Limited access to testing early in the outbreak, false negative results for nasopharyngeal swabs in early stages of disease, and presentation with gastrointestinal symptoms may have led to some patients with COVID-19 being misclassified and placed in non-COVID-19 areas with different infection prevention control processes.3 Enteric features, and the ability of SARS-CoV-2 to persist on surfaces, raise the possibility of faecal-oral transmission in care settings under severe pressure, although the role of this transmission route is uncertain.5 As SARS-CoV-2 is likely to persist as an endemic or seasonal virus in coming years, it is critical to use the lessons learned so far in the pandemic to minimise the burden of hospital-acquired infections, and to consider new approaches to reduce the burden further. Unlike at the beginning of the pandemic, there are opportunities to pre-empt hospital-acquired infections and break chains of transmission through regular patient, resident, and staff testing including point-of-care diagnostics, as recently introduced for NHS staff, coupled with robust hospital infection prevention and control policies that include staff vaccination, environmental disinfection, and appropriate isolation, all supported by sentinel monitoring systems. PJMO reports personal fees for consultancy from Janssen and from the European Respiratory Society; grants from the MRC and Wellcome; funding from the EU and the European Federation of Pharmaceutical Industries and Associations for the respiratory syncytial virus consortium in Europe; and funding from the NIHR, the MRC, and GSK to the EMINENT Network.