Swimming competitions in the era of COVID-19: Lessons from successfully hosting the International Swimming League.

Background: Organization of mass sport events in the COVID-19 era is utterly complicated. Containments measures, required to avoid a virus outbreak, force athletes to compete under circumstances they never experienced before, most likely having a deleterious effect on their performance. Purpose: We aimed to design a so-called athlete-friendly bubble system for the International Swimming League 2020 event, which is strict enough to avoid a COVID-19 outbreak, but still provides a supportive environment for the athletes. Methods: To avoid the feeling of imprisonment, athletes were permitted to spend a certain amount of time in the parks surrounding the hotels. Such alleviations were possible to apply with strict adherence to the hygienic and social distancing protocols and regular COVID-19 testing. Evaluation of every COVID-19 positive case was key, and if prolonged PCR positivity or false positive PCR result was identified, the unnecessary quarantine was planned to be lifted. Return to play protocol (RTP) was planned, in case of a COVID-19 infection of an athlete inside the bubble. To test, if the athlete-friendly system provided a supportive environment, we evaluated athlete performance. Results: 11,480 PCR tests were performed for 1,421 individuals. 63 COVID-19 positive cases were detected, of which 5 turned out to be clinically insignificant, either because of prolonged PCR positivity or because of a false positive result. 93.1% of the positive cases were detected in the local crew, while no athlete got infected inside the bubble, as the two infected athletes were tested positive upon arrival. RTP was provided for two athletes. 85% of the athletes showed improvement during the bubble and 8 world records were broken. Conclusion: The applied protocol proved to be effective, as no athlete got infected inside the bubble, moreover, the athlete-friendly system supported the athletes to improve their performance.

[Implementation of immediate feedback system into hand hygiene practice in the intensive care unit]. / Azonnali visszajelzo rendszer bevezetése a kézhigiéné gyakorlatába intenzív osztályon.

Introduction: Infections affect about 30-50% of intensive care unit patients resulting in substantial morbidity and mortality. Multimodal interventions proved to be successful in the prevention of healthcare-associated infections. Appropriate hand hygiene including correct disinfection technique and timing is essential. Aim: The aim of our study was to investigate the hand hygiene practice among the intensive care unit healthcare workers by immediate feedback system implementation and compliance study. Method: A 3-week-long observational study was conducted at the Department of Anaesthesiology and Intensive Therapy, Semmelweis University, during November and December, 2018. Data regarding hand hygiene technique were collected by using the Semmelweis Scanner technology, while compliance data were recorded by direct observations. Statistical analysis was performed by Kruskal-Wallis test, Fisher's exact test and χ2-test. Results: 604 measurements were recorded by the electronic system. Hand disinfection was appropriate in 86.5% of cases. The median value of coverage was 99.87%. The trend of these indices showed persistently high values. A lower error rate was observed in the physiotherapy group compared to others (doctors: p<0.01, nurses: p = 0.03, assistant nurses: p = 0.03). 162 opportunities were recorded during direct observations. The mean compliance rate was 60.49%, with the lowest among doctors (53.97%). The difference was non-significant compared to nurses (62.92%, p = 0.26). Conclusions: Hand hygiene technique during the study period was found to be highly and permanently appropriate, while compliance was lower than expected. The immediate feedback system may be useful in achieving appropriate hand disinfection technique, although further interventions are needed for higher compliance rates. Orv Hetil. 2019; 160(49): 1957-1962.