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The challenge and management of nosocomial infection control during the “post-outbreak” period of SARS-CoV-2

The novel coronavirus SARS-CoV-2 is causing a pandemic worldwide Several months after the initial outbreak, with the help of tight isolation policy, SARS-CoV-2 transmission in the general population is now under control in China The number of new cases dramatically decreases compared to the outbreak period Thus, we name this phase the "post-outbreak" period when China has lived through the pandemic phase while many other countries are still facing fast growing cases To keep the number of new cases at low level under the consistent pressure of imported cases from other countries and prevent a second outbreak in China are tremendous challenges to all workers in the health care system Currently available studies of the basic reproduction number (R0) of SARS-CoV-2 demonstrate that the new virus has a higher transmission capacity than other coronaviruses such as SARS-CoV and MERS-CoV Besides, longitudinal serological studies illuminate that protective antibodies to SARS-CoV-2 may turn negative at early convalescent phase in certain patients, indicating a relatively short protection time Recent prediction models of the transmission dynamics suggested a risk of recurrent outbreaks of SARS-CoV-2, even in seasonal or perennial pattern When autumn and winter are approaching, the number of patients infected with SARS-CoV-2 will be likely to increase if appropriate measures are not taken, which will further challenge the medical system It has been shown that during the outbreak period, the infection rate of SARS-CoV-2 among medical workers is relatively high According to the serum specific antibody test, about half of the front-line medical staffs have been infected in some countries Some cluster cases of SARS-CoV-2 infection in hospital settings have been reported This indicates that the risk of virus transmission in the hospital environment is high and more intensive infection control is needed In this article, we particularly focus on several high-risk areas, such as respiratory clinics, eye clinics and obstetrical clinics We summarize their unique clinical practices and possible risks of virus transmission, and propose some suggestions for the protection of health care workers in daily work during the "post-outbreak" period based on guidelines proposed by international groups and specialists of the fields The review also discusses some approaches that hospitals can take during the "post-outbreak" period to early detect infected patients and cut nosocomial transmission We focus on the topics including the prevention of the virus spreading via aerosol between patients and doctors, innovation of fast and reliable diagnostic methods to effectively identify SARS-CoV-2 carriers from large number of suspected patients, implementation of effective remote doctor consultation and establishment of a patient stratification system to reduce cross-infection, etc This article aims to highlight the awareness of SARS-CoV-2 virus transmission in hospitals and clinics during the "post-outbreak" phase and propose crucial aspects for the research of nosocomial infection control © 2021, Science Press All right reserved