5 Questions for the Infection Control Experts from Rush University Medical Center

A team of epidemiology experts from Rush University Medical Center has been consulting with Columbia College Chicago on COVID-19 precautions as the college finalizes preparations for the reopening of campus and the resumption of in-person instruction on September 21.

The Rush team is led by Dr. John Segreti, M.D., Medical Director of Infection Control and Prevention. He is joined by Tiffany Wiksten, a Master of Nursing Practice, certified in Infection Control and Epidemiology and Manager of Infection Control and Prevention, and Alexandra Seguin, nurse epidemiologist.
You have been briefed on Columbia’s COVID-19 plans and have walked much of the campus to see what’s planned in classrooms and offices. What are your impressions?
Dr. Segreti: We were impressed with the college’s plans, which are very much in line with the guidance provided by local health officials as well as what we have found to be effective at Rush in controlling spread of the virus. We have also been impressed with how well the campus, and especially the classroom spaces, have been clearly marked to promote social distancing, mask wearing, and hand hygiene. The college has varied facilities, and the low planned occupancies will serve the community well. We did find instances in which departments were planning some activities in courses that we thought might be a cause for concern. Columbia responded by eliminating those activities and/or revising those plans to afford greater protection. While no one can fully eliminate the risk of COVID-19, we think Columbia has done a very good job positioning itself for the fall semester by emphasizing and requiring the most effective methods of control: mask wearing, physical distancing and reduced density, and proper hygiene.
There is a lot of information available about the science of preventing the spread of COVID-19, and sometimes we are presented with varying or even opposing scientific viewpoints. What for you rises to the top?
Dr. Segreti: We all have a lot to learn still about COVID-19, but there is no question about what’s been proven to work to stem the spread: frequent hand sanitizing or hand washing, keeping six feet part as much as possible, and wearing masks, which we now know protects both the wearer and those around them. We call these precautions “source control” and they are far and away the most effective measures to keep people from getting and transmitting COVID.
You have managed through COVID-19 at both your hospital and university and have consulted with a variety of organizations. From your perspective, what is the biggest risk to “reopening”?
Ms. Wiksten: We all need to adhere to the guidance from health officials, and we have found that sound implementation of the source control measures such as masking and social distancing noted above is critical. The biggest challenge is people getting too relaxed away from work or in less formal settings with people they think are “safe” (like lunch breaks, break rooms, etc.). Continuous communication is important so that members of the community do not let their guard down on campus and off.
What about air quality and ventilation?
Dr. Segreti: Air quality is important but the best way to control against spread is for people to wear masks, keep room occupancies low and maintain adequate distancing. Any organization needs to make sure its HVAC systems are functioning as designed. It’s well documented that some small aerosolized COVID-19 particles are generated by human activities and can linger in the air (as opposed to the heavier droplets that quickly fall down). The best preventive measures are still masks and distancing. It’s also important to note that most activities (like talking) generate very low amounts of aerosols. Some activities can generate higher amounts of aerosols, such as some of Columbia’s specialties: singing, playing certain instruments, and, to a lesser extent, dance and some aspects of theater and film production. Columbia opted to install supplemental ultraviolet air filtration systems as an added precaution, which is commendable. But it’s just that: an added precaution. The best weapon against both droplets and aerosols remains mask-wearing, social distancing, and proper hand hygiene.
On the topic of hand hygiene, what is best: hand-washing or using hand sanitizer?
Ms. Wiksten: Both are effective, and should be performed as often as possible, but for different reasons. Hand sanitizer doesn’t remove soil or debris but will kill any virus that is on the hands. Handwashing, on the other hand, removes organisms such as bacteria and viruses as well as dirt. That is why handwashing has to be long, at least 20 seconds. Hand sanitizer can be less effective if hands are dirty or grimy, so both methods are important.