As we reflect on 2020, we can’t help but focus on how COVID-19 has upended our world and tested the health care systems, especially infections preventionists. We recognize that health care is experiencing a transformative period and the need to deliver consistent and quality care is more important than ever.
As hospitals and health systems have had to meet extraordinary challenges this year with innovation, flexibility, and compassion, we have learned an immense amount this year and take those learnings to create a better health care system for the future. We’ve asked our infection prevention experts to share their predictions for the New Year.
Here’s what they had to say for what’s in store in 2021:
2020 is wrapping up and COVID-19 cases, hospitalizations, and deaths are rising across the United States. On December 10, 2020, an assembly of Governors issued support for a historic Call to Action to Defeat COVID-19 and Promote National Recovery and Renewal. The recommendations in the Call to Action address five key pillars of an effective response to COVID-19 including:
- Testing to reduce viral transmission and enable various community settings to operate safely
- Robust contact tracing to prevent and control outbreaks
- Public health and social measures to protect the public and reduce community spread
- Enabling effective vaccines and treatments through close collaboration with manufacturers, communities, research institutions, and healthcare providers
- Identifying common indicators of success through the collection, reporting, and analysis of public data to empower evidence-based decision making.
In 2021, I expect to see a continued laser-focus on each of these key areas coupled with vast improvements in our nation’s efforts to combat COVID-19 in a united, comprehensive, and bipartisan way. I also expect to see positive improvements in our public health communication efforts by providing timely and credible evidence-based messages directly from trusted sources to the public on an ongoing basis. Lastly, I expect to see new, innovative, and equitable efforts to eradicate barriers that continue to challenge public health and public safety across the nation.
Throughout 2020, infection preventionists and the health care systems they serve have had to manage the stress and burden of the COVID-19 pandemic as it continues to weigh heavily on health care workers at all levels and in all disciplines. A multidisciplinary effort in battling the pandemic continues to require attention from the housekeeper to the CEO because we all are at risk from a personal and professional standpoint. Infection preventionists have proven resilient during previous times of pandemic—H1N1 in 2009—and various outbreaks such as Ebola, SARS, and MERS which have placed infection prevention and control teams center stage and strained our often-fragile resources. However, COVID-19 is a once in a lifetime challenge for every infection preventionist and the biggest infection control event in over 100 years!
As we head into 2021, the impact of the COVID-19 pandemic on the spread of antibiotic resistance in health care settings has not been fully explored. In response to a rapid increase in SARS-CoV-2 infections, many health care facilities adopted mitigation strategies to contend with physical space limitations, constrained availability of personnel, shortages in PPE, and an increase in critically ill patients. These health care system responses to COVID-19–related care needs may also result in other unintentional changes in standard practices for preventing the spread of MDROs and device-associated infections. For example, less frequent patient bathing with CHG or less aggressive MDRO screening practices. These changes may stem from competing clinical priorities, challenges in personnel availability, and an effort to minimize staff members’ interaction time with patients. Facilities may experience critical shortages in personnel for nursing and environmental services, resulting from staff members’ illness, quarantine, and a surge in the number of patients with COVID-19. Increased patient-to-staff member ratios and the need to minimize patient contact may lead to unidentified IPC breaches.
Lastly, infection preventionists are under additional pressure to ensure their organizations are aware and responding to ever-changing requirements and recommendations. This will remain an ongoing challenge as it takes an incredible amount of time to stay up-to-date on all information necessary to implement effective control measures as well as constantly sorting through new information as our science evolves.
At this time, we know the pressures on our national health care infrastructure will continue to expand going into 2021. This week the CDC received forecasts from 30 modeling groups of new reported COVID-19 cases in the next 4 weeks ending on January 2, 2021, to be between 1 million to 2.3 million new cases. In 2020, 21 hospitals closed, in part, due to the financial damage linked to the COVID-19 pandemic. 32 additional hospitals filed for bankruptcy in the same time frame.
Nurses must practice under increasingly stressful and potentially life-threatening conditions. More than 500,000 seasoned nurses are anticipated to retire by 2022, while the U.S. Bureau of Labor Statistics projects the need for 1.1 million new RNs for expansion and replacement of retirees to avoid a nursing shortage.
With the pandemic, the need for seasoned, expert infection preventionists is greater than ever. A survey of infection prevention demographic characteristics, published by APIC in 2017, showed at that time, that 41% of the infection prevention workforce was over the age of 56. A significant number of these experts will be retiring in the near term.
In 2021 expect to see continued pressures on health care infrastructures as well as providers and needed infection prevention experts. This will most likely further drive the need for automation in electronic clinical surveillance.