Latest / The SHEA Podcast / COVID-19 The Role of State Healthcare-Associated Infections Programs, 12/3

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COVID-19 The Role of State Healthcare-Associated Infections Programs, 12/3 · The SHEA Podcast

• 0:09
  SPEAKER_01: Welcome to the REF Response Podcast, brought to you by the Society for Healthcare Epidemiology of America, today, promoting the prevention of healthcare associated infections and antibiotic resistance and seeking to advance the field of healthcare epidemiology and antibiotic stewardships.
• 0:23
  SPEAKER_01: I am Dr.
• 0:23
  SPEAKER_01: David Danick from the University of Connecticut and I will serve as today's podcast moderator.
• 0:28
  SPEAKER_01: The session on the podcast does not reflect state's perspective, but facilitates communication of multiple perspectives and experiences as we go through this challenging time together.
• 0:37
  SPEAKER_01: Today is excited to launch this episode of the podcast, COVID-19 updates what we know now.
• 0:42
  SPEAKER_01: Today's discussion will focus on the role of state healthcare associated infection programs in the COVID-19 response.
• 0:49
  SPEAKER_01: Our speakers today are Dr.
• 0:50
  SPEAKER_01: Vivian Leon, medical epidemiologist and HAI program coordinator at the Connecticut Department of Public Health, and Rosa Tammer, Infectional Epidemiologist at the Oregon Health Authority.
• 1:01
  SPEAKER_01: Thank you for joining us today.
• 1:03
  SPEAKER_01: Before we start our discussion, I would like to turn over to Dr.
• 1:06
  SPEAKER_01: Prynne to get us started with a brief news and guidance update for the week.
• 1:10
  SPEAKER_03: Thank you, David.
• 1:11
  SPEAKER_03: As of this recording, according to the WHO, there are 63 million cases of COVID-19 worldwide with 1.5 million deaths.
• 1:19
  SPEAKER_03: In the U.S., there are 13.4 million cases and 266,000 deaths.
• 1:33
  SPEAKER_03: In the U.S., the Advisory Council on Immunization Practices recommended that healthcare workers and residents of long-term care facilities are to be priority populations for vaccination when there's an approval in the U.S.
• 1:46
  SPEAKER_03: Pfizer and Moderna have applied for emergency use authorizations in the U.S., and the FDA Advisor Committee will review those applications within the network.
• 2:34
  SPEAKER_03: The majority of cohort and cross-sectional studies also demonstrated this disparity for Hispanic populations compared to non-Hispanic white populations.
• 2:42
  SPEAKER_03: In addition, the authors concluded with moderate confidence that African American and black populations have 1.5 to 3 times a higher risk for COVID-19 hospitalization compared to white populations, and there's 1.5 times higher for Hispanic populations compared to non-Hispanic white populations.
• 3:02
  SPEAKER_03: The authors concluded with a high confidence that African American and black populations experienced 15% access to COVID-19 data and 3.2 times higher risk of COVID-19 mortality compared to white populations.
• 3:16
  SPEAKER_03: For Hispanic populations, the authors noted 21% excess COVID-19 data and 3.2 times higher risk of COVID-19 mortality compared to non-hispanic white populations, although with moderate rather than high confidence in that findings.
• 3:30
  SPEAKER_03: The authors did not notice 30 increased fatality among these regional and ethnic groups, although they started low confidence in that findings, due to their data being limited to only one health care system.
• 3:48
  SPEAKER_03: During the COVID-19 third from February to July, and a 53 hospital and carbon interest, 34 patients were identified with hospital-acquired infections or colonization of carbon resistance associated after bananing I during the time period with the 28 of those cases coinciding with COVID-19 storage-related for the personnel kind of covers between more than expensive changes and hospital infection control policies.
• 4:36
  SPEAKER_03: The identification of the carbapenum-resistant acetated actor balmanii cluster in early May, along with a reduction in the COVID-19 surge, led to re-implementation of research policies, with a subsequent decrease in hospital-associated carbapenum-resistant acinata bacteria balmanii cases by June and a return to the baseline of zero cases in August.
• 4:57
  SPEAKER_01: So thank you, Dr.
