Universal pandemic precautions-An idea ripe for the times

• Published in: Infection control and hospital epidemiology Vol. 41; no. 11; pp. 1321 - 1322
• Main Authors: Weber, David J, Babcock, Hilary, Hayden, Mary K, Wright, Sharon B, Murthy, A Rekha, Guzman-Cottrill, Judith, Haessler, Sarah, Rock, Clare, Van Schooneveld, Trevor, Forde, Corey A, Logan, Latania K, Malani, Anurag, Henderson, David K
• Format: Journal Article
• Language: English
• Published: United States Cambridge University Press 01-11-2020
• Subjects: Acquired immune deficiency syndrome; AIDS; Coronaviruses; COVID-19; Disease control; Gloves; Hepatitis B; HIV; Human immunodeficiency virus; Nursing; Pandemics; Prophylaxis; Public health; State of the Pandemic; United States > US
• ISSN: 0899-823X; 1559-6834
• DOI: 10.1017/ice.2020.327

The number of acute HBV infections among healthcare personnel (HCP) was estimated as 17,000 infections in 1983.1 In the United States, 58 confirmed and 150 possible cases of occupationally acquired HIV infection were reported to the Centers for Disease Control and Prevention (CDC) between 1985 and 2013.2 The threat of bloodborne pathogens to HCP led to institution of universal precautions (now called standard precautions), which recommend that HCP wear gloves for anticipated contact with all body fluids except sweat. Implementation of standard precautions plus pre-exposure hepatitis B vaccine, postexposure prophylaxis for HIV and HBV, and engineering controls (eg, blunted suture needles, self-sheathing needles, needleless connectors, etc) have dramatically reduced the risks for HIV and HBV acquisition by HCP. Since 1999, only 1 confirmed case of HIV (a laboratory technician who sustained a needle puncture while working with a live HIV culture in 2008) has been reported.2 The rate of HBV infections among HCP decreased ~98% from 1983 to 2010.1 Although some initial pushback occurred with the implementation of standard precautions due to concern that routine wearing of gloves would be poorly received by patients and impair the ability to perform procedures such as placing intravenous catheters, they are routinely practiced and accepted today. [...]we realize that institution and discontinuation of universal pandemic precautions should be based on current local case numbers (or rates or burden) and local prevalence of infection in asymptomatic populations (eg, preprocedural test positivity rates because symptom screening cannot detect these potentially infectious patients.