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The pandemic put infection prevention to the test — how does medicine make the most of it?

April 8, 2022

By Libby Plummer

Quote by Kay Miller

The Healthcare Infection Society (HIS) gives an inside view of its response to COVID-19 and how it has impacted the field Kay Miller, CEO of the Healthcare Infection Society, said turbulent times have proven to be a good opportunity to try out different things, such as unique event formats.

Infection prevention and control (IPC) in healthcare settings was already a vital specialty, but at the start of 2020, no one could have predicted just how important it was about to become.

As the SARS-CoV-2 virus started to spread around the globe, limiting this spread became top priority: hospitals prepared to treat the growing influx of COVID-19 patients while protecting their healthcare workers and those patients admitted for other reasons. In this harrowing scenario, IPC was pushed to the forefront of the COVID-19 response, transforming the field of infection control forever.

As a leader in this area, the Healthcare Infection Societyopens in new tab/window rose to the challenge. The society shares evidence, research and best practices through training, education and research funding. It also produces two journals — the Journal of Hospital Infection (JHI)opens in new tab/window and Infection Prevention in Practiceopens in new tab/window (IPIP) — both published by Elsevier. The JHI publishes impactful IPC research for an international audience, while its open access sister journal, IPIP, leans more towards the pragmatic side of the specialty, focusing on local experiences worldwide, and quality improvement and case studies from infection control practitioners.

With its strong role in the pandemic response, the society has seen its membership grow over the last two years. HIS now has almost 1,400. Members include a variety of frontline healthcare professionals, specialty trainees, consultants, clinical scientists, nurses and others with specialist knowledge of infections contracted within healthcare settings.

Supporting this membership during a very challenging time continues to be a top priority for the society. As CEO Dr Kay Milleropens in new tab/window explained:

Like everybody else, we went into firefighting mode and had to deal with the operational aspects of cancelling face-to-face events and transferring them online. We are very reliant on our volunteers to help us develop and deliver training, to publish clinical guidelines, and to keep our journals going, and we were keenly aware of the pressure that they were under professionally. So we were really keen to support our members in their day-to-day jobs, give them the information that they needed, and also disseminate the information that was coming in.

One of first things the society did was to develop a series of one-hour webinarsopens in new tab/window, hosting these twice a month during the early months of the pandemic. Each of the audience-led webinars focused on a pre-announced topic, and members were asked to submit questions to a panel of four experts working in IPC. This “fireside chat” format meant that members could get answers to real-life challenges in real time.

Another way HIS engages with its members is through its biennial FIS/HIS International event, which went virtual in 2020 and is set to make a return as a physical event with a hybrid element in 2022. “Moving online has enabled HIS to offer training to more people than ever before,” Kay said, “so we need to think about how we can maintain and grow that kind of rate.”

Inevitably, the pandemic has also had a major impact on the society’s two journals. The Journal of Hospital Infection’s article submissions grew significantly, with the team receiving roughly double the number they would usually see in a year. During the peak of the pandemic, they were receiving around three times more submissions than usual.

The huge influx of COVID-related submissions presented a significant challenge for the team in deciding which studies should go through to peer review when dealing with a novel virus.

The definitive early article gets 2M views

The journal also saw an uptick in engagement with its published research, with one paper — Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agentsopens in new tab/window — rapidly becoming the definitive early article on disinfectants and SARS-CoV-2. The article had more than 1,600 citations on Scopus and more than 120 policy citations, according to PlumXopens in new tab/window Metrics, along with high social media traffic, featuring in more than 12,000 tweets and 31,000 engagements on Facebook.

JHI Editor-in-Chief Dr Jim Grayopens in new tab/window, who is also Consultant Microbiologist at Birmingham Children’s and Women’s Hospitalsopens in new tab/window and Editor of Elsevier’s International Journal of Antimicrobial Agentsopens in new tab/window, explained:

At the beginning of the pandemic, there was lots of uncertainty on how we could safely destroy the virus. And so this paper really hit a chord with a lot of people because they were all faced with the same issue of wanting to know whether the disinfectants that they used in their hospitals would actually be effective on SARS-CoV-2 or not.

