Introduction
The covid-19 virus is an extremely contagious communicable respiratory condition caused by a novel type of virus known as SARS-CoV-2. The virus was originally found in China in the final quarter of 2019, and by March 11th, 2020, had already spread to nearly every country on the planet, prompting WHO to proclaim it a worldwide pandemic (Lone and Ahmad, 2020). Despite the efforts of many organizations including the WHO, government of various countries, clinical institutions, and individuals’ precautions, the virus keeps spreading as it mutates into numerous versions of itself in order to avoid being brought under control (Noh and Danuser, 2021). Millions of individuals have been infected over the world, with a substantial number of deaths reported.
To discover appropriate infection control practices (IPC) of the virus, the government, various institutions, and health workers must work together to build a high-quality combination therapy system. The funds made up to prevent the plague should be put to good use by using evidence-based (EB) procedures. Other measures such as hand washing, social distance, environment sanitation, and mask wearing are advised since IPC alone cannot ensure complete viral eradication. These actions need public education and practice. Public compliance, on the other hand, is dubious and obstructs the virus’s control. The fundamentals of covid-19 infection and control will be examined in this study, as well as the obstacles of treatment of infections in the healthcare setting.
Nature of the Microorganism and Infection Spread
Nature
SARS-CoV-2 is a causal agent, according to microbiological pathogenicity. The SARS COV-2 viruses is a single-stranded coronavirus which has been genetically related to the SARS virus. During the initial stages of the condition, it sheds the most in the respiratory tract. The illness begins after early incubation and can persist up to 14 days, as per the World Health Organization (Cheng et al., 2021).
Infection spread
Williams (2020) describes the covid-19 infection chain as having six distinct phases.
Infectious stage
The SARS-CoV-2 virus causes the illness, which is extremely infectious and causes respiratory sickness. The symptoms of the covid-19 are very severe leading to extreme death cases globally.
Reservoir
The virus can be found in humans, the surroundings, or even animals. It can also be present in mucous, saliva, filthy hands, substances such as faces, respiratory droplets, or the tract in people, and so on. Clothes, walls, and other surfaces are among the surfaces. Coming into close conduct with infected surfaces mentioned above results to transmission of the virus. The virus can remain alive on the surface such as hands for approximately seven hours (Klompas et al., 2020).
Exit portal
Here’s how the SARS-CoV-2 virus spreads from its original source to a new ones. Through e expiratory air, droplets on soiled hands, or spurt-outs are all possibilities. Air transmission is the main channel through which people conduct the virus.
Transmission means
This is how the SARS-CoV-2 virus spreads from a patient’s lips, eyes, or nostrils to someone else’s. It can come via coughs, sneeze, or chatting, as well as indirectly or directly touch with the virus through contaminated objects or hands. According to Wilson et al. (2020), the virus is airborne and spreads by inhaled particles via aerosol-generating techniques.
Entry portal
The virus can enter the body through two routes: through the mouths, eyes, and nose, or by breathing. All body inlets can allow access for the virus if proper care and attention is not taken.
Susceptible host
Anyone can become infected with the covid-19 virus. Patients with poor immune systems, including those with chronic conditions such as respiratory illness, cancer, diabetic conditions, and the aged, are more vulnerable, and once infected, the symptoms are acute (Chiappelli, 2020). Breaking covid-19 viral transmission at any point in the chain, on the other hand, has a high chance of becoming an effective strategy to stop the disease.
The infection impacts the patient and the clinical workplace
Individuals with Covid-19 are more likely to be asymptomatic, with symptoms including coughing, breathing difficulty, lack of smell and taste, muscular discomfort, fever, hoarseness, and so on, and are more likely to develop deadly pneumonia that requires ventilation support and excessive oxygen levels (Volpicelli and Gargani, 2020). Standard precautions (SPs) are the fundamental safeguards used by healthcare practitioners in their operations and contact with employees, visitors, and patients. Personal protection equipment (PPE) such disposable medical masks, water resistant gowns, protective eyewear, and powder-free gloves are among the PPEs. Handling apparatus, linen, and other items in a safe manner works well in limiting the incidence of spread. The virus can be removed from the surface by sanitation and cleaning or using a disinfectant.