• 4:58
  SPEAKER_01: Prinz, for that news and guidance update.
• 5:01
  SPEAKER_01: I'd like to move into moderated discussion with our guest speakers.
• 5:04
  SPEAKER_01: First off, Dr.
• 5:05
  SPEAKER_01: Leon Rosa, thank you for joining the podcast today.
• 5:08
  SPEAKER_01: We're really excited to have you on.
• 5:10
  SPEAKER_01: So the first topic I want to talk about is you know, giving our podcast listeners come from a wide variety of backgrounds.
• 5:16
  SPEAKER_01: Some work in state care hospitals, some work in other types of healthcare facilities, some work in public health, some work in research and laboratories.
• 5:22
  SPEAKER_01: I was hoping you can give kind of a bigger picture of the role of the state HAI programs, and then we can talk a little bit about how this has changed the evolution into the COVID-19 pandemic.
• 5:31
  SPEAKER_01: So I'll start with Vivian.
• 5:33
  SPEAKER_01: Can you tell us a little bit about the role of the HCI program in Connecticut and how this has evolved over the past year with COVID-19?
• 5:40
  SPEAKER_04: Sure.
• 5:40
  SPEAKER_04: So CDC funds healthcare associated infections programs or HEI programs in each state, in addition to some territories and major cities in the U.S.
• 5:51
  SPEAKER_04: And prior to this pandemic, HEI programs were geared towards HEI surveillance, response, and prevention.
• 6:00
  SPEAKER_04: We work with healthcare facilities across the healthcare spectrum, whether it's hemodialysis facilities, acute care, long-term acute care, and then of course nursing homes.
• 6:10
  SPEAKER_04: In addition to outpatient facilities, we do a surveillance using NHSN and using laboratory surveillance when it comes to multidrug resistant organisms, such as highly resistant carbapenamase-producing organisms.
• 6:24
  SPEAKER_04: We are looking at the data and collaborating with healthcare organizations to use the data to drive prevention measures.
• 6:33
  SPEAKER_04: We also respond for containment of MDRO outbreaks, working, for example, with nursing homes and hospitals that share patients with a highly resistant organism such as Canadaoris or a carbapenamase-producing acininobacter.
• 6:51
  SPEAKER_02: Rosa, do you have anything else to add?
• 6:53
  SPEAKER_02: I think that was a great summary.
• 6:55
  SPEAKER_02: I think every state HAI program is structured a little bit differently.
• 7:00
  SPEAKER_02: In Oregon, our program has been, the major roles have been, of course, to prevent and contain infectious disease spread in healthcare settings, as Vivian mentioned, collecting, validating, and publishing statewide data on reportable healthcare-associated infections, and conducting training on a broad array of topics like infection control, surveillance strategies, and antimicrobial stewardship, collaborating with our state and local partners, as well, of course, as our partners at CDC to design, conduct, and implement collaboratives and other projects to gain information about things like whether infection prevention and control practices vary across different types of settings, how these infections are identified and tracked, what risk factors might be associated with different types of healthcare exposures.
• 7:44
  SPEAKER_02: And we also lead response for reports of transmissible pathogens in healthcare settings as well as for infection control breaches.
• 7:53
  SPEAKER_02: We also have core duties outside of healthcare-associated infections for our staff in our program, providing technical assistance for our databases, serving in on-call capacities, et cetera.
• 8:04
  SPEAKER_02: So that has been the overall role kind of traditionally of our program prior to COVID-19.
• 8:10
  SPEAKER_01: Thanks for providing that backdrop.
• 8:12
  SPEAKER_01: I think it's really helpful for listeners to understand the diversity of the roles of the HAI programs.
• 8:18
  SPEAKER_01: It's quite broad.
• 8:18
  SPEAKER_01: I imagine there's going to be some variability from state to state.
• 8:21
  SPEAKER_01: But I want to shift into COVID-19.
• 8:24
  SPEAKER_01: So I'm interested to hear how your respective programs have evolved with regard to the COVID-19 pandemic response.
• 8:30
  SPEAKER_01: Both of you have had very essential roles in your respective programs.
• 8:33
  SPEAKER_01: And I'd imagine that's not a one-size-fits-all.
