488 - SARS-CoV-2 Preparedness among Community Hospitals in Southeastern United States

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Presenting Author(s)

Sonali D. Advani

Assistant Professor
Duke University School of Medicine
Durham, NC
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

EB

Esther Baker

Infection Preventionist
Duke Infection Control Outreach Network (DICON)
Senoia, Georgia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
AC

Andrea Cromer

Infection Preventionist
Duke Center for Antimicrobial Stewardship and Infection Prevention
Inman, South Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
BW

Brittain A. Wood

Infection Preventionist
Duke Infection Control Outreach Network (DICON)
Morrisville, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
KC

Kathryn Crawford

Infection Preventionist
Duke Infection Control Outreach Network (DICON)
Durham, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LC

Linda S. Crane

Infection Preventionist
Duke Infection Control Outreach Network (DICON)
Danville, Virginia
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LA

Linda Adcock

Infection Prevenionist
Duke Infection Control Outreach Network (DICON)
Durham, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
LR

Linda Roach

Infection Preventionist
Duke Infection Control Outreach Network (DICON)
Lexington, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
PP

Polly W. Padgette

Infection Preventitionist
Duke Infection Control Outreach Network (DICON)
KNIGHTDALE, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
DA

Deverick J. Anderson

Professor
Duke Center for Antimicrobial Stewardship and Infection Prevention
Durham, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
DS

Daniel Sexton

Professor of Medicine
Duke University School of Medicine
Durham, North Carolina
Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Background: The SARS-CoV-2 pandemic has placed a tremendous strain on the U.S. healthcare system leading to personal protective equipment (PPE) and resource shortages. Hospitals have developed contingency and crisis capacity strategies to optimize the use of resources, but, to date, community hospital preparedness has not been described.

Methods: We performed a cross-sectional survey of infection preventionists in 60 community hospitals within the Duke Infection Control Outreach Network between April 22 and May 7, 2020 using Qualtrics. The survey included 13 questions related to resource availability, crisis capacity strategies and approaches to testing.

Results: We received 50 responses during the study period with a response rate of 83%. Community hospitals reported varying degrees of PPE shortages (Table 1); 80% of community hospitals were implementing strategies to extend and reuse N95 respirators, Powered Air-Purifying Respirators, face shields and face masks. Over 70% of facilities reported reprocessing N95 respirators (Figure 1). Almost all facilities reported universal masking at time of this survey with 90% performing daily employee screening at point of entry. Additionally, 8% of facilities restarted elective procedures at the time of this survey, but only 54% of facilities reported that they were performing preoperative testing for SARS-CoV-2. Thirty-seven percent of facilities performed one SARS-CoV-2 test before discharging an asymptomatic patient to skilled nursing facility, while 43% of facilities performed 2 tests.Table 1- Supply of Personal Protective Equipment and other resources in 50 community hospitals in southeastern United States

Figure 1: Different methods of reprocessing N95 respirators by 50 community hospitals in southeastern United States

Conclusion: Our findings reveal differences in resource availability, crisis capacity strategies and testing approaches used by community hospitals in preparation for the SARS-COV-2 pandemic. Lack of harmonization in approaches may be in part due to differences in state guidelines and decentralized federal approach to SARS-CoV-2 preparedness.