Ethics of healthcare providers not working during pandemic/e

[SusanBAnthony]

What are the ethics of healthcare providers choosing not to work during a crisis?

What if there aren't enough masks and gloves, etc? Would they still be ethically bound to go to work?

What if they are immunocompromised themselves? Or just old* enough to generally be at higher risk?

What if a healthcare worker needs to take care of their own family? I assume if it was the same household they couldn't work because they'd have been exposed. But what if someone needed to care for family they hadn't yet been exposed to?

Are there general expectations?

*(This is the one I personally am curious about as my mom is an RN and near retirement age, and if her hospital ran out of masks/gloves/etc I selfishly don't want her to go to work).

[wanderingback]

Yes each health care system sets up its own policies.
Most places have essential personnel that if it came down to it would be the ones who are expected to be there.

I don’t know how it works among nurses but for us during natural disaster crises it’s typically whoever is assigned to come in to work still does it, if they weren’t able to do so then there are always back ups and typically people volunteer. During inclement weather the doctors will usually stay on very extended shifts if no one can come and go.

If there were literally no supplies left in the world then I really have no idea. It would be a personal choice, obviously no one can force you to do something that is unsafe or you don’t feel comfortable with doing.

For me personally no I wouldn’t take care of a patient with Ebola if there were no PPE available but I would likely take care of a patient with Coronavirus if I had to if there were no PPE based on what we know now. Then, of course follow the proper protocols for quarantine.

[tacom]

@@@

I don’t have any answers but I’m following.

I’m in healthcare in a city with confirmed cases. I am immunocompromised. I also am the primary caregiver to my 1 year old son with no backup care / family in the area.

I work per diem on a part time basis without benefits. I net about $30/ day after taxes and part time daycare; however, my shifts are canceled if caseload dips so there are some weeks I’m net negative

I work because I enjoy what I do and want to keep opportunities open for the future.

But my top priority is to protect my son and protect my health so I can care for my son. There’s no chance I’m going to work without PPE. I’m not sure if I’ll continue to work even with PPE in the face of a large local outbreak.

I chose this field when I was 21 and child free without a preexisting health condition. Life changes. And if my employer can’t even provide the disability or life insurance my family would need in the wake of a severe case, why should I report? If they can cancel my shifts, can’t I do the same? (The answer is no, unless I want to lose my job)

With that said, I obviously hope other healthcare workers continue to do what they do. We need them. It all makes me uncomfortable to think about.

[SusanBAnthony]

Feb 29, 2020 21:59:56 GMT -5 tacom said:

@@@

I don’t have any answers but I’m following.

I’m in healthcare in a city with confirmed cases. I am immunocompromised. I also am the primary caregiver to my 1 year old son with no backup care / family in the area.

I work per diem on a part time basis without benefits. I net about $30/ day after taxes and part time daycare; however, my shifts are canceled if caseload dips so there are some weeks I’m net negative

I work because I enjoy what I do and want to keep opportunities open for the future.

But my top priority is to protect my son and protect my health so I can care for my son. There’s no chance I’m going to work without PPE. I’m not sure if I’ll continue to work even with PPE in the face of a large local outbreak.

I chose this field when I was 21 and child free without a preexisting health condition. Life changes. And if my employer can’t even provide the disability or life insurance my family would need in the wake of a severe case, why should I report? If they can cancel my shifts, can’t I do the same? (The answer is no, unless I want to lose my job)

With that said, I obviously hope other healthcare workers continue to do what they do. We need them. It all makes me uncomfortable to think about.

I would definitely make the same choices as a per diem employee. Totally agree that if they don't want to pay benefits, etc, these kind of things are the consequence.

[TR]

tacom - you’re an SLP, right? I don’t think you have the same “obligation” (not that anyone is obligated, but i can’t think of the right word to use) as those providing, like, life sustaining care to patients with coronavirus.