• 8:36
  SPEAKER_01: So different HAI programs are going to have different roles.
• 8:38
  SPEAKER_01: But I was hoping you could at least share your experiences with regard to the role of you and your program the COVID-19 pandemic.
• 8:45
  SPEAKER_01: I'll start with Rosa.
• 8:46
  SPEAKER_01: Can you talk a little bit about how things have changed with COVID-19 for you and your group and the HII program?
• 8:52
  SPEAKER_02: Absolutely.
• 8:53
  SPEAKER_02: Thank you.
• 8:54
  SPEAKER_02: So we do continue our core functions: surveillance, responding to breaches of infection control practices, multi-drug resistant organism investigations, grant writing.
• 9:04
  SPEAKER_02: However, many of our activities, like collaboratives and educational initiatives, have been pivoted or delayed as we focus more on projects related to COVID-19.
• 9:13
  SPEAKER_02: And this is really necessary, both because of the critical nature of the current pandemic, and also because our healthcare partners are unlikely to be able to devote significant resources to work on non-COVID-19 projects at this point.
• 9:25
  SPEAKER_02: We have shifted to a more regional model to improve access to infection prevention experts and expanded infection control training for program epidemiologists as well as increased our field work capacity.
• 9:38
  SPEAKER_02: And the focus of our program has actually broadened a bit.
• 9:41
  SPEAKER_02: And we continue to provide infection prevention and control consultation related to COVID-19 outbreaks in healthcare settings, but we also support other congregate settings with similar containment challenges.
• 9:53
  SPEAKER_02: So for those facilities, we provide subject matter expertise, infection control consultation, linkages to practical resources like PPE, disinfectants, testing supplies, and specimen collection, as well as do more sort of follow-up and implementation checks than we had previously, which I think sort of speaks to the expansion of our role as well.
• 10:13
  SPEAKER_02: And then finally, we work more with our regulatory partners than in the past, for example, during joint site visits and consultations, together with state survey staff, establishing information sharing via data use agreements.
• 10:27
  SPEAKER_02: So developing those relationships has been really important and we believe benefits everyone involved.
• 10:33
  SPEAKER_01: That's great.
• 10:33
  SPEAKER_01: I think you really highlighted a lot of what involves the HEI programs.
• 10:36
  SPEAKER_01: So Vivi, I'm interested in your perspective in terms of how COVID-19 has impacted the evolution of the HAI program as.
• 10:44
  SPEAKER_04: Yes, I think Rosa was correct in saying every HEI program is different, but we also do a lot of the same things.
• 10:50
  SPEAKER_04: And I would say that HEI programs across the US have definitely increased in their scope of work and their collaborations.
• 10:59
  SPEAKER_04: In Connecticut, prior to COVID-19, we were working very closely with clinical laboratories and hospitals on the detection and response for multidrug-resistant organisms, bacteria, and fungus.
• 11:12
  SPEAKER_04: And now we've almost fully shifted to viral containment, and we focus most of our time in the long-term care sector.
• 11:20
  SPEAKER_04: Like Oregon, we are working more closely with our state survey agency to help them understand the ever-changing guidance as we learn more about the SARS-CoV-2 virus.
• 11:31
  SPEAKER_04: And given how small our state is and how limited our state public health department is in expertise, we are also involved in a lot of statewide activities in the response, such as determining testing strategies across the state, determining resource allocation methods, and engaging healthcare partners in conversations with state governments.
• 11:54
  SPEAKER_01: Great.
• 11:54
  SPEAKER_01: I think that's really helpful to understand sort of evolving role of each of the different HAI programs.
• 11:59
  SPEAKER_01: And I know your programs are just two examples, 50 different examples out there throughout the country that are all a little bit different.
• 12:05
  SPEAKER_01: You know, I've always viewed the HAI programs as having strength in both their content expertise, but the other strength being the relationship that these programs have across different types of healthcare facilities.
• 12:16
  SPEAKER_01: You know, a lot of us are coming from acute care hospitals, and our perspectives, you know, are really based on what we see in acute care hospitals.
• 12:22
  SPEAKER_01: But COVID-19 has shown that healthcare associated infections occur all over.
