Review Article
Volume 9 Issue 6 - 2020
Coronavirus Epidemic: An Opportunity to Protect Patients and Healthcare Workers from Respiratory Infections Acquired in Healthcare Settings
Mary Catlin1, Hala Jassim AlMossawi2 and Neeraj Kak2*
1Injury and Accident Prevention, Seattle, Washington, USA
2sUniversity Research Co., LLC, Chevy Chase, Maryland, USA
*Corresponding Author: Neeraj Kak, Chief Innovation Officer/Senior Vice President, University Research Co., LLC, Chevy Chase, Maryland, USA.
Received: April 14, 2020; Published: May 12, 2020


During the 1980s AIDS epidemic, U.S. healthcare providers introduced HIV prevention measures into facilities with the welcome but unintended consequence of reducing transmission of general blood-borne infections to patients and healthcare workers. WHO lists TB, pneumonia and influenza in the top ten causes of death worldwide. Yet as patients enter hospitals and clinics for these common conditions, care in facilities both treats as well as amplifies these respiratory infections. As measures are introduced to control SARS-CoV-2 infections, an opportunity exists to introduce infection prevention and control (IPC) measures that reduce healthcare-associated respiratory infections in general. As individuals change behaviors to prevent transmission, they will help change an industry where ingrained beliefs, habits and attitudes that allow respiratory disease to spread unchecked. This paper discusses key measures that facilities could enhance to decrease healthcare associated respiratory transmission. Tuberculosis control measures can be modified as the basis of an effective IPC model in public and private settings to reduce transmission of a variety of respiratory infections from COVID-19 to influenza to tuberculosis.

Keywords: Coronavirus; Covid-19; SARS-nCoV-19; Occupational Health; Tuberculosis; Respiratory Infections; Healthcare settings; Infection Control; Latent TB


