Coronavirus disease (COVID-19) was officially declared a pandemic in March 2020. Many cases of COVID-19 are nosocomial, but to the best of our knowledge, no nosocomial outbreaks on psychiatric departments of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported in Europe. The different nature of psychiatry makes outbreak management more difficult. This study determines which psychiatry specific factors contributed to a nosocomial outbreak taking place in a psychiatric department. This will provide possible interventions in future outbreak management. A case series describing a nosocomial outbreak in a psychiatric department of an acute care hospital in the Netherlands between March 13, 2020 and April, 14 2020. The outbreak was analyzed by combining data from standardized interviews, polymerase chain reaction (PCR) tests and whole genome sequencing (WGS). The nosocomial outbreak in which 43% of staff of the psychiatric department and 19% of admitted patients were involved, was caused by healthcare worker (HCW)-to-HCW transmissions, as well as patient-to-HCW-to-patient transmission. We identified four aspects associated with the mental health care system which might have made our department more susceptible to an outbreak. Infection control measures designed for hospitals are not directly applicable to psychiatric departments. Psychiatric patients should be considered a high-risk group for infectious diseases and customized measures should be designed and implemented. Extra attention for psychiatric departments is necessary during a pandemic as psychiatric HCWs are less familiar with outbreak management. Clear communication and governance is crucial in correctly implementing these measures.

中文翻译：

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为什么精神病学与众不同-在医院护理中应对医院内冠状病毒病暴发（COVID-19）的挑战和困难

冠状病毒病（COVID-19）于2020年3月正式宣布大流行。许多COVID-19病例是医院内的，但据我们所知，严重急性呼吸系统综合症冠状病毒2（SARS-CoV）的精神科没有爆发医院-2）在欧洲已有报道。精神病学的不同性质使爆发管理更加困难。这项研究确定了哪些精神病学特定因素导致了精神科发生医院内暴发。这将为将来的爆发管理提供可能的干预措施。一个病例系列，描述了2020年3月13日至2020年4月14日之间荷兰一家急诊医院的精神病院的医院内暴发。该暴发是通过合并标准化访谈的数据进行分析的，聚合酶链反应（PCR）测试和全基因组测序（WGS）。涉及医院内暴发的精神病科工作人员中的43％和住院患者中的19％是由医护人员（HCW）到HCW的传播以及患者到HCW到患者的传播引起的。我们确定了与精神卫生保健系统相关的四个方面，这些方面可能使我们的部门更容易爆发疫情。专为医院设计的感染控制措施并不直接适用于精神科。精神病患者应被视为传染病的高危人群，应设计和实施个性化的措施。在大流行期间，精神科医务工作者对疫情管理不太熟悉，因此有必要对精神科给予更多关注。