• 12:26
  SPEAKER_01: And I think that the HAI programs are really particularly valuable in that sense.
• 12:30
  SPEAKER_01: So can you share a little bit the relationships that you have had and maybe some that you've developed in the COVID-19 response in providing that expertise to areas outside of acute care hospitals?
• 12:39
  SPEAKER_01: I'll turn to you, Vivian, first on that one.
• 12:42
  SPEAKER_04: The COVID-19 pandemic has spurred us to develop relationships very quickly with areas of the healthcare sector that we might not have had strong relationships with before, including the hemodialysis sector and assisted living.
• 12:58
  SPEAKER_04: And an emerging area is residential care homes.
• 13:02
  SPEAKER_04: So homes that do not necessarily have a medical model, but a social model.
• 13:07
  SPEAKER_04: Rosa did refer to some of these other congregate settings earlier, like those outpatient substance abuse treatment centers or even halfway houses.
• 13:17
  SPEAKER_04: These are all areas needing infection control expertise where they didn't have it before.
• 13:22
  SPEAKER_04: And the HEI programs in state and local health departments are where that expertise is found and where they are reaching out to for help.
• 13:30
  SPEAKER_01: And Rosa, anything to add based on your experience working with all different types of healthcare facilities in your area?
• 13:36
  SPEAKER_02: Yeah, well, I think there's really been a push over the last few years for healthcare associated infection programs across the country to address these infections across the continuum of care.
• 13:48
  SPEAKER_02: Vivian mentioned hemodialysis, skilled nursing, other long-term and outpatient settings.
• 13:54
  SPEAKER_02: So the good news is that these efforts really laid the groundwork and gave us a foot in the door for our current efforts.
• 14:00
  SPEAKER_02: And we could even go back to funding for healthcare associated infections post-Ebola to inventory these facilities across the continuum of care in each of our states.
• 14:10
  SPEAKER_02: Our network is notably bigger, and our teams are routinely working with healthcare settings of all kinds, as well as healthcare tangential settings.
• 14:19
  SPEAKER_02: So at the moment, many of our resources and response efforts are focused on non-acute care settings, just as Vivian mentioned, like long-term care, group homes, even those that really kind of fall sort of quite far outside of a medical model, like correctional settings or agriculture.
• 14:35
  SPEAKER_02: So we are mainly just working now to provide the kind of support that we have to offer, that is infection prevention and control expertise to the facilities and congregate settings of all types that are most in need of assistance.
• 14:47
  SPEAKER_01: Thanks for sharing that.
• 14:47
  SPEAKER_01: I think we're all learning that affection prevention and control encompasses everything, not just limited to certain types of facilities, but so many different areas, healthcare facilities, also non-healthcare cognitive settings, that you know the COVID-19 pandemic has highlighted the importance of hex-minute expertise in all those different areas.
• 15:03
  SPEAKER_01: So I want you guys to reflect a little bit on the last year or so and think about your role as your state specifically, and maybe share with the audience what some of the challenges are maybe what you find to be one of the notable challenges of the COVID-19 response in your area and how you respond to that challenge and what that looks like in the future.
• 15:20
  SPEAKER_01: So I'll turn to Vivian on that one first.
• 15:22
  SPEAKER_01: What can you see as the most challenging part of the COVID-19 response in the state that you've seen and how have you navigated that over the past year?
• 15:29
  SPEAKER_04: There have been so many challenges, both for the self-care sector and the public health sector.
• 15:34
  SPEAKER_04: I would say public health messaging is one of the most challenging parts of our response.
• 15:40
  SPEAKER_04: Clear and consistent messaging to the public about the risks of infection and how to protect themselves.
• 15:47
  SPEAKER_04: It's compounded by the ever-changing guidance as we learn more.
• 15:51
  SPEAKER_04: And it's not unexpected with a novel pathogen for messaging to be difficult.
• 15:56
  SPEAKER_04: For the public and for clinicians alike, changing guidance on who is infectious, what PPE we should be wearing.
• 16:05
  SPEAKER_04: This has been compounded by low resources in terms of staffing, PPE availability, testing resources being strained along with testing that is both helpful and challenging in that they are getting expedited FDA emergency use approvals, and we're using antigen tests in ways that we haven't used before.
