Author:
Dörr Tamara,Güsewell Sabine,Flury Domenica,Süveges Maria,Gaza Valera Camille Beatrice,Botero-Mesa Sara,Zanella Marie-Céline,Iten Anne,Balmelli Carlo,Troillet Nicolas,Tschudin-Sutter Sarah,W Schreiber Peter,Jent Philipp,Damonti Lauro,Sommerstein Rami,Portmann Lea,Vuichard-Gysin Danielle,Cusini Alexia,Nussbaumer-Ochsner Yvonne,Heininger Ulrich,Berger Christoph,Zimmermann Petra,Gardiol Céline,Keiser Olivia,Schlegel Matthias,Kohler Philipp,P Kuster Stefan
Abstract
Abstract
Background
In the initial phase of the SARS-CoV-2 pandemic, masking has been widely accepted in healthcare institutions to mitigate the risk of healthcare-associated infection. Evidence, however, is still scant and the role of masks in preventing healthcare-associated SARS-CoV-2 acquisition remains unclear.We investigated the association of variation in institutional mask policies with healthcare-associated SARS-CoV-2 infections in acute care hospitals in Switzerland during the BA.4/5 2022 wave.
Methods
SARS-CoV-2 infections in hospitalized patients between June 1 and September 5, 2022, were obtained from the “Hospital-based surveillance of COVID-19 in Switzerland”-database and classified as healthcare- or community-associated based on time of disease onset. Institutions provided information regarding institutional masking policies for healthcare workers and other prevention policies. The percentage of healthcare-associated SARS-CoV-2 infections was calculated per institution and per type of mask policy. The association of healthcare-associated SARS-CoV-2 infections with mask policies was tested using a negative binominal mixed-effect model.
Results
We included 2’980 SARS-CoV-2 infections from 13 institutions, 444 (15%) were classified as healthcare-associated. Between June 20 and June 30, 2022, six (46%) institutions switched to a more stringent mask policy. The percentage of healthcare-associated infections subsequently declined in institutions with policy switch but not in the others. In particular, the switch from situative masking (standard precautions) to general masking of HCW in contact with patients was followed by a strong reduction of healthcare-associated infections (rate ratio 0.39, 95% CI 0.30–0.49). In contrast, when compared across hospitals, the percentage of health-care associated infections was not related to mask policies.
Conclusions
Our findings suggest switching to a more stringent mask policy may be beneficial during increases of healthcare-associated SARS-CoV-2 infections at an institutional level.
Funder
Schweizerische Akademie der Medizinischen Wissenschaften
Publisher
Springer Science and Business Media LLC