Most people are practicing social distancing to help flatten the curve and stem the spread of the novel coronavirus (COVID-19). But there is one group of workers who need to be on the front lines of this pandemic. They are working hard to help keep the rest of the world healthy. They are, of course, healthcare workers.
Whether you are an in-home caregiver, or work in a hospital, nursing home, or doctor’s office—you may be exposed to the coronavirus while doing your job. It is vitally important to take every possible step to protect yourself. Here, experts answer frequently asked questions about COVID-19 and the healthcare workforce.
How will I know if a patient has COVID-19?
“Healthcare workers should be notified if they are being exposed to potential patients who may have COVID-19,” says Dr. Shuhan He, emergency medicine physician at the Center for Innovation in Digital Healthcare at Mass General Hospital.
This allows healthcare workers to take extra precautions around these patients. But what if the patient hasn’t been tested or diagnosed yet? How will you know if they might have COVID-19?
“I generally stick to five key symptoms,” says Dr. He. “Fevers, chills, cough, sore throat, and generalized malaise. Someone with a runny nose or runny eyes is less risky, although not entirely guaranteed to not have coronavirus.”
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What steps can in-home caregivers take to protect themselves?
“Wash your hands, wash your hands, wash your hands,” says Barbara Dehn, RN, a women’s health nurse practitioner known as Nurse Barb. “Also, be sure the home has disinfectant for surfaces. If there is no disinfectant, then use a diluted bleach solution.” In-home caretakers care for vulnerable patients, who are likely at high risk of infection, so killing the virus on surfaces is important for their health—and your own.
Personal protective equipment (PPE) is crucial. Make sure the company you work for is keeping you well-stocked with gowns, gloves, and masks. “If you are caring for someone who is mildly sick at home, wear gloves, wash your hands before and after putting on the gloves,” says Nurse Barb. “If you have masks, have the person who is sick use it. Change your clothes after caring for the person and wash in hot water in your washing machine.”
“If the person needs more care, do get guidance from their healthcare provider about whether they should be in a hospital and what symptoms would prompt that,” says Nurse Barb. “If a person is sick and it’s a mild case, continue to speak to the healthcare provider about what symptoms to be alerted for, such as shortness of breath or fever that doesn’t improve with over-the-counter remedies like Tylenol.”
Ensure that your patient doesn’t infect others, particularly if they live with other people. Have the sick person stay in a separate part of the house, 6 or more feet away from their family members or housemates, and close the door. Consider that person to be contagious for two weeks after symptoms start, even if the symptoms are mild.
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How can hospital or nursing home staff protect themselves?
Hospital and nursing home workers have a high risk for coming into contact with COVID-19 patients. Healthcare facilities have infection control committees that formulate infection control guidelines for the staff. Most of the hospitals require proper PPE use while having an encounter with a confirmed or suspected COVID-19 patient. There are more relaxed recommendations if someone is walking across a hallway. It is important to follow the recommendations by your local medical facility.
Dr. He and Dehn both say that the recommendations for hospital and nursing home staffs are very similar to those for home healthcare workers:
- Wash your hands before and after putting on gloves.
- Avoid touching your face.
- Disinfect surfaces with approved cleaners or a bleach solution.
- Wear gowns, gloves, masks, and eye shields.
- Wash any clothes that are exposed to the virus in hot water.
“It’s important we wear full PPE, which includes gowns, gloves, full face masks, and N95 respirators, cover our hair and wear eye shields,” says Dr. He. “The virus has been shown to aerosolize and also be able to spread via our eyelashes.”
Dr. He recommends that you have someone watch you put on and take off your PPE. “Many things often get missed,” he says. “For example, I may forget to put on a hair mask, or it may not be totally covering my hair. It’s like in scuba diving. Have a buddy and have a checklist so we don’t drown.”
What tools do healthcare workers need to successfully protect themselves?
Dehn says the most important protective tools for healthcare workers are PPE and disinfectant. Dr. He agrees and adds that knowledge is also a powerful tool.
“It’s important for care workers to have the knowledge they need to protect themselves and take it seriously,” says Dr. He. “How to don and doff PPE is a key skill that they should make sure to practice.”
One thing the public can do to help ensure our care workers have the supplies they need is to stop stockpiling these PPE tools. Dr. He notes that these items have become very difficult to find, and that is a serious problem. “I could not, for example, buy a thermometer last week, as it seems like everyone is rushing to buy one, and I wouldn’t know if I had a fever from an exposure,” he says. “It’s critical during this time we have the protection we need.”
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If a healthcare worker gets sick, what happens?
If you are an in-home caregiver, and you take care of older or vulnerable people in their homes, Dehn recommends creating a back up plan with your patient’s family.
If you suspect that you may have a viral illness while at work, it is best to distance yourself from the patients or vulnerable people immediately and discuss with your supervisor.
“Make sure people have contact information for someone else to call in case you can’t make it to work,” says Nurse Barb. “Do reach out to the person’s neighbors ahead of time if there is no family available.”
As for hospitals and nursing homes, Dr. He explains that they are doing their best to create backup plans. “We are preparing for the worst at this time,” he says. “We are all hands on deck to ensure that we all have an extra backup for when people get sick. We are all volunteering for extra work to ensure proper coverage for the ill. It will get worse, but we’re ready with back up plans to take care of those in need.”
Are pregnant healthcare personnel at risk if they care for patients with COVID-19?
It’s unknown if COVID-19 poses a higher risk to women who are pregnant. Pregnancy typically increases risk for contracting viral illnesses; however, the data is limited at this point about the risk of complications to pregnancy. As an extra precaution, pregnant healthcare workers may want to limit exposure to COVID-19 patients, especially during procedures that are more likely to expose them to saliva, mucus, or aerosolized germs.
What are my rights as a healthcare worker during an outbreak?
When you’re a healthcare worker during an outbreak, you’re under a lot of extra stress—risk of exposure and long hours can lead to exhaustion and burnout. During times like these, it’s even more important to know your rights. According to the World Health Organization (WHO), they include the right to:
- Information and training on how to protect yourself
- Adequate infection prevention and control and PPE supplies
- Updates on how to best assess and triage COVID-19 patients
- Access to blame-free environment to report issues, and security for personal safety
- Appropriate working hours and breaks
- Stay home when sick, or to excuse yourself from a situation that is imminently and seriously dangerous without undue consequences
- Mental health or counseling resources
- Compensation, rehabilitation, and curative services if you are exposed at work
For more information, consult the WHO guidelines.