  1. Blood-borne Pathogen Standard. U.S. Department of Labor. CRF 1910.1030.
  2. Segal HE., et al. “Hepatitis B antigen and antibody in the U.S. Army: prevalence in health care personnel”. American Journal of Public Health 7 (1976): 667-671.
  3. Gerlich WH. “Medical virology of hepatitis B: how it began and where we are now”. Virology Journal 10 (2013): 239.
  4. Kim WR. “Epidemiology of hepatitis B in the United States”. Hepatology 5 (2009): S28-S34.
  5. “HIV and occupational exposure (2020).
  6. “Global Health Estimates 2016: Deaths by Cause, Age, Sex, by Country and by Region, 2000-2016”. Geneva, World Health Organization (2018).
  7. Tablan OC Anderson LJ., et al. CDC and the Healthcare Infection Control Practices. Guidelines for preventing healthcare- associated pneumonia.
  8. Giuliano KK., et al. “The epidemiology of nonventilator hospital-acquired pneumonia in the United States”. American Journal of Infection Control 3 (2018): 322-327.
  9. Baker D and Quinn B. “Hospital acquired pneumonia prevention initiative-2: Incidence of nonventilator hospital-acquired pneumonia in the United States”. American Journal of Infection Control 1 (2018): 2-7.
  10. Chow EJ and Mermei LA. “Hospital-Acquired Respiratory viral infections: Incidence, morbidity and mortality in pediatric and adult patients”. Open Forum Infectious Diseases 1 (2017): ofx006.
  11. Loubet P., et al. “Impact of respiratory viruses in hospital-acquired pneumonia in the intensive care unit: A single-center retrospective study”. Journal of Clinical Virology 91 (2017): 52-57.
  12. Kim ES., et al. “Comparison of viral infection in health-associated pneumonia (HCAP) and community-acquired pneumonia (CAP)”. PLoS One 2 (2018): e0192893.
  13. Shorr AF., et al. “Viruses are prevalent in non-ventilated hospital-acquired pneumonia”. Respiratory Medicine 122 (2017): 76-80.
  14. Widera E., et al. “Presenteeism: A Public Health Hazard”. Journal of General Internal Medicine11 (2010): 1244-1247.
  15. McMichael TM., et al. “Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington [published online ahead of print, 2020 Mar 27]”. The New England Journal of Medicine (2020).
  16. Washington State Influenza Update. Week 12 March 15-21. 2020. Washington State Department of Health (2020).
  17. Quach C., et al. “Burden of Healthcare-Associated Viral Respiratory Infections in Children’s Hospitals”. Journal of the Pediatric Infectious Diseases Society1 (2018): 18-24.
  18. Bosco E., et al. “Long-term Care Facility Variation in the Incidence of Pneumonia and Influenza”. Open Forum Infectious Diseases 6 (2019): ofz230.
  19. Institute of Medicine (US). Addressing the Threat of Drug-Resistant Tuberculosis: A Realistic Assessment of the Challenge: Workshop Summary. Washington (DC): National Academies Press (US), MDR TB Transmission, HIV Coinfection, and Transmission Control (2009).
  20. Baussano I., et al. “Tuberculosis among healthcare workers”. Emerging Infectious Diseases 3 (2011): 488-494.
  21. Jakab Z1., et al. “Consolidated Action Plan to Prevent and Combat Multidrug- and Extensively Drug-resistant Tuberculosis in the WHO European Region 2011-2015: Cost-effectiveness analysis”. Tuberculosis 1 (2015): S212-S216.
  22. Cohen A., et al. “The global prevalence of latent tuberculosis: a systematic review and meta-analysis”. European Respiratory Journal 3 (2019): 1900655.
  23. Kinikar A., et al. “High risk for latent tuberculosis infection among medical residents and nursing students in India”. PLoS One 7 (2019): e0219131.
  24. Wang XN., et al. “Prevalence of and risk factors for tuberculosis among healthcare workers in Chinese tuberculosis facilities”. Infectious Diseases of Poverty 1 (2018): 26.
  25. Van derWesthuiszen H and Dramowski A. “When students become patients: TB disease among medical undergraduates in Cape Town, South Africa”. South African Medical Journal 6 (2017): 475-479.
  26. Field M. “Committee on Regulating Occupational Exposure to Tuberculosis, Division of Health Promotion and Disease Prevention Occupational Risk of Tuberculosis, in Tuberculosis in the Workplace”. Institute of Medicine. National Academy Press. Washington DC (2001).
  27. Mongkolrattanothai T., et al. “Tuberculosis among healthcare personnel, United States, 2010-2016”. Infection Control and Hospital Epidemiology 40 (2019): 701-704.
  28. Barrera E., et al. “F-A-S-T: a refocused intensive, administrative tuberculosis transmission control strategy”. The International Journal of Tuberculosis and Lung Disease 4 (2015): 381-384.
  29. Prussin AJ., et al. “Viruses in the Built Environment (VIBE) meeting report”. Microbiome 1 (2020).
  30. Magill SS., et al. “Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections”. The New England Journal of Medicine 13 (2014): 1198-208.
  31. Lilly CM., et al. “Prevalence and Test Characteristics of National Health Safety Network Ventilator-Associated Events”. Critical Care Medicine9 (2014): 2019-2028.
  32. Podcast: Beyond Clinical Medicine Episode 18: Beyond Clinical Medicine Episode 18: Be Prepared for Coronavirus – Dr. Jody Crane and Dr. John Sullivan.
  33. Bosco E., et al. “Long-term Care Facility Variation in the Incidence of Pneumonia and Influenza”. Open Forum Infectious Diseases 6 (2019): ofz230.
  34. S. Bureau of Labor Statistics. National Compensation Survey: Employee Benefits in the United States, Bulletin (2019): 2791.
  35. Gutman D and Takahama E. “Swedish has hundreds of nursing jobs open, creating a higher vacancy rate than other local hospitals”. The Seattle Times (2020).
  36. Atkinson J., et al. “Natural Ventilation for Infection Control in Health Care Settings”. WHO (2009).
  37. WHO Policy on TB infection control in Health-Care Facilities, Congregate Settings and Households” (2009).
  38. Francis J. “Curry National TB Center”. TB Infection Control, A Practical Manual for Preventing TB (2011).
  39. “Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings”. MMWR 254 (2005): 17.
  40. Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19). Interim Guidance (2020).
  41. Siegel JD., et al. “Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings” (2007).
  42. Gawande A. “Keeping Coronavirus from Infecting Healthcare workers”. The New Yorker (2020).
  43. “Chapter 7 TB Infection Control” (2020).
  44. Guidelines on hand hygiene in healthcare (2009).
  45. Aiello AE., et al. “Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis”. American Journal of Public Health 8 (2008): 1372-1381.
  46. Hayden S. “How misinformation is making it almost impossible to contain the ebola outbreak in DRC”. Time Magazine (2019).
  47. Burke J. “Ebola Healthcare workers killed and injured by rebel attack in Congo”. The Guardian (2019).
  48. Covid-19 (2020).
  49. Catlin M., et al. “Healthcare Acquired Respiratory Infections – Considerations and Strategies for Prevention and Control”. Journal of Hospital and Healthcare Administration 3 (2019): 124.
Citation: Mary Catlin., et al. “Coronavirus Epidemic: An Opportunity to Protect Patients and Healthcare Workers from Respiratory Infections Acquired in Healthcare Settings”. EC Pulmonology and Respiratory Medicine 9.6 (2020): 17-30.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

May Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the May issue of respective journals and can be viewed in the current issue pages.

Submission Deadline for July Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the June issue of respective journals. Submissions are accepted on/before June 11, 2020.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to