Epidemiologists as Key Partners for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) Outbreak Containment in North Texas Healthcare Facilities

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus has been detected in North Texas healthcare facilities (HCFs) since March 2020. As infection control guidance for this novel virus changes frequently, continued education is essential for HCF administration and staff. The regional health department provides services to 37 counties. One healthcare associated infections (HAI) epidemiologist provided support to the region until January 2021 when an additional HAI epidemiologist joined the team to increase capacity. METHODS: Beginning March 2020, a regional epidemiology healthcare team was created to conduct remote and onsite infection control assessments (ICARs) at HCFs in North Texas. The team includes epidemiologists and board-certified infection preventionists. Every team member received remote ICAR training from the senior HAI epidemiologist through ICAR shadowing and return demonstration. Response and proactive ICARs were conducted using templates for the ICAR, infection control guidance, and case tracking. To ensure consistent messaging, weekly conference calls were held to discuss guidance changes or questions from team members. Facilities were monitored until 28 days after the last exposure to a positive COVID-19 case. RESULTS: From March 2020 through September 2021, the region investigated 480 reported SARS-COV-2 outbreaks in HCFs. Of those, 93% (n=445) had at least one case. Of the 445 HCFs with cases, 67% (n=300) had at least one resident positive, and 91% (n=407) had a least one staff positive for SARS-COV-2. The longest monitoring period was 400 days. Hospitalizations occurred in 113 outbreaks. At least one death occurred in 115 outbreaks. ICARs were conducted for 71% (n=314) of the outbreaks. CONCLUSIONS: The addition of epidemiologists and certified infection preventionists on the regional epidemiology healthcare team increased the regional capacity to respond to the 445 HCF outbreaks. A designated trainer and standardized templates allowed for consistent implementation of infection control guidance throughout the region.