Isolation of COVID-19 patients in cohorted wards or single-patient rooms? Advantages and disadvantages to take into consideration

Background A rapid influx of large numbers of COVID-19 patients had to be handled by hospitals worldwide while specific infection prevention policies were not fully developed yet. This and other factors forced many hospitals to decide to cohort patients with COVID-19, expecting to minimize usage of personal protective equipment (PPE). Aim To investigate whether cohorting or isolation in single-patient rooms saves PPE. Highlight the advantages and disadvantages of organizing patient care in cohort or in single-patient rooms with doors closed. Methods By observation, we measured PPE use, at wards where COVID-19 patients were isolated in single-patient rooms with doors closed. We calculated the breakpoint of PPE use where it is more efficient to isolate patients in a cohort compared to isolation in single-patient rooms with doors closed, when the aim of cohorting is saving PPE. We extrapolated the observed data to estimate PPE use in a cohort situation. We provided an overview of the advantages and disadvantages of both types of isolation. Results On average 6 PPE sets (e.g. gloves, surgical face-mask (IIR), eye protection, gown) are used for one patient in three hours. This shows that when having a cohort that uses less than 6 PPE per patient per 3 hours, the hospital will save PPE when compared to isolation in single-patient room setting with doors closed. Conclusion Before choosing isolation in single-patient rooms with doors closed or establishing a cohort, it is important to consider the expected usage of PPE and the specific advantages and disadvantages per situation.

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