(2020/03/03)Stepping Up Infection Control Measures in Ophthalmology During the Novel Coronavirus Outbreak: An Experience From Hong Kong(+中文摘要轉譯)

香港眼科於武漢肺炎流行時採取三個層級的管制措施。

  • 行政層級。為降低病患就診,以簡訊通知病患重新安排就診及取藥,並提供諮詢電話。為降低感染風險,有發燒、呼吸道症狀、急性結膜炎、或有疫區旅遊史的病人,則要求病患14天後再到眼科求診。
  • 環境控制。為降低飛沫傳染,檢查儀器上加裝防護罩,設備加強消毒,並提供員工眼罩。
  • 鼓勵使用口罩、洗手、及其他個人防護裝備。(國衛院莊淑鈞博士整理)

Purpose: Coronavirus disease (COVID-19) has rapidly emerged as a global health threat. The purpose of this article is to share our local experience of stepping up infection control measures in ophthalmology to minimise COVID-19 infection of both healthcare workers and patients.

Methods: Infection control measures implemented in our ophthalmology clinic are discussed. The measures are based on detailed risk assessment by both local ophthalmologists and infection control experts.

Results: A three-level hierarchy of control measures was adopted. First, for administrative control, in order to lower patient attendance, text messages with an enquiry phone number were sent to patients to reschedule appointments or arrange drug refill. In order to minimise cross-infection of COVID-19, a triage system was set up to identify patients with fever, respiratory symptoms, acute conjunctivitis or recent travel to outbreak areas and to encourage these individuals to postpone their appointments for at least 14 days. Micro-aerosol generating procedures, such as non-contact tonometry and operations under general anaesthesia were avoided. Nasal endoscopy was avoided as it may provoke sneezing and cause generation of droplets. All elective clinical services were suspended. Infection control training was provided to all clinical staff. Second, for environmental control, to reduce droplet transmission of COVID-19, installation of protective shields on slit lamps, frequent disinfection of equipment, and provision of eye protection to staff were implemented. All staff were advised to measure their own body temperatures before work and promptly report any symptoms of upper respiratory tract infection, vomiting or diarrhoea. Third, universal masking, hand hygiene, and appropriate use of personal protective equipment (PPE) were promoted.

Conclusion: We hope our initial experience in stepping up infection control measures for COVID-19 infection in ophthalmology can help ophthalmologists globally to prepare for the potential community outbreak or pandemic. In order to minimise transmission of COVID-19, ophthalmologists should work closely with local infection control teams to implement infection control measures that are appropriate for their own clinical settings.

Keywords: COVID-19; Coronavirus; Hong Kong; Infection control; Ophthalmology; SARS-CoV-2.

Author:Tracy H T Lai, Emily W H Tang, Sandy K Y Chau, et al.
Link:https://reurl.cc/8G4xy7