[tacom]

Feb 29, 2020 22:32:01 GMT -5 TR said:

tacom - you’re an SLP, right? I don’t think you have the same “obligation” (not that anyone is obligated, but i can’t think of the right word to use) as those providing, like, life sustaining care to patients with coronavirus.

Yes! I’m in med SLP so I work primarily with patients who have swallowing disorders. We’re often consulted by MDs for patients with respiratory issues, including respiratory failure and pneumonia given the overlap between swallowing and respiratory function and the need to safely establish a method of nutritional intake prior to discharge home. Biggest immediate concern is to reduce the risk of aspiration pneumonia, which can be fatal and is the leading cause of death in some neurodegenerative populations.

I have yet to have experienced a bad enough natural disaster where we weren’t considered essential employees (expected to come in and even stay overnight in the hospital once we’ve safely arrived to cover for the next day’s staff). But something like a pandemic for a respiratory disease is a different story since more healthcare workers (especially those who aren’t going to intubating patients or providing immediate life sustaining treatments) seems like more opportunity to continue to transmit something highly contagious. And of course fewer supplies to go around. My hope is that physicians and nurses could manage these patients more directly while relying on allied health services on a more consultative basis, but frankly these providers are already overburdened and the training ends in swallow screening. We’re the only service who can complete objective testing to guide recs, but at some point I guess that goes down the drain and you just accept some level of risk that some of your patients will aspirate and may develop aspiration pneumonia and subsequently die. But that is not the current standard of care in the US.

With that said, my hospital is already rationing N 95 respirators, starting daily counts and removing them from general areas in the hospital. They’ve written about a contingency plan that includes the use of powered air purifier respirators (PAPRs) but no mention whatsoever on limiting staff at this point.

[aprilsails]

I’m not in health care but like a mentioned in other threads on CE&P my Mom is a virologist. She is semi-retired and is only supposed to be working 5-6 training shifts per month. She has been working 4 days per week since COVID-19 became a pressing issue. My Mom is the most experienced in her lab on genetic test kits and has been setting up the testing procedures and guidelines for the hospital. She expects that she will continue to work this much or will be pressed to work overtime if the disease starts to circulate in our region.

My Mom has the ability to retire at any point (she is fully vested in her pension) but was continuing to work since my Stepdad is younger and is going to work for probably 3 more years. She has very real concerns that he will be unable to work due to quarantine or have a very slow year (he is in car sales) so she is expecting that her working full time will make up the difference.

Now she did say when Ebola came back in 2013 that if it came to North America she would be tempted to set up the lab and leave. She travelled to Africa during the 90s with WHO and did work on vaccine research following that outbreak here in Canada. It sucked and she was an absolute ball of stress and nerves throughout the project. I have very distinct memories of that time and I was pretty young. She actually left clinical lab work for teaching shortly after, but later went back.

[Saudade]

I'm a flight nurse full time for a L2 hospital and an ICU nurse on a prn basis for a L1 hospital.

For my PRN job (which used to be my FT job) we are considered essential..duh. Every winter we have at least one winter storm that requires us to test "essential". That means, if people are in the hospital they're asked to stay, with overnight accommodations provided. If you're at home and unable to come in, work will send someone to get you. Several days prior to the "event" many emails are sent out reminding those that are essential (MD, RN, RT) to make plans.

Essential staff: MD, RN, RT. Then, each department has a list of essential. So not all maintenance are essential. Not all housekeeping are essential. No therapies are essential (except respiratory).

I struggle with the ethics of this. I have no obligation to my PRN job and yet, I know how short staffed they already are and will become if coronavirus comes here. As a flight nurse I have an additional skill set that 90% of nurses do not have. That will become invaluable should this area outbreak as well.

@@
However, I do feel an immense sense of duty because I can, because I have the skills, because so few can. And then I struggle because I also have a duty to keep my kids safe and return home to them.

