In the context of COVID-19 transitioning to a Group B infectious disease and being sustainably controlled, the Ministry of Health has issued Decision No. 2407/QD-BYT on “Guidelines for Infection Prevention and Control of COVID-19 in Healthcare Facilities”. This document replaces previous guidelines, aiming for safe, flexible adaptation while ensuring maximum safety for patients and healthcare workers.

Below are the key contents to note regarding infection control work in medical facilities according to the new guidelines:

Organization of early detection, screening, and timely isolation

Healthcare facilities need to maintain screening processes based on clinical symptoms and epidemiological factors. At the reception area or Emergency Department, if a patient shows signs of acute respiratory infection (cough, fever, shortness of breath…), they must be guided to the infectious disease clinic or a separate examination area.

Regarding testing, indication for SARS-CoV-2 testing (rapid test or RT-PCR) is applied with a focus on specific cases: Patients with acute respiratory distress syndrome of unknown cause; People with suspected symptoms of COVID-19 accompanied by underlying medical conditions belonging to the high-risk group for severe progression.

For confirmed COVID-19 cases:

• Mild cases, asymptomatic, and no risk factors: Guidance for home monitoring and isolation or at health stations.
• Cases detected in clinical wards: Transfer the patient to the ward’s temporary isolation room for treatment, minimizing movement to avoid cross-contamination.

Application of standard precautions and transmission-based precautions

The use of personal protective equipment (PPE) must comply with the principle of “Correct risk level – Correct procedure”. Do not wear full-body protective gear (coveralls) for healthcare workers working in general areas with no high risk of infection.

Standard precautions apply to all patients. Healthcare workers need to wear medical masks and gloves when anticipating contact with blood, body fluids, or mucous membranes of patients. Routine hand hygiene is the mandatory and most important measure to break the chain of transmission.

For aerosol-generating procedures (such as intubation, bronchoscopy…), healthcare workers need to apply airborne transmission precautions, using N95 masks and face shields/goggles.

Special infection control for high-risk patient groups

An important new point in Decision No. 2407/QD-BYT is focusing resources on protecting vulnerable groups. Patients in high-risk groups (undergoing hemodialysis, cancer treatment, immunocompromised, elderly with multiple underlying conditions) need to be arranged in separate treatment areas if conditions permit.

In these areas, compliance with regulations on hand hygiene, environmental surface cleaning, and visitor control needs to be strictly enforced compared to other areas to prevent source entry.

Ensuring ventilation and hospital environmental hygiene

Patient rooms, especially reception areas, Emergency Departments, and isolation rooms, need to ensure good ventilation. Prioritize natural ventilation or use mechanical ventilation systems, ensuring airflow from clean areas to dirty areas.

Surface cleaning and disinfection must be performed periodically, paying special attention to high-touch surfaces (doorknobs, bed rails, keyboards…). Infectious waste from COVID-19 patients is collected and treated according to regulations on hazardous medical waste management.

Strengthening training and compliance monitoring

Medical facilities are responsible for organizing annual training and knowledge updates for healthcare workers, interns, and cleaning staff regarding infection control. Simultaneously, encourage patients and their families to wear masks when visiting medical facilities to protect their own health and the community.

Proper implementation of Decision No. 2407/QD-BYT will help healthcare facilities maintain a safe environment, “living with” the epidemic proactively and scientifically.

Assoc. Prof. Dr. La Ngoc Quang – Center for Support & Continuing Education