considered. Where aerosolising activities have a potential of contaminating occupied spaces with partially diluted or undiluted contaminated air, or where this is indeterminate, aerosolising activities should be designated to an alternate area. In the event that an alternative is not available, some treatment regime (air filtration or air disinfection) may be necessary.
As SARS-CoV-2 is not considered airborne, general respiratory protection against airborne transmission is not considered necessary, except where aerosolisation of particles may be a risk. The following procedures have been identified as having the potential for liberating infectious aerosols.
- tracheal intubation,
- non-invasive ventilation,
- tracheotomy,
- cardiopulmonary resuscitation,
- manual ventilation before intubation and bronchoscopy
- diagnostic sampling as patients can be induced to cough and sneeze