As it stands, I'll be honest, I don't have the best post-work hygiene. Some people come home, leave their shoes outside, put their scrubs straight in the washer, and take a shower. I leave my shoes in the entryway, put my scrubs in the laundry basket, and go straight to bed. I think I would still do my job if all I had was gloves and a mask. If they were out of gowns, fine. I can wear hospital provided surgical scrubs. If masks and gloves became scarce? I'm not sure at this point.

I'd rather work without gloves than without a mask. My fingers are intact and I can scrub in/out vs all the exposed mucous membranes of the face.

[mockingbird]

This is tough and personal. I’m a per diem psych nurse. I love my job, I love my patients. But we also have patients that throw bodily fluid at us, spit at us, there’s a lot of exposure. And my facility has proven time and time again that they aren’t willing to take extra measures to protect us. I was recently stuck with used needle in a code, I had to harass them all week to get them to test the patient, meanwhile I took prophylactic medication that made me sick. I’d be hard pressed to not lay low if it gets hot here.

[orangeblossom]

I would likely go. Now without PPE it’s questionable, only because of my asthma, otherwise I’d be less hesitant.

That said, I have a real problem with the martyrdom of nurses and other healthcare workers sacrificing their safety and housing to work. I’m thinking Katrina and other disasters. It’s not as if healthcare workers don’t have lives outside of the hospitals, but too often it’s a too bad, so sad mentality when disaster strikes.

I get it, HCW are needed, but it doesn’t make it any easier when it seems like your job and others try to make you feel bad for not doing more or being a team player.

[Michelle]

HR for hospital:
@@@


If you are the sole provider for a dependent at home, you could take a leave of absence to be home to care for your dependent child or elderly parent and could probably qualify for FMLA for 12 weeks.

Our pandemic scenarios include routing all Suspected cases to one facility For triage, to centralize and be most efficient with PPE. We have also discussed setting up a block of rooms at an extended stay hotel Or in-house sleeping facilities to offer to those workers who care for COVID19 patients if they don’t want to risk possible exposure to their families.

Like someone mentioned up thread, we have put protective measures in place for the PPE so even staff don’t start taking them in a panic when they aren’t necessary and then have none if needed.

If you are immunocompromised you would qualify for an ADA accommodation to not care for these patients, which might include taking a leave.

Other than that, nurses know what they signed up for and most would feel horrible abandoning patients when the mortality rate for this is currently so low. They don’t abandon influenza patients.

Ebola - much higher mortality rate - no one should have to care for an Ebola patient without PPE.

[orangeblossom]

Mar 2, 2020 8:15:06 GMT -5 Michelle said:

HR for hospital:
@@@


If you are the sole provider for a dependent at home, you could take a leave of absence to be home to care for your dependent child or elderly parent and could probably qualify for FMLA for 12 weeks.

Our pandemic scenarios include routing all Suspected cases to one facility For triage, to centralize and be most efficient with PPE. We have also discussed setting up a block of rooms at an extended stay hotel Or in-house sleeping facilities to offer to those workers who care for COVID19 patients if they don’t want to risk possible exposure to their families.

Like someone mentioned up thread, we have put protective measures in place for the PPE so even staff don’t start taking them in a panic when they aren’t necessary and then have none if needed.

If you are immunocompromised you would qualify for an ADA accommodation to not care for these patients, which might include taking a leave.

Other than that, nurses know what they signed up for and most would feel horrible abandoning patients when the mortality rate for this is currently so low. They don’t abandon influenza patients.

Ebola - much higher mortality rate - no one should have to care for an Ebola patient without PPE.

I hate the “know what they signed up for” mentality. We are individual people first, nurses second, despite what HR and society at large believe.

[Michelle]

Mar 2, 2020 8:27:34 GMT -5 orangeblossom said:

Mar 2, 2020 8:15:06 GMT -5 Michelle said:

HR for hospital:
@@@


If you are the sole provider for a dependent at home, you could take a leave of absence to be home to care for your dependent child or elderly parent and could probably qualify for FMLA for 12 weeks.

