Introduction
One of the defining features of the 2020s will undoubtedly be the long-term societal effects of the Covid-19 pandemic. The first known case of the severe respiratory syndrome was reported in Wuhan, China, in November 2019. It continued to spread to almost all countries around the world, leading to lockdowns, political protests, mass unemployment, and economic instability (The British Academy, 2021). It has resulted in almost half a billion cases worldwide and over six million deaths (Worldometer, 2022). More than two years later, the world is gradually reverting to its normal state as employees return to work and governments ease epidemiological restrictions. However, one crucial area suffering from the burden of the pandemic is being forgotten: the healthcare industry, which is still experiencing a heightened risk of infection both for care providers and patients. Covid-19 has had a significant impact on the running of healthcare facilities, but numerous academic studies offer solutions that could ameliorate the situation.
Impact of Covid-19 on Infusion Centers
Experience
My professional experience of Covid-19 is based on my work performing blood transfusions, antibiotics, and injections in an infusion center. Each employee is required to wear a respirator, maintain hand hygiene, and uphold a physical distance of at least six feet from other employees or patients whenever possible. Furthermore, the pandemic has radically shifted the way our organization sees patients. Patients that enter the building are obligated to undergo a screening process, which involves answering Covid-related questions such as whether they have experienced signs of fever, lost their sense of smell, or have recently been in close contact with Covid-19 positive persons. No visitors are allowed to accompany them unless they need assistance going to the bathroom or eating. After Covid-19, infusion centers now regulate and record patients’ activities, behaviors, and actions more rigorously.
Data
Most of the data concerning the impact of Covid-19 on infusion centers comes from a survey of 89 OIOBD members, including North America, Europe, Israel, Hong Kong, New Zealand, Brazil, China, and India. Before the pandemic, the centers were staffed by general patients providing over fifty infusions per week to patients from different specialties (Dotan et al., 2020). Clinical disease activity, laboratory tests, and therapeutic drug monitoring were routinely performed, but patients were discharged immediately after infusion without further monitoring. During Covid-19, 81% of infusion centers increased cleaning between infusions, 67% reduced the number of patients allowed in the center to maintain social distancing, and 28% consequently expanded hours of operation. The vast majority of other infusion centers around the world enforced the same rules as my place of work.
Strategies to Deal with Covid-19
Disinfecting High-touch Surfaces
The article by Choi et al. (2021) focuses on strategies to mitigate the transmission of Covid-19 through surfaces in healthcare settings. Research has shown that one of the ways coronavirus is transmitted is through contact with touched objects, and it can survive on inanimate surfaces for up to nine days. The classical disinfection strategy involves the use of chemicals, but its efficiency is undermined by the fact that cleaning is done sporadically in healthcare facilities. One potential way to resolve this issue is by implementing automated disinfection approaches such as hydrogen peroxide vapor and ultraviolet light (Choi et al., 2021). Another method involves using copper, a material with antimicrobial properties that had been confirmed to rapidly inactivate coronavirus. A copper-based alloy can be used to coat high-touch surfaces, including doorknobs, credit card holders, pens, computers, or pumps (Choi et al., 2021). Apart from traditional chemical treatment, techniques such as automated disinfection and copper-coating could be enforced by healthcare facilities to improve disinfection capability.
Waste Management
The article by Das et al. (2021) describes numerous strategies to manage healthcare waste during the pandemic. The increased number of hospitalizations due to Covid-19 and the use of personal protective equipment has led to the production of more healthcare solid waste. Its improper disposal may cause further infection, particularly for exposed waste pickers, who can then unintentionally spread the virus within their community (Das et al., 2021). The Center for Disease Control and Prevention does not differentiate between regular healthcare waste and waste generated by Covid-19 patients; thus, both are treated the same. However, in Hubei, China, hospital employees segregate and sterilize infected waste with chlorine before packing it in double bags and storing it in temporary facilities before incineration (Das et al., 2021). The Philippines passed an amendment that requires special registered transporters and facilities to acquire permits to handle the infected waste. In Jordan, Covid-19-contaminated waste is sanitized and disposed of daily. The authors state that the most optimal strategy is to transfer hospital waste to temporary treatment centers before waste disposal centers. In other countries, infected waste produced by Covid-19 patients is collected and stored separately to lower the possibility of further infection.
Impact of Strategies on Infusion Centers
Infusion centers could implement the strategies proposed in these two articles to lower the risks of infection. While masks, physical distancing, and pre-appointment screenings are the foundation of combatting Covid-19, the severity of the stressor warrants further action. Firstly, high-touch surfaces in infusion centers should be coated with copper-based alloys to inactivate coronavirus and other pathogens. These include doorknobs, computers, chair rails, and drip stands. While this measure will lower the risks of infection, it has a potentially negative impact because copper is more expensive than the steel traditionally used in healthcare facilities. Furthermore, copper oxidizes and tarnishes to dark brown after a few years, although it still retains its antibacterial properties. Installing copper-based coating on high-touch surfaces potentially has some financial and aesthetic drawbacks, but its ability to inactivate pathogens outweighs both.
Secondly, proper waste management procedures should be implemented. Infusion centers generally utilize offsite waste treatments due to cost efficiency. However, the center should be more active in addressing the problem of excess and inadequately sanitized waste. A possible solution is having infusion center employees disinfect the waste with chemicals approved by the CDC against Covid-19. The waste could be double-bagged and stored in a temporary facility, separate from workers and patients, for a maximum of 24 hours before being transported to offsite incineration treatment centers. Sanitation and daily disposal are more expensive due to material and staffing costs but improve workplace safety and prevent further infection.
Conclusion
In conclusion, Covid-19 is a significant problem in contemporary healthcare, but various organizations are implementing effective strategies to mitigate the risk of infection. The infusion center I work at has mostly limited its epidemiological measures to masks, patient screenings, and physical distancing. Academic articles propose further action, such as installing copper-based coating on high-touch surfaces based on its antibacterial properties. Furthermore, it is recommended to sterilize and dispose of health waste daily. These strategies are potentially more high-cost than traditional healthcare methods, such as stainless steel and offsite waste treatment, but have been confirmed to lower infection rates.
References
Choi, H., Chatterjee, P., Lichtfouse, E., Martel, J. A., Hwang, M., Jinadatha, C., & Sharma, V. K. (2021). Classical and alternative disinfection strategies to control the COVID-19 virus in healthcare facilities: a review. Environmental Chemistry Letters, 19(3), 1945-1951.
Das, A. K., Islam, M. N., Billah, M. M., & Sarker, A. (2021). COVID-19 pandemic and healthcare solid waste management strategy–A mini-review. Science of the Total Environment, 778, 1-6.
Dotan, I., Panaccione, R., Kaplan, G. G., O’Morain, C., Lindsay, J. O., & Abreu, M. T. (2020). Best practice guidance for adult infusion centres during the COVID-19 pandemic: Report from the COVID-19 International Organization for the Study of IBD [IOIBD] task force. Journal of Crohn’s and Colitis, 14(Supplement_3), S785-S790.
The British Academy. (2021). The COVID Decade: understanding the long-term societal impacts of COVID-19. Web.
Worldometer. (2022). Covid-19 coronavirus pandemic. Web.