02299nas a2200181   4500000000100000008004100001260005400042653001700096653001300113653002400126653001300150100001500163700001200178245011800190856016200308520162200470022002502092       2020                            d  bAmerican Society of Tropical Medicine and Hygiene10aParasitology10aVirology10aInfectious Diseases10aCovid-191 aMcGriff JA1 aDenny L00aWhat COVID-19 Reveals about the Neglect of WASH within Infection Prevention in Low-Resource Healthcare Facilities  uhttp://www.ajtmh.org/docserver/fulltext/10.4269/ajtmh.20-0638/tpmd200638.pdf?expires=1601376043&id=id&accname=guest&checksum=340FE5609544D996E9714A265997DF763 aThe highly infectious nature of the SARS-CoV-2 virus requires rigorous infection prevention and control (IPC) to reduce the transmission of COVID-19 within healthcare facilities, but in low-resource settings, the lack of water access creates a perfect storm for low-handwashing adherence, ineffective surface decontamination, and other environmental cleaning functions that are critical for IPC compliance. Data from the WHO/UNICEF Joint Monitoring Programme show that one in four healthcare facilities globally lacks a functional water source on premises (i.e., basic water service); in sub-Saharan Africa, half of all healthcare facilities have no basic water services. But even these data do not tell the whole story, other water, sanitation, and hygiene (WASH) assessments in low-resource healthcare facilities have shown the detrimental effects of seasonal or temporary water shortages, nonfunctional water infrastructure, and fluctuating water quality. The rapid spread of COVID-19 forces us to reexamine prevailing norms within national health systems around the importance of WASH for quality of health care, the prioritization of WASH in healthcare facility investments, and the need for focused, cross-sector leadership and collaboration between WASH and health professionals. What COVID-19 reveals about infection prevention in low-resource healthcare facilities is that we can no longer afford to “work around” WASH deficiencies. Basic WASH services are a fundamental prerequisite to compliance with the principles of IPC that are necessary to protect patients and healthcare workers in every setting.  a0002-9637, 1476-1645