Public Perception vs Public Health: Why Infectious Disease Preparedness Still Matters

More than 6 years after the COVID-19 pandemic began, concern about infectious diseases remains high, but has public understanding kept pace? In this exclusive Infection Control Today® (ICT®) interview, Norris Gearhart, CR, executive vice president of Regulatory Business Practice at First Onsite, discusses why public concern is justified, where misconceptions persist, and how education, environmental hygiene, and preparedness remain essential for protecting communities from emerging infectious disease threats.

ICT: The survey found that 61% of Americans remain concerned about the transmission of infectious diseases in public settings, and 56% are worried about another global pandemic. More than 6 years after COVID-19 emerged, what do these findings tell us about how public perceptions of infection risk have changed, and are these concerns justified based on the current infectious disease landscape?

Norris Gearhart, CR: Yes, I believe the concerns are completely justified. As to how these public perceptions have changed, have they? From my perspective, very little behavior has changed regarding the professed concerns, and if I see anything, it is that we as a society have changed our behavior for the worse.

When I am traveling through airports and other public venues, I see the same inconsiderate behaviors toward both our fellow humans and potential pathogen risks as before the COVID-19 shutdown. I see people using the restroom without washing their hands or not washing them effectively, which can increase the spread of pathogens. I see sneezing and coughing without covering their mouths or using their hand without thinking of washing it prior to touching something or someone else. I see the crowding of personal space and the lack of ventilation and airflow. I see people who use cleaners and disinfectants without understanding how to use them effectively.

This misuse creates a placebo effect, making them feel like they have done something good. The reality is that they may have contributed to creating resistance in a pathogen to the active ingredient in their cleaning product. There is a decline in flu and COVID-19 vaccination, and resistance to receiving vaccinations that have proven safe and saved hundreds of millions from suffering life-altering consequences or death. These are basic personal discipline and value decisions being made without any consideration of risks to community health.

Decisions driven by misinformation, laziness, and fear. This opens the discussion to our country’s understanding of public health risk mitigation from communicable diseases in general. I have had many discussions about the flu vaccine and people’s reasons for not getting it annually. Regardless of the excuse for not getting vaccinated, what I hear in their responses is a lack of understanding of the science and why they should get vaccinated. That is a failing of our public health system to educate. Using the flu vaccine as an example, if you are not young, old, or immunocompromised and you get the flu, chances are you will feel miserable for a week or so, but you recover and are fine.

Why take the “risk” or inconvenience of getting the shot? The reason for the person who doesn’t get the flu shot, regardless of the excuse, is not about them or their personal freedoms. It is for the greater good and protection of the community. It is to protect the vulnerable in society. Think of those you may expose if you contract the virus. Your young children or older parents, those with weak immune systems due to other health conditions. Think of limiting the host opportunity for the virus to grow and mutate, which you provide by not getting vaccinated.

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Professor Gian Maria Rossolini Discusses the Global Threat of Antimicrobial Resistance and the Future of Clinical Microbiology

Antimicrobial resistance (AMR) continues to rank among the world's most urgent public health threats, challenging clinicians, microbiology laboratories, and infection prevention teams across every health care setting. As resistant pathogens evolve and spread, advances in surveillance, diagnostics, antimicrobial stewardship, and laboratory medicine are becoming increasingly important to protecting patients and preserving the effectiveness of existing therapies.

To better understand the current state of AMR and where the field is headed, Infection Control Today spoke with Gian Maria Rossolini, MD, professor of microbiology and clinical microbiology at the University of Florence, Italy, and director of the Clinical Microbiology and Virology Unit at Florence Careggi University Hospital. Rossolini is internationally recognized for his work in antimicrobial resistance, clinical microbiology, surveillance, and the clinical impact of drug-resistant infections. He has authored more than 470 scientific publications indexed in PubMed and serves on numerous international scientific initiatives focused on combating antimicrobial resistance.

In this exclusive Q&A with Infection Control Today® (ICT®), Rossolini discusses the evolving AMR landscape, emerging resistance mechanisms, the role of rapid diagnostics and surveillance, and what infection preventionists and clinical microbiologists should prioritize as they prepare for future challenges.

ICT: In real-world hospital settings, what are the consequences—clinically and operationally—of delayed or missed multidrug-resistant organisms (MDRO) identification, and where do you see those gaps most often occurring today?

Gian Maria Rossolini, MD: Delayed or missed identification of MDRO carriage in hospital settings is expected to reduce the efficacy of infection prevention and control (IPC) practices and, consequently, to increase the risk of MDRO dissemination within the health care context. Moreover, delayed or missed identification of MDRO carriage could also [affect] the selection of the initial empiric treatment for infections in terms of delayed or lack of MDRO coverage, which might reflect on clinical outcomes, especially with some categories of high-risk patients. Similar gaps are expected to occur most often in settings where diagnostic microbiology is outsourced, with consequent delays in the pre-analytical phase.

ICT: Rapid molecular tests can provide faster results, but not all results are equally actionable. How should infection preventionists and clinicians interpret and prioritize MDRO screening data without creating confusion or unnecessary interventions?

GMR: Rapid molecular tests are faster and more sensitive than conventional culture for screening of MDRO carriage. Provided that rapid molecular tests have been validated for in vitro diagnostic use and are performed following the recommended protocols, including suitable controls, the results of these tests are reliable and actionable for infection preventionists to enforce more rapidly the IPC measures aimed at contrasting MDRO dissemination within the health care setting.

Moreover, when dealing with high-risk patients with infections, clinicians can rely on the faster, more sensitive results from rapid molecular tests to screen for MDRO carriage, enabling faster decisions on empiric antimicrobial regimens while awaiting information about the infecting pathogens.

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