Hospital-acquired COVID infections worsened as the pandemic progressed, research finds

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The chances of becoming infected with COVID-19 while hospitalized increased as the pandemic progressed, according to recent Canadian research.

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In fact, significantly more Canadians became infected with hospital-acquired COVID-19 during the fifth and sixth waves of the pandemic — the first two Omicron waves from late 2021 until the spring of 2022 — than during earlier waves, according to the study published in the journal JAMA Network Open. Researchers looked at cases of patients hospitalized with COVID-19 between March 2020 and May 2022.

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The reasons for that sharp increase in hospital-acquired COVID-19 two years into the pandemic “are uncertain,” researchers added. But they offered some possibilities.

Among them is that people were dealing with “personal protective equipment fatigue” which became more prevalent as the pandemic progressed. Also, significantly, they cited the discontinuation of public health measures in communities.

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Many public health measures in Ontario and elsewhere were dropped in the spring of 2022, even as the Omicron variant — the most contagious version of the virus until then — continued to spread.

The authors also noted that there was a higher incidence of COVID-19 in the community during the Omicron waves, which could have resulted in a large number of patients being admitted to hospital for other reasons and who were also infected with COVID-19 — something that was initially missed. They also suggested there was an increase in health-care workers becoming infected out in the community “leading to an increase in patient exposures”.

The authors said their findings were similar to a report from England in which about 20 per cent of patients hospitalized with COVID-19 were first identified more than seven days after being admitted, in Dec. 2021, compared with only 8.3 per cent of patients in early November 2021, which could reflect the Omicron wave.

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And, the authors wrote that a decreased adherence to infection control practices by patients, visitors and staff “as the perceived risk of COVID-19 waned” also likely caused more patients to become infected.

The proportion of adults and children admitted to hospitals with COVID-19 was higher in general during waves five and six than in earlier waves, the authors found. But the rates of intensive care admissions and deaths were lower, reflecting increasing rates of vaccination as the pandemic progressed, among other factors.

In January 2022, there were 44 hospital-based outbreaks of COVID-19 in Ottawa alone. An outbreak is declared when there is evidence that at least one case was acquired in the facility.

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This newspaper has written several articles about patients who were hospitalized with other health issues and later died after contracting COVID-19 while in the hospital.

Earlier research, from January 2022, published in CMAJ Open, found that patients under the age of 75 who became infected while in hospital were more likely to die than patients who became infected elsewhere. The study looked at patients in a Montreal hospital from March to June 2020.

There are ongoing efforts to study and reduce rates of hospital-acquired infections, including antimicrobial-resistant infections, across Canada, because of the serious risk they present to patient safety and quality of care.

This week, health experts called for an independent national inquiry into Canada’s COVID-19 response, after the prestigious British Medical Journal, in a series of papers, cited major failures in the way federal and provincial governments responded.

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