Transmission-based precautions (TBP) work to disrupt the covid-19 chain, preventing transmission by airborne route, droplets, or touch. This is due to the virus’s high contagiousness and many modes of transmission. To improve contact precautions, minimize contact and interaction with infectious material, likely excreta, infected hands, or even other people’s spit and mucous. Surgical masks and maintaining social distance are implemented to avoid droplet transfer. Whenever there would be less than one meter range spread, as per Fend et al. (2020), a respirator mask can minimize particle droplets by >5m whenever there is excellent air ventilation.
Infection prevention, the control measures, special and standard precautions to manage covid-19 and its spread
Hospital-acquired infection (HAI) has become an important metric of infection prevention and control quality in order to assure safety and therapeutic effectiveness. Effective IPC treatments can aid in maintaining high-quality healthcare. To enhance IPC, defined standards for expected clinical services, audit, and monitoring approaches may be used. Research can provide technical skills to help in increasing public health measures, recommendations, and policy to limit COVID-19 spread and the virus’s effect (Escandón et al., 2021). Disease research helps to improve practice by refining recommendations and policy. Efficient communication can promote public understanding and participation in preventative behaviors and proposals. There is insufficient empirical data to indicate the efficiency of a single use of certain metrics in COVID-19 IPC intervention techniques. Based on empirical findings, the WHO modified its advice to nations to encourage the people to use masks in specific situations or settings as part of a holistic approach to preventing transmission. Furthermore, there is a lack of understanding about the minimal ventilation requirements for limiting viral transmissions, as well as efficacy evaluations of the N95 respirator vs. mask when performing AGPs for COVID-19 training.
The information on covid-19 prevention and management that is now accessible is insufficient. However, while additional study is being undertaken, it is necessary to control the infection. Since the discovery of the SARS COV-2 virus, a large amount of studies have been done in an attempt to better understand this lethal virus and the respiratory illness, including infection origin, virus pathogenesis, route of exposure, risk factors, monitoring equipment, lab tests, medication diagnosis, and the effectiveness of preventive and control (WHO,2020). Monitoring, epidemiology research, lab diagnostic improvement, patient and health professional protection, as well as community IPC interventions and communication were all studied (WHO, 2020). Better understanding of transmission mechanisms, such as the role of droplets vs. aerosols, as well as non-respiratory transmission channels, such as the fecal-oral route, are just a few examples.
Organizational issues related to covid-19 prevention and control policy and practices and Hong Kong
Local-level
Because Covid-19 is a new problem, there haven’t been many studies done yet. Citizens in Hong Kong rely on hospital officials’ guidance or WHO standards at the local level. Many residents have obtained information that is important for their life in order to be able to survive with the virus till it is eradicated after some time has passed. The typical practices of masking, social rejection, hand, and respiratory cleanliness, among other things, are most of the primary difficulties surrounding the extremely infectious lethal illness.
Government level
Many countries have asked the WHO for help with pandemic IPC measures, such as comprehending respiratory droplets contact and respiratory transmission. The Hong Kong government is already in responsibility of public outbreak management and prevention, including supervising, reacting to, and directing it. To assist restrict the transmission of illness, the Centre for Health Protection (CHP) works with the hospital authorities and infection prevention and control team to develop risk control and oversight in a track-and-trace system. By collaborating with the state’s epidemic management strategy, the hospital authority adds to the CHP’s infection prevention and control efforts (Kwok, 2021).
Relevant policies and public health guidelines
The Hong Kong government and other hospital organizations have been working together to build necessary regulations to stem the transmission of the deadly virus since the covid-19 virus was designated a pandemic on March 11, 2019. This involves adhering to the IPC’s epidemiologic policies and standards. The governmental and human authorities focus on behaviours in the majority of policies, therefore normal processes are promoted to Hong Kong inhabitants. Respiratory as well as hand hygiene, social separation, living in well ventilated rooms, disinfecting surfaces and equipment, and so on are all examples.
