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by Yaneer Bar-Yam
Step VI: Create Disinfection Gateways
Bedrails, bedding, clothing, curtains, cell phones, pagers, and myriad other objects can all be locations for pathogen transfer.

We have to consider how pathogens are transferred: from one patient to the surfaces and fabrics near that patient to the care providers and their clothing, cell phones and pagers. From there the pathogens are transferred either directly to another patient or to the fabrics and surfaces in common areas or around that patient from which they eventually reach that patient at a different contact opportunity.

Most of the possible transmission events happen because of the large number of contacts within a local ward between patients and doctors, nurses, medical technicians, food service people and cleaning staff. Each of these contacts has the potential to transfer pathogens between patients, and to contaminate objects in shared spaces, such as computer keyboards.

If there were no virulent pathogen in the ward in the first place, none of those possible transmission events could actually transfer virulent pathogens. Using boundary protocols to reduce transmission between wards would eliminate a large number of potential transmission events among the individuals within each ward.

With the use of boundary protocols, there would be a reduction not only in the transmission of existing pathogens but also in the emergence of new resistant strains. The high number of physical contacts makes medical care facilities a uniquely fertile environment for pathogens to evolve into more virulent strains. By blocking the spread of infection between areas, we can cut down on the appearance of virulent pathogens as well as their prevalence.

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