Environmental contamination is an important mode of transmission
for COVID-19. This means residual contamination of environmental
surfaces can lead to infection. Contaminated surfaces are touched by
hands, followed by touching of the eyes and nasal or oral pharynx.
COVID-19 is an enveloped virus that is highly susceptible to isopropyl
alcohol, chlorhexidine, and low concentrations of povidone iodine;
the virus is inactivated with brief exposure to these agents. Timely
use of these agents, based on our knowledge of the epidemiology of
transmission of other infectious organisms like S. aureus, creates an
evidence-based defense strategy against COVID-19. Improvements in
hygiene practices, such as patient decolonization, will help combat
the spread of COVID-19. When exposure to COVID-19 occurs, it puts
your providers and subsequent patients at increased risk of infection
because of the transmissibility of the virus. You must consider not
just the patient undergoing surgery, but patients who will receive care
in the same ORs.
Nasal decolonization is currently applied to a subset of patients —
primarily those undergoing joint replacements — but the evidence for
surgical site infection prevention suggests its use should be more
widespread.
COVID-19 should serve as a wake-up call. We need to pay attention
to limiting transmission by universally applying evidence-based meas-
ures, including nasal decolonization. It's through that approach that
we'll control the spread of bacteria and viruses, reduce infections and
dramatically improve patient outcomes.
OSM
Dr. Loftus (randy-loftus@uiowa.edu) is a professor of anesthesiology at the
University of Iowa in Iowa City.
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