According to Kwok et al. (2020), the Hong Kong government implemented many initiatives after the revelation of the covid-19 epidemic. Measures including travel limitations were altered under Cap. 599 regulation to meet the pandemic scenario. There were also limits on entering the nation. Border crossings to or from Hong Kong remained blocked, according to Xue et al. (2020). Citizens visiting the nation were required to undergo obligatory quarantine and testing in order to guarantee that they were fit to mix with the general public. The government also promoted social distancing measures, such as limiting the number of persons who must attend a meeting. Catering businesses and other places that demand public meetings were shuttered, boosting the revenue of delivery firms like Uber and Deliveroo. Schools were also shuttered, allowing for the expansion of online learning regulations. Early laboratory testing was made easier as a result of government policy, which made it easier to discover the virus at an early stage, when it could be controlled before it caused deadly symptoms.
To curb the virus’s spread, Hong Kong’s hospitals devised a variety of IPC-appropriate policies. The policies and recommendations are as follows, according to Li et al. (2020). All personnel, healthcare professionals, and patients are required to wear surgical masks, according to the hospital administration. This was done to ensure the safety of all those who worked at the hospital. The no-visiting rule was also achieved by preventing visitors from becoming newly infected while visiting the hospitals or infecting the patients. As a result, all parties engaged’ health was safeguarded. Several evaluations are among the other rules and procedures adopted in hospitals to minimize infections. To expedite testing and reporting, they used the FTOCC “fever, travels, occupation-related, contact, and cluster” method in triage. The “Staff early sickness alert system” (SESAS) and the “enhanced admission screening test” (EAST) help to detect early illness and maybe epidemics. PPE and AIIR (Lower pressure airborne virus isolation room) are used in the care routes, which are guided by risk evaluation.
With safety in mind, the medical authority stress levels were steadily reduced, and the use of PPE and AIIR within healthcare systems was enhanced. Infectious droplets can spread during procedures involving high-flow oxygenation, such as NP specimens, that should be managed with “airborne aerosol particles” (AGPs) through the use of a N95 mask. Tested patients must adhere to more stringent droplet, touch, and airborne level restrictions, which can be supported in AIIRs with negative pressure. Advanced filtration facilities and transportable HEPA filters are used in high-risk patient rooms and for AGPs (Mak et al., 2021). Correct disinfectants, more timing, and terminal cleaning all help to increase environment cleaning compliance. COVID-19 dead body regulations also notify healthcare personnel in protection of the environment, following medical strategic approach, indicated preventative category, labelled “contaminated linen,” “clinical waste” (Hung et al., 2020). The success of the IPS standards in hospitals is assured by health care personnel who follow the right PPE donning and donning sequence, use mask, and wash their hands appropriately. In all hospitals, the N95 respirator fit-test must be rechecked and the seal for choices documented. The hospital’s rules also mandate that there be a contingency option to swap usage and networking ventilator use systems to meet surge admission.
Audit, Surveillance and Risk Management as processes to control and prevent the covid-19 spread
Audit
In terms of compliance, auditing is the process of determining if health care personnel are appropriately executing the procedure in accordance with the standards and guidelines (Gaddis, 2018). It aids in the tracking of medical practice, the discovery of potential problems, and the giving of performance feedback. As a result of the data indicating the need for training and resources, the stages of plan, do, and act are employed to make things better. Audit collaboration can be shown in hand washing compliance, PPE installation, and doffing sequencing. Effective communications about goals and performance plans might help to facilitate change.
Surveillance
Monitoring is the systematic collection of data to track the occurrence of diseases (Han et al., 2019). Its primary objective is to evaluate data and distribute findings in order to detect outbreaks and direct IPC interventions. It might be utilized in the clinical auditing process, and “Hospital Acquired Infections” (HAIs) could be used as a performance improvement outcome indicator. The requirement for appropriate steps to be performed for identified high-risk groups, as well as swift responses to handle health crises, is assessed using visual information. Some examples include contact tracing and improved laboratory testing to identify high-risk groups, as well as asymptomatic transmitters for early notification and diagnosis (Ibrahim, 2020). Separation and care are required to prevent the sickness from spreading.