• 16:27
  SPEAKER_04: So the public health messaging, I would say, has been the most challenging part, and it will continue to be.
• 16:33
  SPEAKER_04: I think we are learning a lot about how to better message to the public, but we always seem to be a few steps behind what the public wants to hear or needs to hear.
• 16:42
  SPEAKER_01: Well, thanks for sharing that.
• 16:43
  SPEAKER_01: I think you know, speaking from the acute care hospital perspective, we shared similar challenges in providing information that is based on the best available guidance that keeps evolving is something that we have also been bounced up with.
• 16:54
  SPEAKER_01: So what do you think, Rosa, from your perspective, what's been the most challenging part of the COVID-19 response in Oregon?
• 16:59
  SPEAKER_02: Yeah, I think Viviane really touched on so many of these major challenges.
• 17:04
  SPEAKER_02: So of course, tremendous resources are needed in public health and healthcare at all levels to respond to COVID-19.
• 17:11
  SPEAKER_02: There has been a ton of effort to get more infection control expertise housed at the State Health Department level and here within our healthcare associated infections programs specifically.
• 17:20
  SPEAKER_02: Infection prevention expertise, particularly as it kind of relates to varied healthcare settings, remains a key and often limited resource.
• 17:28
  SPEAKER_02: And kind of related to that, reduced staffing in the clinical environment or turnover in staffing and leadership is also a major challenge.
• 17:37
  SPEAKER_02: Of course, healthcare workers can be excluded due to their own illness, and there are real challenges related to kind of a fear of working with infected patients or residents.
• 17:46
  SPEAKER_02: As Vivian mentioned as well, communications is something that we are constantly working to improve.
• 17:52
  SPEAKER_02: So, how can we inform the general public?
• 17:54
  SPEAKER_02: How can we address misinformation?
• 17:56
  SPEAKER_02: And how can we get consistent and timely guidance at all levels to kind of lay people, clinicians, and local public health authorities as recommendations are changing all the time.
• 18:07
  SPEAKER_02: We're really building the plane while it's in the air, so to speak, new data systems, new guidance, the ground sort of shifts beneath us on a daily basis.
• 18:15
  SPEAKER_02: For example, we just really haven't been doing this long enough for us to really know things like what is the long-term outcome of COVID-19 infection in all cases, or how long does immunity last after natural infection, or what is the clinical significance of antibody testing results?
• 18:31
  SPEAKER_02: So we are building this knowledge and seeing more data come out in the published literature all the time.
• 18:36
  SPEAKER_02: But the challenge is, you know, translating this information into practice and recommendations and then making sure the right people have that information so it's actionable.
• 18:47
  SPEAKER_01: I think that's very well described.
• 18:48
  SPEAKER_01: I hadn't heard of that airplane analogy of building the airplane while it's flying, but that seems like salient given the situation.
• 18:54
  SPEAKER_01: You know, you both have broad perspectives on the COVID-19 pandemic from the public health approach.
• 18:59
  SPEAKER_01: I'm interested in hearing what your concerns are moving into the winter.
• 19:02
  SPEAKER_01: You know, we're seeing rises in cases across the country, and there's an evolution in what we're seeing in hospitals.
• 19:08
  SPEAKER_01: And in some good ways, we have new treatments, we have improvements in mortality rates, but you know, I'm interested in your perspective as to your biggest concerns moving into the winter.
• 19:17
  SPEAKER_01: So I'll start with Rosa.
• 19:19
  SPEAKER_01: So what do you see as the biggest concern from your view for heading into the upcoming month?
• 19:23
  SPEAKER_02: So I think this will not be unique to the Oregon Healthcare Associated Infections program by any stretch of the imagination, but influenza season is at the top of our mind, of course.
• 19:34
  SPEAKER_02: So, how will flu season make diagnosis and rollout of COVID-19 more difficult?
• 19:39
  SPEAKER_02: How will it impact our cohorting efforts in long-term care and other congregate settings, which has been an enormous challenge even before influenza season?
• 19:49
  SPEAKER_02: And how might our existing priorities like infection control, outbreak response, vaccination, and testing align with influenza efforts?