Our pandemic scenarios include routing all Suspected cases to one facility For triage, to centralize and be most efficient with PPE. We have also discussed setting up a block of rooms at an extended stay hotel Or in-house sleeping facilities to offer to those workers who care for COVID19 patients if they don’t want to risk possible exposure to their families.

Like someone mentioned up thread, we have put protective measures in place for the PPE so even staff don’t start taking them in a panic when they aren’t necessary and then have none if needed.

If you are immunocompromised you would qualify for an ADA accommodation to not care for these patients, which might include taking a leave.

Other than that, nurses know what they signed up for and most would feel horrible abandoning patients when the mortality rate for this is currently so low. They don’t abandon influenza patients.

Ebola - much higher mortality rate - no one should have to care for an Ebola patient without PPE.

I hate the “know what they signed up for” mentality. We are individual people first, nurses second, despite what HR and society at large believe.

I know you do. I was posting my post when you posted yours but then read it.

but there are also different levels of risk. Like I said, you don’t abandon flu patients, right? As of today this is only slightly worse than the flu. So to leave your patient with no care when there is a low threat risk is unethical. That would be like an ER nurse abandoning their GSW patient because it was gang related and there was a potential threat that gang members could come into the hospital to check on their friend.

immunocompromised individuals excepted per my post.



in contrast, with a more deadly disease that carries a truly risky personal health concern, one has to put one’s personal safety first.

if the mortality rate of COVID19 changes, my position on this may change. It is all about relative risk v doing our jobs. Because if we don’t do our jobs viruses will spread and the greater community will be at even greater risk.

my job is HR but I take on a different role during disasters. I might be serving food to the same patient or cleaning their room. And as long as my husband is home to care for our daughter, I will do that role because if we leave all the infected people to fend for themselves, my daughter will be at an even greater risk.

[turboteal]

Lol orangeblossom I enjoyed the irony of that statement immediately after your post.

I work in L&D and Mother Baby. I certainly didn't "sign up" for taking care of pandemic patients, but it seems pretty likely we will see some moms with this. I'm young and healthy and with appropriate PPE can't see myself refusing to care for them. But I definitely won't be excited about it, just like I (and every one else on the unit) hope not to be assigned to that patient with possible flu, or anyone on any kind of isolation precautions really. And that's with an available flu shot that I get every year. I think there are relatively few areas where you can say the nurses knowingly signed up to care for patients with brand new, not fully understood, and apparently very contagious diseases.

As I said, I'm not super worried about it and would care for the patient as long as PPE is available (though it would be nice to know for sure what the mode of transmission is). But I wouldn't side eye any nurse who asked to avoid that assignment due to their personal risk factors or @ reasons @@@ (like how I preferred not to go into flu patient rooms while pg, and my coworkers generally tried to accommodate that).

[Michelle]

Mar 2, 2020 8:44:17 GMT -5 turboteal said:

Lol orangeblossom I enjoyed the irony of that statement immediately after your post.

I work in L&D and Mother Baby. I certainly didn't "sign up" for taking care of pandemic patients, but it seems pretty likely we will see some moms with this. I'm young and healthy and with appropriate PPE can't see myself refusing to care for them. But I definitely won't be excited about it, just like I (and every one else on the unit) hope not to be assigned to that patient with possible flu, or anyone on any kind of isolation precautions really. And that's with an available flu shot that I get every year. I think there are relatively few areas where you can say the nurses knowingly signed up to care for patients with brand new, not fully understood, and apparently very contagious diseases.

As I said, I'm not super worried about it and would care for the patient as long as PPE is available (though it would be nice to know for sure what the mode of transmission is). But I wouldn't side eye any nurse who asked to avoid that assignment due to their personal risk factors or @ reasons @@@ (like how I preferred not to go into flu patient rooms while pg, and my coworkers generally tried to accommodate that).

