Outbreak of SARS-CoV-2 in a geriatric acute-care ward during summer 2023: current aspects of infection control in the postpandemic period.

Abstract

Aim: Management of a SARS-CoV-2 outbreak in geriatric patients, taking into account the transition to the post-pandemic period.

Methods: PCR tests were conducted to identify the scale of infection during the outbreak; no new patients were admitted to the ward until the availability of the PCR results. Based on the results and individual risk assessment, three cohorts were formed and treated as recommended by the RKI. After terminating the admissions stop, new admissions received PCR screening. Contact patients were retested on days 3 and 5. Employees carried out self-monitoring, and if symptoms developed, an antigen test was performed.

Results: Nine of the 11 PCR-positive patients (6m, 5f), median age 85 years, were immunized. Eight patients were symptomatic, ten received antiviral therapy and two required intensive care. Three symptomatic employees had a positive antigen test. Patients without direct contact to the positive cases who initially tested negative and the 16 new admissions with a negative PCR test did not contract COVID-19. Outbreak management ended after 15 days without deaths from COVID-19.

Conclusion: During the outbreak, PCR screening, the temporary stop in new admission until the availability of PCR results, and the risk-adapted cohorting of patients supplemented by consistent PCR tests of new admissions formed the basis for successful outbreak management. Treatment can be made possible despite high vulnerability. Close symptom monitoring and rapid implementation of measures reduce the risk. Repeated PCRs of direct-contact patients on day 3 can warrant pre-emptive antiviral therapy despite being asymptomatic; testing on day 5 makes it possible to shorten preventive isolation measures. The use of protective masks and self-monitoring by employees are fundamental to preventing further infections.