Strategies for Prevention of COVID-19 Transmission in Hospitals: a Nationwide Survey of Controversial Issues Related to Infection Control and Prevention in Korea

Background: Infection-control measures against the coronavirus disease 2019 (COVID-19) within a hospital are often based on expert experience and intuition due to the lack of clear guidelines. This study aimed to survey the current strategies for the prevention of the spread of COVID-19 in medical institutions.Methods: In a systematic review of national-level guidelines, 13 key topics were selected. Six hospitals were provided an open survey between August 11 and 25, 2020, to assess their responses to these topics. Using these data, an online questionnaire was developed and sent to the infection-control teams of 46 hospitals in South Korea. The survey was conducted between January 31, 2021, and February 20, 2021.Results: All 46 hospitals responded to the survey. All hospitals operated screening clinics, while 89.1% (41/46) allowed symptomatic patients without COVID-19-associated symptoms to visit the general outpatient clinics. Most hospitals (87.2%; 34/39) conducted polymerase chain reaction (PCR) tests for all hospitalised patients. Moreover, 35 (76.1%) hospitals had preemptive isolation policies for hospitalised patients, of which 97.1% (34/35) released patients from isolation after a single negative PCR test. Most hospitals (76.9%; 20/26) allowed shared-room accommodation for patients who met the national criteria for release from isolation but showed positive PCR results with cycle threshold values above a certain threshold (34.6%; 9/26) or after a certain period that satisfied the national criteria (26.9%; 7/26). Conclusions: Various guidelines were being applied by each medical institution, but an explicit set of national guidelines to support these guidelines was unavailable.