I wouldn’t side eye them either - hence listing all their rights to take a job protected leave, ask for a reasonable accommodation which could be to avoid caring for specific patients do to health conditions, and pregnancy is one of those.

[Beagle]

mockingbird holy shit, that is awful. I worked at a psych hospital and they always took exposures very seriously.

I’m a hospital Social Worker. We are considered essential staff and have to be in. I assume it’s the same until told otherwise. I’m worried, but I’m also relatively young and healthy and I have no kids at home, so I will probably go in for as long as I need to do my coworkers with children can stay home.

[Saudade]

lol at HR entering the ethics of healthcare providers post. Michelle, you may work for a hospital, but you're not a healthcare provider so your viewpoint is irrelevant.

[Michelle]

Mar 2, 2020 9:02:34 GMT -5 Saudade said:

lol at HR entering the ethics of healthcare providers post. Michelle, you may work for a hospital, but you're not a healthcare provider so your viewpoint is irrelevant.

That is LOL

My team is the one that protects the rights of the employees and sets policies on accommodations and partners with infection control to set disaster planning guidelines. If my opinion is irrelevant, good luck to the employees.

[turboteal]

Mar 2, 2020 8:48:45 GMT -5 Michelle said:

Mar 2, 2020 8:44:17 GMT -5 turboteal said:

Lol orangeblossom I enjoyed the irony of that statement immediately after your post.

I work in L&D and Mother Baby. I certainly didn't "sign up" for taking care of pandemic patients, but it seems pretty likely we will see some moms with this. I'm young and healthy and with appropriate PPE can't see myself refusing to care for them. But I definitely won't be excited about it, just like I (and every one else on the unit) hope not to be assigned to that patient with possible flu, or anyone on any kind of isolation precautions really. And that's with an available flu shot that I get every year. I think there are relatively few areas where you can say the nurses knowingly signed up to care for patients with brand new, not fully understood, and apparently very contagious diseases.

As I said, I'm not super worried about it and would care for the patient as long as PPE is available (though it would be nice to know for sure what the mode of transmission is). But I wouldn't side eye any nurse who asked to avoid that assignment due to their personal risk factors or @ reasons @@@ (like how I preferred not to go into flu patient rooms while pg, and my coworkers generally tried to accommodate that).

I wouldn’t side eye them either - hence listing all their rights to take a job protected leave, ask for a reasonable accommodation which could be to avoid caring for specific patients do to health conditions, and pregnancy is one of those.

I kind of doubt that having a condition that makes you higher risk would get you an official accommodation to not be assigned those patients, though. I would expect that request to be denied with the reasoning that PPE mitigates that risk. Which is why we make our own accommodations for each other on the unit for pregnant nurses, etc., generally out of good will and expectation of that same consideration in return. And unfortunately a lot of nurses probably fit into some of the higher risk categories (older, chronic health condition like asthma or whatever). I do agree they would feel bad about it (choosing not to care for any patient), but again, if there wasn't PPE or they felt particularly at risk to the point where they dont want to risk working, I think that's their personal decision and agree they shouldn't have to martyr themselves or feel like moral degenerates for making that choice. Please note that I am not saying they should be able to keep their jobs if they just call in for days/weeks either. Generally I am saying that while health care workers are usually conscientious people who want to help others and choose to sacrifice a lot to take care of complete strangers, it is still just a job, and not worth sacrificing your own health/that of your family just because others expect you to be more altruistic than society in general.

And once more, I don't have any plans to abandon patients, nor do I expect the scenario of mass infection and zero PPE to even happen, which is what would probably have to happen for me to say "ok I'm out".

[Michelle]

Mar 2, 2020 9:11:07 GMT -5 turboteal said:

Mar 2, 2020 8:48:45 GMT -5 Michelle said:

I wouldn’t side eye them either - hence listing all their rights to take a job protected leave, ask for a reasonable accommodation which could be to avoid caring for specific patients do to health conditions, and pregnancy is one of those.