• 19:58
  SPEAKER_02: The symptom profile can be very similar, and coinfections or comorbid outbreaks are a concern and might be extremely dangerous and vulnerable populations.
• 20:07
  SPEAKER_02: As you mentioned, currently cases are surging across the country.
• 20:11
  SPEAKER_02: We're seeing more introduction events.
• 20:14
  SPEAKER_02: And then, of course, the holidays are well upon us.
• 20:18
  SPEAKER_02: Quarantine and pandemic fatigue is real, and winter weather will bring more activities indoors.
• 20:23
  SPEAKER_02: So these are some of the concerns in the general population.
• 20:26
  SPEAKER_02: And finally, I'll just mention that we continue to work towards further collaboration between Oregon and other state public health jurisdictions.
• 20:36
  SPEAKER_01: Thank you.
• 20:36
  SPEAKER_01: And what do you think, Vivian?
• 20:37
  SPEAKER_01: What's your biggest concern of the upcoming month?
• 20:40
  SPEAKER_04: Yeah, I agree.
• 20:41
  SPEAKER_04: Influenza is a major concern.
• 20:43
  SPEAKER_04: One of my biggest concerns for a while now has been COVID fatigue, particularly amongst our healthcare providers.
• 20:51
  SPEAKER_04: Our providers deserve a break, but they can't get one because almost the entire US is surging with COVID cases.
• 20:58
  SPEAKER_04: And that mental and emotional fatigue can lead us to wanting to have more in-person interactions.
• 21:05
  SPEAKER_04: It can lead us to being less attentive with source control, and it just makes our jobs a little more difficult.
• 21:11
  SPEAKER_04: So I'd like to take this opportunity to remind healthcare providers to prioritize their well-being as we continue on this marathon.
• 21:19
  SPEAKER_04: Though we hear that the vaccine is right around the corner, we know that this will continue to challenge us for a while.
• 21:26
  SPEAKER_01: Well, thank you for sharing that.
• 21:27
  SPEAKER_01: And we would like to also emphasize that our public health partners are focused on well-being as well, because the fatigue in the community and healthcare workers also tend to all of our public health partners, we're here to support you as well.
• 21:39
  SPEAKER_01: I mean, we have a very diverse audience for the podcast.
• 21:41
  SPEAKER_01: We have clinicians, we have folks in research, folks coming from the community listening to this podcast.
• 21:47
  SPEAKER_01: So if there was one thing that you wanted our audience to know about the state HAI programs, what would that be?
• 21:52
  SPEAKER_01: Because I'll start with Vivian.
• 21:54
  SPEAKER_04: So the HI programs are here to help healthcare facilities and also individual clinicians.
• 22:00
  SPEAKER_04: In even clinical laboratories.
• 22:02
  SPEAKER_04: We can help answer questions about infection control procedures.
• 22:06
  SPEAKER_04: We can help investigate if you've noticed a series of patient infections that might be related to a contaminated medical product or other common medical source.
• 22:17
  SPEAKER_04: And we can provide you with information about rates of certain healthcare-associated infections or pathogens in your state and nationally.
• 22:25
  SPEAKER_04: We're here as a resource.
• 22:26
  SPEAKER_04: We do not wish to be a burden, but when we work with you to investigate infections, we will ask you to gather a little more information to help us help you.
• 22:36
  SPEAKER_01: That's great.
• 22:36
  SPEAKER_01: And Rosa, any thoughts on what our audience would know about the ACI program?
• 22:41
  SPEAKER_02: Yes, I think it's possible that many clinicians may not know of this resource available at your state public health authority.
• 22:48
  SPEAKER_02: So at least in Oregon, we are often looking to partner with clinicians.
• 22:52
  SPEAKER_02: We need our clinical partners to help us advance our goals to reduce healthcare-associated infections.
• 22:57
  SPEAKER_02: And we want to hear from our clinical partners about their priorities and how we can be most helpful.
• 23:02
  SPEAKER_02: And there are forums for that.
• 23:04
  SPEAKER_02: We are also, as Vivian mentioned, a resource, hopefully both during COVID-19 and non-COVID-19 times.
• 23:11
  SPEAKER_02: Our purpose is primarily non-regulatory technical assistance.
