Lessons learned from an outbreak of COVID-19 in the head and neck surgery ward of a Japanese cancer center during the sixth wave by Omicron

• Published in: Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 28; no. 12; pp. 1610 - 1615
• Main Authors: Itoh, Naoya, Akazawa, Nana, Ishikane, Masahiro, Kawabata, Takanori, Kawamura, Daichi, Chikusa, Tomoyuki, Kodama, Eiichi N., Ohmagari, Norio
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-12-2022; Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd
• Subjects: Cancer center; Cancer patient; COVID-19; Hospital outbreak; Nosocomial infections; Omicron; Original; COVID-19; Cancer center; Cancer patient; Hospital outbreak; severe acute respiratory syndrome coronavirus 2; methicillin-resistant Staphylococcus aureus; variant of concern; coronavirus disease; Omicron; Nosocomial infections; carbapenem-resistant Enterobacterales
• ISSN: 1341-321X; 1437-7780
• DOI: 10.1016/j.jiac.2022.08.010

We describe a coronavirus disease (COVID-19) outbreak in a cancer center's head and neck surgery ward and the interventions to halt ongoing exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among healthcare workers and patients with cancer.
Case definition included all healthcare workers and all patients associated to the ward from January 27 to January 31, 2022 with a positive SARS-COV-2 antigen test. This retrospective descriptive study was conducted between January 27, 2022, and February 14, 2022.
From January 28, 2022, to February 9, 2022, 84 cases (36 healthcare workers, 48 patients) were screened, and 26 (12 healthcare workers, 14 patients) were identified as SARS-CoV-2-positive. The proportion of healthcare providers who performed aerosol generating procedures on positive patients was 91% for positive cases and 49% for non-cases. Room sharing with patients with COVID-19 was 64% for positive cases and 21% for non-cases (57% vs. 21% with positive tracheostomy patients; 43% vs. 9% with positive cases using a nebulizer; 50% vs. 15% with positive cases requiring sputum suctioning, respectively). Compliance with the universal masking policy for patients was 36% of positive cases and 79% of non-cases.
This is the first report of a nosocomial outbreak of COVID-19 in a head and neck surgery ward during the Omicron pandemic. Notably, there were a high number of positive cases among healthcare workers who performed aerosol generating procedures for positive patients and patients who shared the room with a patient with COVID-19 with the potential to generate aerosols.