Risk management
Following the identification and prioritization of infection hazards, a risk management plan is implemented to prevent infection-related harm. Patient care, the environment, equipment, and other readily available resources, as well as technical and social shortcomings, are all potential risks. The four steps of the risk management framework are risk assessment, management, communications, and monitoring.
Risk assessment
In IPC, assessment is used to identify potential hazards and common practice gaps, and to classify, quantify, and document them. Inadequate triage areas, single rooms, PPE, and ventilators are some of them, while noncompliance with applications and policy are others.
Risk Management
Management is performed by planning and agreeing on the essential execution procedures. Redesigning ILI segregation zones, cohorting patients with the same COVID-19 diagnosis in a separate part, enhancing ventilation, finding N95 standard replacement masks, hand and respiration hygiene monitoring rounds, and PPE fitting techniques are just a few examples.
Risk communication
Informing health-care professionals about the administration of measures is part of communication. For example, communication on new rules and policies, education and assistance on SPs and TBPs, and the use of PPE is sent to employees on a periodic manner, and feedback is sought. The group’s website, institutional bulletin, and personnel forums are all used to send out updates on a regular basis.
Risk monitoring
It requires a continuous cycle of effects monitoring and assessment, as well as supervisory activities. Lessons from past mistakes can be used to future professional practice to reduce the risk of relapse and spread.
Recommendations to control the covid-19 spread
Healthcare workers training
Standard precautions paired with transmission-based precautions are the most important infection, prevention, and control (IPC) methods in providing proper care for covid-19 patients in the clinical environment (WHO, 2020). Clinical healthcare personnel, on the other hand, will need enough skills and expertise to apply the SPs and TBPs. Because covid-19 is a new virus, there hasn’t been enough training for health care providers on how to deal with it. As a result, this study proposes that healthcare professionals receive proper and extensive training on how to treat covid-19 patients in order to reduce the incidence of dissemination. Clinical staff are also advised to adhere to government and hospital authority rules on how to treat the pandemic at all times, since their compliance is vital.
Public awareness
The prevention of covid-19 is an individual responsibility, according to Giritli et al., (2020). Individual compliance is essential for minimizing transmission rates and maintaining everyone’s safety. Coordination and teamwork are essential because this is a worldwide epidemic. The rapid transmission rate of covid-19, according to Sridhar et al. (2021), contributes to the virus’s fast mutation rates, making it more difficult to resist. If everyone takes responsibility for their own health and ensures that they are safe, the infection will be reduced more quickly. This guarantees that normal processes such as masking, social distancing, and so on are followed. However, due to widespread non-compliance with basic precautions, it is difficult to break the infection’s transmission cycle. This research advises that the public be made aware of the virus, its harmful effects, and statistics on mortality causes, and methods for individual protection be implemented. As a result, each member will assume greater responsibility, increasing the chances of breaking the transmission chain.
Scientific evidence
The covid-19 pandemic is a recent problem with limited scientific knowledge on the transmission chain as well as infection control and prevention. Despite the fact that numerous researchers have attempted to investigate the virus, there are still many unknowns. As a result, this study suggests that additional research on the covid-19 infection be undertaken in order to complete research gaps and eliminate uncertainty.
Conclusion
The SARS-CoV-2 virus is a new and fast spreading illness, and the Hong Kong government is collaborating with hospital authorities and infection prevention and control teams to establish efficient IPC measures to battle the pandemic through all the CHP. IPC carries out audits, surveillance, and risk assessment operations such as triage, testing, tracking, and isolation. The hospital authority aligns with HK policies to manage COVID-19 propagation; complications such as respiratory and hand washing, masking, significant discrepancies, and environmental cleaning limit virus contact and propagation, but lack of certainty about controversial evidence is inadequate justification for action. HK employs the most up-to-date infection control procedures for quality and safety. Gaps in scientific proof questions are examined, as well as improvements to IPC.
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