Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method.
Nasa P., Azoulay E., Chakrabarti A., Divatia JV., Jain R., Rodrigues C., Rosenthal VD., Alhazzani W., Arabi YM., Bakker J., Bassetti M., De Waele J., Dimopoulos G., Du B., Einav S., Evans L., Finfer S., Guérin C., Hammond NE., Jaber S., Kleinpell RM., Koh Y., Kollef M., Levy MM., Machado FR., Mancebo J., Martin-Loeches I., Mer M., Niederman MS., Pelosi P., Perner A., Peter JV., Phua J., Piquilloud L., Pletz MW., Rhodes A., Schultz MJ., Singer M., Timsit J-F., Venkatesh B., Vincent J-L., Welte T., Myatra SN.
During the current COVID-19 pandemic, health-care workers and uninfected patients in intensive care units (ICUs) are at risk of being infected with SARS-CoV-2 as a result of transmission from infected patients and health-care workers. In the absence of high-quality evidence on the transmission of SARS-CoV-2, clinical practice of infection control and prevention in ICUs varies widely. Using a Delphi process, international experts in intensive care, infectious diseases, and infection control developed consensus statements on infection control for SARS-CoV-2 in an ICU. Consensus was achieved for 31 (94%) of 33 statements, from which 25 clinical practice statements were issued. These statements include guidance on ICU design and engineering, health-care worker safety, visiting policy, personal protective equipment, patients and procedures, disinfection, and sterilisation. Consensus was not reached on optimal return to work criteria for health-care workers who were infected with SARS-CoV-2 or the acceptable disinfection strategy for heat-sensitive instruments used for airway management of patients with SARS-CoV-2 infection. Well designed studies are needed to assess the effects of these practice statements and address the remaining uncertainties.