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Strategies utilized to prevent and control SARS-CoV-2 transmission in two congregate,psychiatric healthcare settings during the pandemic
Institution:1. Department of Infection Prevention, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, NC;2. Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, NC;3. Division of Infectious Diseases, University of North Carolina School of Medicine, Chapel Hill, NC;4. Department of Psychiatry, University of North Carolina School of Medicine, Chapel Hill, NC;5. Department of Inpatient Psychiatry Services, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, NC
Abstract:BackgroundThe COVID-19 pandemic has had a substantial effect on the delivery of psychiatric health care. Inpatient psychiatric health care facilities have experienced outbreaks of COVID-19, making these areas particularly vulnerable.MethodsOur facility used a multidisciplinary approach to implement enhanced infection prevention and control (IPC) interventions in our psychiatric health care areas.ResultsIn a 16-month period during the COVID-19 pandemic, our 2 facilities provided >29,000 patient days of care to 1,807 patients and identified only 47 COVID-19 positive psychiatric health inpatients (47/1,807, or 2.6%). We identified the majority of these cases by testing all patients at admission, preventing subsequent outbreaks. Twenty-one psychiatric health care personnel were identified as COVID+ during the same period, with 90% linked to an exposure other than a known positive case at work.DiscussionThe IPC interventions we implemented provided multiple layers of safety for our patients and our staff. Ultimately, this resulted in low SARS-CoV-2 infection rates within our facilities.ConclusionsPsychiatric health care facilities are uniquely vulnerable to COVID-19 outbreaks because they are congregate units that promote therapeutic interactions in shared spaces. IPC interventions used in acute medical care settings can also work effectively in psychiatric health care, but often require modifications to ensure staff and patient safety.
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