Jim Gray, MRCP, FRCPath

Meanwhile, Infection Prevention in Practice also saw substantial growth in its submission rates. Gemma Winzoropens in new tab/window, IPIP’s Editor-in-Chief and Consultant Microbiologist at UKHSA Birmingham Regional Public Health Laboratory and University Hospitals Birmingham, explains that one of the key challenges during the pandemic has been getting articles peer-reviewed:

We were very keen to try and get the papers out there in a timely fashion to help people understand what we should be doing, but actually trying to get reviewers was really difficult as people were so busy.

Gemma Winzor, MBChB MPH FRCPath

In terms of content, both JHI and IPIP have tried hard to maintain a balance between COVID and non-COVID articles. Jim said:

We were fearful that our authors were likely to be dragged into COVID-related work and not have time to do anything else and that our other content would dry up all together. And actually that hasn't really happened. We've had a good flow of good quality research from around the world that has carried on against a background of all the extra COVID research.

IPIP has worked with the society to actively commission non-COVID work, using academic posters prizes at the society’s conference to offer winners a commission into the journal. “We picked topics that varied in scope to try and demonstrate the sort of work that we were looking for,” Gemma said. “It worked really well, and we've done the same again this year.”

Overall, the pandemic has thrown challenges to the young journal, but it has equally provided an opportunity for IPIP to find its voice: “It has helped me to become more decisive about what I see as the future of IPIP and what the journal’s unique selling points should be,” Gemma said.

We’ve had a lot of good papers coming through from low- and middle-income countries talking about the challenges they face locally. This made me realize that we should be calling for submissions and promoting the journal more in those parts of the world.

Lessons learned: “Don’t be afraid of trying something new.”

The pandemic has provided a steep learning curve, both for the journal teams and for the society as a whole. Kay said the turbulent times have proven to be a good opportunity to try out different things, such as unique event formats. The CEO’s advice for other society leaders: “Don't be afraid of trying something new.”

For the Society’s journals, the experience has offered ideas for how to adapt to similar situations in the future. Jim explained:

In terms of lessons learned, we have a large international editorial board, and on reflection, we would put out an immediate call to those board members in order to publish their local experience as soon as possible, because obviously the early stages of the pandemic affected countries differently.

If we were going through this again, we would probably consider putting together a time-limited editorial team from amongst the board members to help us identify papers that we should be publishing. We would also try to recruit a team of 10 to 20 ‘super reviewers’ who could turn around papers quickly.

Next steps

With the pandemic now in a relatively more stable phase, what happens next?

HIS plans to harness the changes it has made to its training to expand its reach, while always maintaining the expert-led quality the society is known for. “Going forward, I predict that we will see an enthusiastic re-engagement with non-COVID-specific IPC content,” said Kay. “More people are now engaged in the topics that infection control specialists have been talking about for years.”

Jim agrees that while COVID has shifted the role of infection control to the forefront, the focus needs to be on what happens next:

What we’re focused on now is trying to move away from people reporting just on COVID and trying to get them to publish on what they think might be relevant to the future. We have an article collection on IPC in refugee situationsopens in new tab/window out at the moment, with a call for more papers on this sadly extremely relevant topic, for example.

On IPIP, Gemma explained that it’s hard to predict which of the current COVID literature will be relevant going forward, as the pandemic has gone on far longer than most expected. However, the journal will continue to try to keep a balance between COVID and non-COVID content and is also looking at new forms of engagement with readers:

One of our strategies for the next 12 months is finding new ways to engage with our readership. We’re currently dipping our toe into podcasting so that the readers can get a bit of a behind-the-scenes look and more of a conversation with the authors about what they're publishing.