Faculty Q&A
As the coronavirus spreads throughout the country, an increasing number of American health care workers helping to treat patients are contracting the infection.
Christopher Friese, the Elizabeth Tone Hosmer Professor of Nursing at the School of Nursing and professor of health management and policy at the School of Public Health, leads a research team focused on health care delivery in high-risk settings. He discusses the importance of health care worker safety while treating coronavirus.
Your research has shown that health care workers often don't receive the equipment and training they need or they use the equipment improperly. How can they protect themselves?
Friese: To me, the strategy for any health care worker is first take care of yourself. It's the old analogy, when you're on the airplane put your own mask on first. Take the time to study up on this problem. There's good resources at the CDC-WHO website to learn about this virus, how it spreads and what you can do to protect yourself.
The second step is to practice yourself. Don't wait for your employer to roll out some complicated training. We know from our work that despite training nurses do not apply and remove their protective equipment as recommended, They're subject to contamination. They need to practice this. They can't assume they will do it right when the urgent matter arises.
Health care workers should have the conversation with their employer to make sure the supplies are present. One thing that happened with H1N1 about 10 years ago is that many hospitals had to buy different kinds of masks than the staff were used to, and this led to failures because the staff didn't know how to wear them properly.
I think it's important to stay connected to the CDC and WHO. We may learn over time the guidelines may change like it did with Ebola-the initial information was updated but it's not clear all health care workers were updated with that new information. My strong recommendation is to check at least daily the CDC and WHO to see if there have been changes. That may seem like a lot but we're in uncertain territory, and personal, up-to-date knowledge is your best defense right now.
The public has been asked to save masks for health care workers. Why do health care workers need masks but the public has been told they're not helpful?
There is no data that suggests that for regular people who are not sick, wearing a mask in public will do anything to reduce exposure to the virus. But, for health care workers, we need this workforce to stay healthy. There are already reports of potential shortages in particular areas, so we have to be really thoughtful about how we use the supply that we have. The best use right now is for health care workers who have to go patient-to-patient and who, in the long run, will have to care for sick patients for months and months.
What about workers and patients in home health care, nursing homes and outpatient clinics?
The problem in places like nursing homes and home care and EMS is they're under-resourced (in training and equipment). Often in these areas, workers are part-time and working in multiple agencies or facilities, so that allows the spread to happen more rapidly. The third part is these environments are not designed to isolate patients; nursing homes often have two beds to a room. Obviously, you're going house-to-house and EMS picks up dozens of patients a day-how do you clean and disinfect those spaces? All places that treat patients, particularly vulnerable patients, will need this equipment and they'll need to be able to isolate patients.
What kind of equipment keeps health care workers safe?
The most important thing is to wash your hands thoroughly, and then with a 60% or higher alcohol hand gel if soap and water are not available. For appropriate respiratory protection, the current recommendation for CDC is to wear an N95, which is a specific kind of face mask. In the hospital setting with confirmed coronavirus patients, they recommend disposable gowns and gloves. Unless you are told otherwise by the CDC, you do not reuse and you must remove properly and wash hands after you wear them.
How can patients safely interact with health care providers?
The most important thing a patient can do is alert the health care team they're having respiratory symptoms immediately. The health care provider can put a mask on the patient and then put on their own equipment.
