subee, MSN, CRNA 4,773 Posts Specializes in CRNA, Finally retired. Has 51 years experience. Sep 21, 2021 6 hours ago, RJMDilts said: This is from your reference you provided to me. Material from the report is in quotes. The information below, from YOUR source, shows HAI risks are minimal "pre-vaccine" when the appropriate mitigation steps are implemented, the transmission rates not only could, but did go down, w/o the vaccine. That being said, Once again, I am advocating for getting the vaccine. AND keeping unvaccinated RN's based on the data. Yes, the vaccine is the best way, but apparently not the only thing we can do. "According to the meta-analysis by Zhou et al. , the rate of HAIs (of inpatients) is 2% but the overall proportion of Coronavirus 2 infections contracted in hospitals (all cases, including healthcare personnel) is 44%. Notwithstanding, in other studies such as the one by Rhee et al. , the incidence of hospital-acquired COVID-19 is low and negligible." (You must read the entirety of the report for proper context. Much of the data came from early in the pandemic in China, Hong Kong, Italy and England. One U.S. city, Boston, was used in the report. 2 cases out of 697 COVID-19 patients in Boston, for a rate of 0.002%) "An explanation of these differences is not simple as well as a number of factors that may be associated: socio-demographic context, the lack of individual protective equipment and healthcare personnel, and the overcrowding of hospitals. The increased number of parameters to be taken into consideration and a limited understanding of the virus has proven difficult in obtaining a complete evaluation." "The high number of HAIs refers to the first wave of the pandemic when hospitals were still unaware of how to manage the new global pandemic and individual prevention equipment was still insufficient. Compared to other reported rates of HAIs during previous global pandemics, it appears that the pandemic rates of COVID-19 are much lower [4,20]." "The countries with the highest number of SARS-CoV-2 infections were the first to be “struck” by the pandemic (such as China, Italy, and the UK). It is possible that the hospitals in these countries found themselves “unprepared” to manage the emergency. Instead, countries that were stricken afterward had ample time and knowledge to prepare the resources needed to manage the emergency. This may have allowed for the timely diagnosis of COVID-19 cases, the proper isolation in dedicated “COVID-19” wards, and the use of efficient measures of individual protection .The main reasons behind the nosocomial spread were the incorrect isolation, the use of shared healthcare equipment, and the constant movements of infected personnel, (a particularly serious and widespread problem especially during the first wave of the pandemic) [16,20,44]." "During the first phase of the pandemic, healthcare professionals unknowingly played a role in the spread of the infection. During the first months, they were confronted with the difficult situation of managing a rare and dangerous reality. The shortage of individual protective devices, the incorrect implementation of distancing measures, and work overload have favored the spread of the infection among healthcare personnel and patients. In fact, the progress that has been achieved in recent months has reduced risks. Improvements include optimized triage systems, greater knowledge of transmission and the role of asymptomatic and presymptomatic infections, better access to effective personal protective equipment, improved testing capabilities, implementation of new contagion prevention measures such as the continued use of masks in hospitals . During the first stage of the pandemic, nosocomial transmission could have been considered “inevitable” due to the reality that healthcare workers were facing an emergency never experienced before and hospitals often lacked space, equipment, and supplies to handle the emergency. What could have been done to avoid hospital-acquired infections given the overcrowded hospitals (due to the quickly elevated number of patients), insufficient protective equipment and tests, and overworked healthcare personnel? Probably little or nothing. In situations of absolute emergency, even the utmost diligence and care are not sufficient due to the insurmountable difficulties of healthcare management. With time, the scientific community began to understand how to effectively confront the pandemic. Prevention strategies were validated and forms of protection and early diagnosis (individual protective equipment, tests, tracking, and correct isolation) had become sufficient. Cases of hospital-acquired COVID-19 should be considered unexpected events that require a thorough analysis of medical records in order to determine what the miscalculations were. We must verify at what moment of the hospitalization did the infection occur, if a correct screening was performed and if there was a “failure” of the measures to prevent the risk of contagion. Reference https://www.ncbi.nlm.younih.gov/pmc/articles/PMC7827479/ Barranco R, Vallega Bernucci Du Tremoul L, Ventura F. Hospital-Acquired SARS-Cov-2 Infections in Patients: Inevitable Conditions or Medical Malpractice?. Int J Environ Res Public Health. 2021;18(2):489. Published 2021 Jan 9. doi:10.3390/ijerph18020489 If you had gone through this whole thread, you would know that PMH articles are NOT peer reviewed and should be viewed with skepticism. The ncbi is a collection of well conducted research and awfully bad research. It's just a repository for any study in general. I fell for the same thing pre-Covid because it has the "NIH" attached to the actual website but I have seen some ricidulous Ivermectin studies there with an N of 15 and other such nonsense.