OBJECTIVE
To assess COVID-19 infection policies at leading U.S. medical centers in the context of the initial Omicron wave.
DESIGN
Electronic survey study eliciting hospitals' policies on masking, personal protective equipment, cohorting, airborne infection isolation rooms (AIIRs), portable HEPA filters, and patient/employee testing.
SETTING AND PARTICIPANTS
Hospital epidemiologists from U.S. News top 20 hospitals and 10 hospitals in the CDC Prevention Epicenters program.
METHODS
Survey results were reported using descriptive statistics.
RESULTS
23/30(77%) hospital epidemiologists completed the survey between February 15-March 3, 2022. 18(78%) hospitals used medical masks for universal masking while 5(22%) used N95 respirators. 16(70%) required universal eye protection. 22(96%) used N95s for routine COVID-19 care while 1(4%) reserved N95s for aerosol-generating procedures. 2(9%) utilized dedicated COVID-19 wards, 8(35%) used mixed COVID-19/non-COVID-19 units, and 13(57%) used both dedicated and mixed units. 4(17%) used AIIRs for all COVID-19 patients, 10(43%) prioritized AIIRs for aerosol-generating procedures, 3(13%) used alternate risk-stratification criteria, and 6(26%) did not routinely use AIIRs. 9(39%) did not use portable HEPA filters, but 14(61%) used them for various indications, most commonly as substitutes for AIIRs when unavailable or for specific high-risk areas or situations. 21(91%) tested asymptomatic patients on admission, but post-admission testing strategies and preferred specimen sites varied substantially. 5(22%) required regular testing of unvaccinated employees; 1(4%) reported mandatory weekly testing even for vaccinated employees during the Omicron surge.
CONCLUSIONS
There is substantial variation in leading hospitals' COVID-19 infection control practices. Clearer public health guidance and transparency around hospitals' policies may facilitate more consistent national standards.