• 23:15
  SPEAKER_02: And our recommendations are aimed towards improved safety for patients and healthcare personnel rather than punitive actions.
• 23:23
  SPEAKER_01: I think that's really valuable for our listeners to know that the state HAI programs are critical resources to partner and group to partner with.
• 23:30
  SPEAKER_01: Encourage any clinician who has a concern about an aspect of HAI prevention or response out of your local state HAI department.
• 23:37
  SPEAKER_01: All right, so before we wrap up, I'm very interested in hearing your perspectives on what the COVID-19 response is going to mean for HCI programs and what we may learn from COVID-19 response that's going to extend beyond the pandemic.
• 23:50
  SPEAKER_01: I'll turn to you, Rosa, first.
• 23:52
  SPEAKER_01: Talk to our listeners about improvements that you see coming out of the COVID-19 response and what you think will extend beyond the pandemic.
• 23:59
  SPEAKER_02: Thank you so much.
• 24:00
  SPEAKER_02: I think that we inevitably will see silver linings here, no matter how unfortunate the situation is.
• 24:07
  SPEAKER_02: So some of those might be additional requirements for infection prevention programs, staff and training in long-term care facilities, as well as more collaboration between public health and regulatory agencies.
• 24:19
  SPEAKER_02: In Oregon, we have kind of collaborative outright consultations and site visits, our new COVID response and recovery unit, and greater information sharing, kind of all in service of our shared goals, right, to prevent transmission of COVID-19.
• 24:34
  SPEAKER_02: And I think we're also already seeing increased awareness and understanding of infection prevention principles and practices and leadership and staff across the continuum of care, especially right in non-acute care settings, for example, in community-based care, like group homes for folks with disabilities.
• 24:51
  SPEAKER_02: And then also an increased awareness and understanding of how these infections can spread and the potential consequences of infectious disease in the community, right?
• 25:00
  SPEAKER_02: I think there's more general awareness, of course, the media, news, personal experience.
• 25:04
  SPEAKER_02: And also because of efforts to curtail spread in folks' workplaces, schools, and the institutions and groups that they interact with regularly.
• 25:13
  SPEAKER_02: So I think these are all some positive things that are coming out of what's currently going on.
• 25:19
  SPEAKER_01: Thanks, Vivian.
• 25:19
  SPEAKER_01: Any thoughts on this?
• 25:20
  SPEAKER_04: Yeah, I think Rosa summed it up.
• 25:22
  SPEAKER_04: We've identified gaps in our healthcare and social systems that can be filled.
• 25:29
  SPEAKER_04: We're already working on filling those gaps, and it will take a while after the pandemic to really plug them up.
• 25:36
  SPEAKER_04: In addition, I think the public and government leaders have come to understand the role and importance of public health, which will hopefully lead to more consistent and robust support for public health programs in the future.
• 25:48
  SPEAKER_01: Great.
• 25:49
  SPEAKER_01: I really like that.
• 25:50
  SPEAKER_01: Both of your optimistic viewpoints.
• 25:52
  SPEAKER_01: I want to thank you both for joining the podcast.
• 25:54
  SPEAKER_01: I think we've learned quite a bit about the HAI program and specific roles in the COVID-19 response.
• 25:59
  SPEAKER_01: And during this holiday season, I want to know that we are very grateful for the important work that you do.
• 26:03
  SPEAKER_01: So thank you for that.
• 26:04
  SPEAKER_01: And thank you for joining the podcast.
• 26:06
  SPEAKER_02: Thank you.
• 26:07
  SPEAKER_02: Pleasure to be speaking with you guys today.
• 26:10
  SPEAKER_01: This podcast can be accessed on SHA's online education center, learning CE, under the Rapid Response Program.
• 26:16
  SPEAKER_01: You'll also find resources such as the recorded webinars, healthcare facility outbreak preparedness in the SHAY COVID-19 town hall.
• 26:23
  SPEAKER_01: You can now receive 50% off 2021 SHA membership using the coupon code WELCOME2021DILING Checkout.
• 26:30
  SPEAKER_01: That concludes this episode of the Rapid Response Podcast.
• 26:33
  SPEAKER_01: Thank you for tuning in.