Measures needed to prevent COVID-19 spread in psychiatric facilities

Implementation of tailored infection prevention and control measures in psychiatric facilities may help prevent the spread of SARS-CoV-2, according to results of a report published in MMWR.

“Clinicians working with psychiatric patients need to consider the best way to implement infection prevention and control (IPC) measures to reduce the risk of transmission of SARS-CoV-2 in the unique patient populations they work with in residential psychiatric facilities, which might require adaption of standard IPC measures,” Anna W. Callaghan, MSc, an epidemiologist with the CDC, told Healio Psychiatry.

Callaghan and colleagues reported on two patients with SARS-CoV-2 infection who transferred from a private psychiatric hospital with confirmed COVID-19 cases among its staff members and residents to Wyoming’s state psychiatric hospital. Prior to this transfer, the state hospital had no known COVID-19 cases among its patients or staff members. Upon arrival on April 13, the two patients were asymptomatic, and one had a negative test result for COVID-19 at the originating facility; however, both were isolated and received testing upon arrival at the state facility. Test results on April 16 indicated both patients had COVID-19, and in response, the hospital implemented expanded COVID-19 IPC procedures, including enhanced screening, testing and management of new patient admissions, as well as several standard IPC measures to facilitate implementation among the psychiatric patient population.

Investigators conducted a point prevalence survey to determine the likely effectiveness of IPC procedures and COVID-19 infection prevalence among health care personnel and patients at the state hospital. 18 days after the patients’ arrival, 61% of patients and 61% of health care personnel contributed nasopharyngeal swabs, which were tested for COVID-19 by reverse transcription-polymerase chain reaction.

All tests were negative, and Callaghan and colleagues concluded that the hospital’s expanded IPC strategies may have effectively prevented the introduction and spread of COVID-19 within the facility.

“Adaption of standard IPC strategies in psychiatric facilities to meet patient and facility needs might prevent SARS-CoV-2 transmission, and point prevalence surveys can be useful to assess the likely effectiveness of any adapted IPC measures,” Callaghan told Healio Psychiatry. “Some standard IPC measures may not be feasible to implement within a psychiatric facility to prevent the transmission of SARS-CoV-2, and psychiatric facilities need to take into account their unique challenges and exposure risks and expand or adapt these standard measures to best fit their context.”