key: cord-1008677-p7p4v6c8
authors: Unruh, Larissa H; Dharmapuri, Sadhana; Soyemi, Kenneth
title: The Utility of Video Technology and Enhanced Infection Control in Reducing COVID-19 Disease Burden in a Custodial Setting.
date: 2020-10-26
journal: Am J Infect Control
DOI: 10.1016/j.ajic.2020.10.016
sha: 170f44e2adbccc60acd92f6ff4658f3bf431ea3b
doc_id: 1008677
cord_uid: p7p4v6c8

We describe the use of video technology to enhance case interviews, identify COVID-19 contacts, and determine exposures risk within a large juvenile temporary detention center. We created a COVID-19 outbreak management protocol which included the formation of an outbreak management team (OMT) and enhanced infection control practices using video surveillance. Currently, our institution's positivity rate remains low for both staff and residents largely because of the OMT. Video technology combined with enhanced infection control practices can be a useful technique to reduce COVID-19 infections in custodial settings.

largely because of the OMT. Video technology combined with enhanced infection control practices can be a useful technique to reduce COVID-19 infections in custodial settings.

On Wednesday, March 11, 2020, the World Health Organization (WHO) declared COVID-19, the disease caused by the virus known as SARS-CoV-2, a pandemic. SARS-CoV-2 is transmitted via respiratory droplets and has caused significant morbidity and mortality worldwide. At the end of July 2020, more than 4 million cases of COVID-19 and 140,000 deaths were reported in the United States 1 . There have been multiple large outbreaks within custodial secured settings because these settings have complex internal and external factors that place them at high risk for the rapid spread of infection. Those factors include poor ventilation, lack of negative pressure rooms, outdated environmental engineering designs, and difficulties maintaining social distancing 2, 3 . The odds of a viral outbreak, including SARS-CoV-2, in custodial settings is high and is often introduced into these settings by employees, contractors, and visitors. In light of the many accounts of rapid transmission and high morbidity from the SARS-CoV-2 virus in federal and state correctional facilities 4, 5 Upon case notification, a member of the OMT interviewed the infected employee or resident to determine contacts and last locations. The interview was supplemented with time clock confirmation for employee's location and entry point into the facility and the surveillance video which was review by a specialized team within 48 hours. Identified close contacts who were employees were instructed by HR to quarantine, get tested for SAR-COV-2, complete daily temperate check, and at the end of 14 days obtain medical clearance from their health care provider before returning to the facility (Figure 1 ). In cases where the close contact was a resident, that resident was monitored using established isolation and quarantine guidelines 6 

who had close contacts with residents. All residents exposed to an infected employee were tested to determine the secondary attack rate. The primary and secondary attack rates for residents were 5.4% and 2.9% compared with 7.2% and undetermined for employees. The secondary attack rate for employees could not be determined for the following reasons: 

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Centers for Diseases Control and Prevention. Interim Guidance on Management of Coronavirus Disease 2019 (COVID-19) in Correctional and Detention Facilities

Establishing prison-led contact tracing to prevent outbreaks of COVID-19 in prisons in Ireland

Covid-19 National Emergency Response Center E, Case Management Team KCfDC, Prevention. Contact Transmission of COVID-19 in South Korea: Novel Investigation Techniques for Tracing Contacts