I kind of doubt that having a condition that makes you higher risk would get you an official accommodation to not be assigned those patients, though. I would expect that request to be denied with the reasoning that PPE mitigates that risk. Which is why we make our own accommodations for each other on the unit for pregnant nurses, etc., generally out of good will and expectation of that same consideration in return. And unfortunately a lot of nurses probably fit into some of the higher risk categories (older, chronic health condition like asthma or whatever). I do agree they would feel bad about it (choosing not to care for any patient), but again, if there wasn't PPE or they felt particularly at risk to the point where they dont want to risk working, I think that's their personal decision and agree they shouldn't have to martyr themselves or feel like moral degenerates for making that choice. Please note that I am not saying they should be able to keep their jobs if they just call in for days/weeks either. Generally I am saying that while health care workers are usually conscientious people who want to help others and choose to sacrifice a lot to take care of complete strangers, it is still just a job, and not worth sacrificing your own health/that of your family just because others expect you to be more altruistic than society in general.

And once more, I don't have any plans to abandon patients, nor do I expect the scenario of mass infection and zero PPE to even happen, which is what would probably have to happen for me to say "ok I'm out".

I totally agree with your comments, except that I am blessed to work for an employer that cares very much about employee safety, so we would do whatever we could to meet the accommodation needs of our workers while providing patient care.

Edit - the ADA protects individuals with a disability that substantially limits one or more major life activities, and immunocompromised conditions would be included since the ADA was amended in 2008. Employers have an undue hardship defense, but not if it puts the worker’s safety at risk. The employer may not be able to find another floor, unit, etc so the person may have to take an unpaid leave as a reasonable accommodation. We offer six month personal leave so that would be our max, and job protection would be covered subject to the conditions of FMLA. /edit

In our case it could include creating an incentive pay for volunteers to work with these patients while the number is small and that is possible. It means preplanning a whole site change so all the cases can go to one location to protect employees and patients at other locations. It means float pools to that location through the pandemic.

I mean, we are willing to house people if they are exposed and don’t want to risk taking it home to their families.

We are working through all these scenarios early, before a case has even been confirmed in our area, to be ready for everything we can imagine and protect our patients and employees.

But I will stop now because all these creative ideas for our employees are irrelevant to the ethics of handling a pandemic since I am just in HR.

[Saudade]

@@

Yeah I'll remember how much HR cares the next time I'm forced to stay at work through a snowstorm with no one to take care of my kids at home, when I'm told by my manager that if I try to leave that I'll be fired and reported to the BON for abandonment.

[Michelle]

Mar 2, 2020 9:26:00 GMT -5 Saudade said:

@@

Yeah I'll remember how much HR cares the next time I'm forced to stay at work through a snowstorm with no one to take care of my kids at home, when I'm told by my manager that if I try to leave that I'll be fired and reported to the BON for abandonment.

That means YOUR HR might lack some ethics. Doesn’t mean every HR person or company would do the same.

Our disaster plan exempts employees who have dependents who can’t care for themselves and have no childcare. And we offer 10 days of backup child care AND during hurricanes we run quick fresh background checks on HR staff who are assigned to the labor pool duty of the in-house daycare.

Now - if the snowstorm blew through unexpectedly and staffing ratios would go to unsafe levels, and your kids at home are teenagers who can go to a neighbor’s house, that is a different story.

[wesleycrusher]

I am a psych nurse but I work outpatient. I'm not worried about myself as I am healthy and (reasonably) young. DH- who can easily work from home- is on immunosuppressants. So my main worry would be about bringing this home to him. The other nurse I work with also has a spouse who is immunocompromised and shares these same concerns. But ultimately I don't work in a hospital so my risk for exposure is much lower- I'll be interested to see the plans they have for our office (it's a huge hospital system in our area so we don't make the decisions ourselves).

