The “Fix is in” to prevent all avoidable infections and Improve the Patient Safety

Source: cdc.gov press note

US government is planning to spend about $2.1 billion (about INR 15,000 crores) to improve infection control procedures in health care settings, aimed at preventing the transmission of diseases within healthcare institutions, hospitals, dialysis centres and other facilities.

This funding is part of the $1.9 trillion COVID-19 relief bill that was signed into law by President Joe Biden this year. The Biden-Harris Administration, working through the Centers for Disease Control and Prevention (CDC), is investing American Rescue Plan funding to strengthen and equip state, local, and territorial public health departments and other partner organizations with the resources needed to better fight infections in U.S. healthcare facilities, including COVID-19 and other known and emerging infectious diseases.

Additionally, these investments will help address the rise of healthcare-associated infections (HAI), which increased as U.S. hospitals were inundated by COVID-19—reversing national progress seen prior to the pandemic.

Of the new funding, $500 million will create and train “strike teams” to help facilities with known or suspected COVID-19 outbreaks. As per CDC director Dr. Rochelle Walensky the funding “will dramatically improve the safety and quality of the health care delivered in the United States during the pandemic and in the future.”

The five major components of the allocation are:

-         Strengthening state capacity to prevent, detect, and contain infectious disease threats across healthcare settings

-         Laboratory capacity for healthcare: Funds to increase state and regional laboratory capacity to conduct surveillance for emerging pathogens to better identify patients infected with or carrying infectious disease threats

-         Project Firstline: Funds will expand on efforts to design and implement effective infection prevention and control training and education to frontline healthcare staff.

-         National Healthcare Safety Network (NHSN): CDC will increase data and monitoring through NHSN to determine where and when infections occur in healthcare settings and target IPC interventions.

-         Antibiotic Stewardship: Funds will support state data analyses of antibiotic use and implement programs to improve antibiotic prescribing across communities. The Antimicrobial Stewardship (AMS) is the key to reduce emergence of Antimicrobial Resistance (AMR).

Nearly $900 million will be spent over the coming years to support “healthcare partners, academic institutions, and other nonprofit partners to develop new prevention interventions and capacities for infection prevention and control training, data collection, and technical assistance”. The research and training will focus on new ways to control the spread of infections.

Unintended consequences of our modern healthcare system are growing at fastest rate putting patients at risk. COVID19 pandemic has exacerbated the situation. In fact, hospitals which are supposed to be saving the patients have become the contributing factor to array of adverse events including HAI and AMR.

Seemingly intractable problems like HAI and AMR will have solution with right investments and resource allocation into creating optimal infrastructure and human resource capacity.

The chain of events that led to such phenomenal allocation of fund by US federal Government, hopefully should have positive impact on other countries too.

Recently Indian government too had made significant allocation to strengthening testing capacity required taking into consideration a multitude of issues related to capacity, data monitoring, skilled human resource and supply chain constraints. The government undertook a slew of measures to overcome these challenges. The available technology was utilized by putting in place a system to build laboratory linked case-based data, which enabled analyses at the district, state and national levels for strategic public health interventions and breaking the chain of transmission.

The cumulative advantage of such allocations should lead into addressing current issues of HAI & AMR but also to improve the safety and quality of the health care delivered worldwide.