In any infectious disease outbreak, it is the front-line health-care personnel who are at the highest risk and who need to be protected. In the case of airborne infections, health-care personnel who work in emergency wing are particularly at risk.
There is new evidence that SARS-nCoV 2, the pathogen that causes COVID-19, though primarily a droplet infection spread through close contact, can also be aerosolized. This means that in certain conditions the virus has the capacity to remain suspended in air, infecting anyone who might pass through the cloud of particles.
The “cough corners” started in most government hospitals last year, as part of a major initiative to check the transmission of airborne diseases such as TB and H1N1, have more relevance now than ever. The name, cough corners, might be a misnomer as these are in fact infection control (IC) help desks set up as a separate counter in a well-ventilated area near the entrance to the hospital, where all patients coming in are screened for respiratory symptoms and then cared for separately.
“Airborne infection control in all hospitals was an initiative launched last year. The idea is to identify a person coming into a hospital with a respiratory infection immediately so that other patients and visitors to the hospital are not exposed to a new infection,” a senior Health official said.
After screening, the patients will be briefed about respiratory hygiene, the importance of hand washing and will be provided a mask or a tissue.
These patients should be separated in a well-ventilated waiting area or seated away from immunocompromised persons.
Fast track
A person with suspected infectious respiratory disease should be fast-tracked or allowed to jump the queue and see the doctor ahead as this will minimise the time he/she spends inside the hospital. A number of government hospitals and private hospitals have already adopted the concept.
Incidentally, it was Kerala’s first brush with Nipah virus (NiV) in 2018 that brought up the importance of reducing the transmission of airborne diseases inside hospitals and the necessity of adequate infection control practices in health facilities, so that hospitals do not turn out to be the potential sources of infection.
The epidemiological analysis of 2018 Nipah outbreak had revealed that except for the index case (the first icase to be documented), the rest were all due to nosocomial transmission at three different hospital settings. Of the 23 cases of NiV reported, 18 persons (who were patients, health-care personnel or visitors) had contracted it from two hospitals where the index case had been admitted. Apart from the lack of personal protection measures such as masks or gloves, crowded hospital environment and ill-ventilated settings were what had fuelled disease transmission.
On the other hand, those hospital workers or patient companions who had used masks and gloves did not contract NiV, despite coming into close contact with the index case.
IC help desks should have all information material on display as well as proper signages and provide hand sanitisers. “All hospitals need these kind of cough corners because one would be cutting off the infection at the source and protecting health-care workers and others. They should be incorporated into infection-control practices as one component of Standard Precautions,” an official said.