[xokell2]

www.nytimes.com/2020/03/05/us/coronavirus-nurses.html?te=1&nl=morning-briefing&emc=edit_NN_p_20200306§ion=topNews&campaign_id=9&instance_id=16533&segment_id=21932&user_id=a29d72e579472a5a5993116c777ebcb6®i_id=97002487tion=topNews

This article sums up my feelings about it pretty well. I think hospitals want to say they’re doing what’s best for the front line staff but ultimately there are not strong enough contingency plans for staffing a crisis

[sonrisa]

Put on your own oxygen mask first.

Elderly and high risk healthcare workers should be protected from this just like other elderly and high risk people. 

[lolobeth802]

My H works in the ICU and OR and is essential staff. We live in an area frequented by hurricanes, so there are essential staffing plans in place already. I honestly think most hospitals are required to have emergency preparedness plans, but I actually don’t really know. :/

[bugandbibs]

My job will likely close because I am a school nurse, but there are lots of other scenarios that I have to deal with that put me at risk because of my working environment. I have severe asthma and history of pneumonia and hospitalization for flu. If I was in a hospital environment and didn't have access to PPE- I couldn't work. I don't see the risk as worth it.

[tacom]

I don’t know which thread to put this in. Since it impacts hospital employees maybe here?


Our hospital has 4 suspected cases (which i only knew from other frontline staff) and I just met with someone from our “command center” to ask questions. I was told they’re not disclosing suspected cases pending test results from the CDC because thus far none of these cases have been in our hospital for longer than 72 hours. I was told there is an “incubation period” of 72 hours where staff to staff transmission does not occur. They are keeping a list of all the staff who provided direct patient care and plan to furlough them if we don’t get CDC results before the 72 hour timeline ends tomorrow.


Does anyone have any sources for this 72 hour magical business where someone could theoretically be infected but has no way to infect those around them?

They don’t seem to be at all worried about environmental transmission outside of the patient rooms. For example, one PUI was transferred from the ICU to our locked unit and traveled several hallways, elevator etc. nothing is disinfected except for the pt room.

[Saudade]

Mar 6, 2020 16:04:37 GMT -5 tacom said:

I don’t know which thread to put this in. Since it impacts hospital employees maybe here?


Our hospital has 4 suspected cases (which i only knew from other frontline staff) and I just met with someone from our “command center” to ask questions. I was told they’re not disclosing suspected cases pending test results from the CDC because thus far none of these cases have been in our hospital for longer than 72 hours. I was told there is an “incubation period” of 72 hours where staff to staff transmission does not occur. They are keeping a list of all the staff who provided direct patient care and plan to furlough them if we don’t get CDC results before the 72 hour timeline ends tomorrow.


Does anyone have any sources for this 72 hour magical business where someone could theoretically be infected but has no way to infect those around them?

They don’t seem to be at all worried about environmental transmission outside of the patient rooms. For example, one PUI was transferred from the ICU to our locked unit and traveled several hallways, elevator etc. nothing is disinfected except for the pt room.

I just texted my medical director, an ER doc, to ask if he's heard of this. I can't find anything online. I think they're full of shit but I'll update you when I hear back

[picksthemusic]

So I work really near to ground zero here in Snohomish County, WA. We have seen positive cases in my clinic. We are doing lots of things, such as any non-essential personnel are WFH, screening patients at the door/by phone/in their cars for signs of COVID and if we suspect, we send to the ER for further workup and possible testing. We have PPE available for all workers that want it, though the N-95s are 'reserved' for walk-in clinic staff mostly since they're first line of defense.

As of next week, we're moving all walk-in staff to our larger facilities and closing small walk-ins to all patients so we can consolidate our resources where they can do the most good.

If we are exposed while at work or are diagnosed, we get full pay for 2 weeks to stay home.