By Daniel R. Lucey MD, MPH, FIDSA
For the past three days the Vivantes Humboldt-Klinikum hospital in Berlin, Germany announced that due to nosocomial spread to patients and staff of the variant virus B.1.1.7, it would not accept new patient admissions and would place all roughly 1,700 employees on “shuttle quarantine” between home and hospital.
Although I am not (yet) aware of any similar policies in hospitals in the United Kingdom, Denmark, the United States, elsewhere in Germany, or in any of about 60 nations where this variant B.1.1.17 has been reported, we should learn from this unfolding lesson in Berlin. Will any U.S. hospitals react in a similar way, especially given that the U.S. Centers for Disease Control and Prevention has stated that this variant could become the predominant virus in this country by March?
Will any U.S. hospitals, or non-U.S. hospitals react in a similar manner when nosocomial spread of other variants is found (e.g., the 501Y.V2 (aka B.1.351) first reported in S. African, or the P.1. variant spreading in northern Brazil)?
Who will decide for US hospitals?
This Berlin hospital coordinated with the Reinickendorf Health Department and the scientific and public health Robert Koch Institute. For the U.S. will the CDC, now under the new leadership of Dr. Rochelle Walensky, and the jurisdictional health departments, plus the Department of Health and Human Services and its office of the Assistant Secretary for Preparedness and Response (ASPR), and the White House CoV Task Force coordinate with US hospitals and hospital organizations to decide?
The Berlin hospital website posted the following status as of Jan. 24:
“In coordination with the pandemic staff at Vivantes Humboldt-Klinikum and the hygiene officers with the actors of the Reinickendorf Health Department and the Robert Koch Institute, no new patients will be admitted to the clinic for the time being by order of the Health Department. The Vivantes Humboldt-Klinikum concentrates on the patients currently being treated there. The measure will be supported with the funds available to Vivantes, so that the virus variant B.1.1.7 identified in the Vivantes Humboldt Clinic in the last few days, does not spread and contain in Berlin.
The admission stop has been in effect since 01/22/2021, midnight. Emergencies are taken to other hospitals, new, inpatients as well as outpatients are no longer admitted. This also applies to women giving birth and visitors (with the exception of relatives of the dying). On the evening of January 22nd, 2021, the clinic management informed the staff about the upcoming measures.
The employees of the Vivantes Humboldt Klinikum are currently under shuttle quarantine between their home and the clinic. This is done in close coordination and according to the guidelines of the Robert Koch Institute. Vivantes organizes shuttle and shopping services to support around 1,700 employees in implementing the quarantine. Leasing workers will no longer be used until further notice.”
Daniel Lucey, M.D. MPH, FIDSA, FACP, is a Clinical Professor of Medicine at Dartmouth Geisel School of Medicine, Infectious Disease adjunct Professor at Georgetown Medical Center, senior scholar at Georgetown Law, Anthropology Research Associate at the Smithsonian Museum of Natural History and a member of the Infectious Diseases Society of America Global Health Committee. He served as a volunteer to outbreaks overseas including hands-on Ebola patient care in Sierra Leone and Liberia (Doctors without Borders) 2014, MERS 2013, SARS 2003, as well as HIV, H5N1, Zika, yellow Fever, and pneumonic plague 2017 (with WHO/USAID/CDC). Since Jan. 6, 2020 he has contributed over 75 posts to Science Speaks on COVID-19 and traveled to China in February 2020. He initially proposed, then fundraised and helped design the content for 2018-2022 Smithsonian Exhibition on Epidemics due to zoonotic viruses. From 1982-1988 he trained at University of California San Francisco and Harvard and was an attending physician at the NIH (NIAID) in the 1990s while in the US Public Health Service.