Apparently, it’s Monday Morning somewhere…

I suppose it was only a matter of time before the forensic unraveling of the last two years or so would begin to take center stage, so the latest issuance from the folks at the Association for Professionals in Infection Control & Epidemiology (APIC — https://apic.org/between-a-rock-and-hard-place-march-2022/) is surprising only to the extent that they are (more or less) the first.

That said, we’ve all certainly had more than enough time to parse through a lot of what’s happened over the last two years and I don’t think that there’s be any substantial disagreement with the recommendations (more on those in a moment).

Most of (actually, pretty much all) the recommendations take on the form of things that should be undertaken by the various levels of government and various agencies contained within those structures, so there’s no immediate regulatory impact (by that, I mean that there doesn’t seem to be anything that any of the accreditation organizations can take and use as the basis for survey findings). But you can certainly make the case that some of the recommendations would likely/eventually be administered by CMS. So:

1. Improve PPE—particularly funding of research to develop one-size fits-all respiratory devices that can be used during infectious disease emergencies, as well as the development of PPE that is cleanable and reusable.

2. Promote the use of masks in response to infectious disease threats—while this stops short of consideration of a mandate during “normal” times, it’s kind of bumping up against it. As a frequent airplane traveler, I know the mask mandate has been extended in the U.S. for a bit longer (April 18, 2022, as I write this), but I’m not sure that I won’t continue to wear a mask when I travel. Everyone will get to make their own decisions on this, probably before the summer months, but I’m thinking about extending my personal mask mandate.

3. Improve the supply chain for PPE and disinfection supplies—industry in general is not necessarily designed to be nimble, so it would seem that stockpiling might be something of a useful strategy, but then you have to get into the whole issue of monitoring expiration dates, etc. I suspect that there are expiration dates on products for which there is no demonstrable change in efficacy (for instance, anything that has a specific date of expiry—day/month/year—I suspect some gamesmanship—it’s good until midnight, then at 12:00:01 it turns into a pumpkin—maybe Cinderella is responsible for this…)

4. Infection preventionists should play prominent roles during a pandemic—I don’t know how any healthcare organization would have been able to endure the last 24 months without some sort of access to infection preventionist resources, inclusive of participation in command and response activities. I suppose, from a practical standpoint, the HEICS job action sheets do not necessarily reflect Infection Control & Prevention as a specific pursuit, but I don’t know that it’s possible to work through an event like this without their participation. Would a regulatory mandate change that? I guess it depends on the availability of resources as much as anything. Hopefully, there’s a plethora of IC professionals in the pipeline.

5. Properly trained healthcare workers should staff high-risk settings—absolutely—you can’t keep patients and staff safe without competent staff, including IC support (see also No. 4.)

6. Promote infection prevention and control surge capacity—again, a pretty reasonable “ask,” but the trick will be figuring out what that looks like. It would likely be event-driven and hopefully any events we’ll be driving in the foreseeable future will be somewhat less impactful.

7. Testing and contact tracing—we can only get better at this—right?

8. Data sharing and interoperability for infection surveillance data—I suspect that, over time, this one is going to prove to be the most important. Looking back over the last decade, we definitely had some close calls with Ebola, H1N1, etc.—but were those “misses” because of luck or design? My gut tells me that we need to keep a closer eye on the global aspects of pandemic identification—the sooner we know about outbreaks, the more likely we can effectively manage the outbreaks.

9. Vaccine confidence—I get this and I know there’s quite a gap in the U.S. on this front (part of free will, I suppose), but I can’t say that I’ve heard a lot of about global perceptions on this front, so, as an opportunity for improvement, this certainly rules in.

10. Pandemic preparedness workforce capacity and training—again, no disagreement from me on this front. I just don’t know how it happens. The report indicates a lot of governmental “should,” but I don’t know how many of them (and this is true for a lot of the recommendations) will become governmental “cans.” Making ends meet in the healthcare industry is always going to be challenging and the level to which government is inclined to provide assistance is always going to be changeable, at the very least.

About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at stevemacsafetyspace@gmail.com.