Today in Infection Control & Hospital Epidemiology, findings from a 2021 survey of infection preventionists at 900 US hospitals suggest that strong hospital leadership support led to lower levels of COVID-19 pandemic–related burnout—although half reported burnout—and greater psychological safety.

Researchers at the Veterans Affairs (VA) Health Administration at the University of Colorado and University of Michigan surveyed 415 infection preventionists at the randomly sampled hospitals from April to December 2021. The survey was part of a project that has been asking the specialists about their hospital's organizational characteristics and infection-prevention protocols every 4 years since 2005.

The researchers noted that, early in COVID-19, infection preventionists had to grapple with risk of exposure to SARS-CoV-2, rapidly changing information, limited guidance, and scarce personal protective equipment.

"Over time, infection preventionists' roles shifted from training staff to enforcing evolving policies like face shields and contact tracing, which were questioned for their effectiveness and purpose," they wrote. "This shift resulted in many infection preventionists reporting feeling a lack of control and a lack of credibility among staff."

77% reported support in bringing up problems

Among survey respondents, 64% reported very good to excellent hospital support for their infection prevention and control programs, but 49% said they were burned out. Strong hospital support was tied to less burnout (incidence rate ratio [IRR], 0.61), greater perceptions of psychological safety (IRR, 3.20), and a corresponding 1.2 increase in safety climate on an ascending Likert scale from 1 to 10.

Over time, infection preventionists' roles shifted from training staff to enforcing evolving policies like face shields and contact tracing, which were questioned for their effectiveness and purpose.

About 30% of respondents were characterized as having "high psychological safety," and 76% were considered as having a "high safety climate." Over 90% of respondents said they asserted their views, even though their supervisor may disagree, while 77% reported feeling supported in mentioning problems, and 77% said they were comfortable speaking up when they saw a physician not wash his or her hands. 

"These findings aid in identifying factors that promote the well-being of infection preventionists and enhance the quality and safety of patient care," the study authors wrote.

Argentina's National Agri-Food Health and Quality Service (Senasa) yesterday reported new detections of highly pathogenic H5 avian influenza in marine mammals from Chubut province in the south of the country, including the first positive detection in a sea elephant.

The animals—including both sea elephants and sea lions—were found dead in three of the province's coastal cities: Comodoro Rivadavia, Rada Tilly, and Punta Tombo. The event marks Argentina's tenth involving sea lions.

Other countries in the Americas and elsewhere have recently reported avian flu in marine mammals, and scientists are closely tracking the events to assess if the animals are contracting the virus from infected wild birds or if they are passing the virus among themselves, which might be a sign that the virus is becoming more transmissible among mammals.

Finland orders culling for all fur farms affected in H5N1 outbreaks

Elsewhere, 2 months after the first H5N1 at a fur farm, the Finnish Food Safety Authority today ordered that all animals at 26 affected farms be culled, according to a statement translated and posted by Avian Flu Diary, an infectious disease news blog. The step targets about 115,000 animals, mainly foxes.

All mink on the farms have already been culled. Minks are known to be a potential mixing vessel for respiratory viruses. Today's statement said all foxes and raccoons at the fur farms will now be culled to protect human health. The group added that genetic sequencing of viruses from the affected fur farms suggests that the virus spread to fur animals at other locations.

Finnish officials also said the genetic analysis identified mutations in six samples from mink, foxes, and raccoons that could facilitate transmission in mammals. Further analysis is underway.

Following the deaths of two people from Nipah virus , with two more in the hospital, health officials in India's Kerala state have ordered some schools and offices to close to limit the spread of the virus, according to several media sources, including Al Jazeera, that cite local health officials. They have also announced containment zones in villages with connections to the cases.

The initial patient who died is a landholder in the village of Marutonkara in Kozhikode district, where outbreaks of the highly lethal disease have been reported before, and fruit bats in the area are known to harbor Nipah virus.

Media reports said the second patient who died wasn't related to the first case-patient, but had contact earlier in a hospital. The other confirmed patients who are hospitalized include an adult and a child who are family members of one of the patients who died.

So far, more than 300 contacts have been identified, 127 of them health workers, the Indian Express reported.

India battled an outbreak in Kozhikode district in 2018, which resulted in 17 deaths. Since then, the country has reported sporadic cases, including one in 2021, also from Kozhikode district.