Protecting Healthcare Workers From Infection
Atul Gawande’s thoughtful article on protecting healthcare workers offers some guidance and hope on controlling the spread of new SARS-CoV-2 infections among healthcare workers. Based on my own experience in clinic, some of the points I thought were important from a primary care perspective include:
Clinic staff wearing regular surgical masks for all patient interactions. The degree of asymptomatic spread (or what may really be pre-symptomatic, or early symptoms) is likely less important overall than spread by people with cough or other active symptoms. BUT we still don’t understand the transmission dynamics for sure so I agree with having some degree of protection in all clinical interactions.
Care and testing for symptomatic patients, which we know can be a broad category, takes place at dedicated sites. This is important because it allows for making sure the dedicated sites have the training and protective equipment needed to handle large numbers of potentially positive patients.
Within outpatient practices, social distancing still needs to apply, including among clinic staff, and between clinicians and patients except during exams. I think this is important and needs to be reinforced to counter the “we’re all exposed anyway” attitude that can develop.
Defining what a “close contact” is. I’d like to read more about how these definitions were defined, data-wise, but from my perspective anything that allows us to better triage who is at high risk and who truly needs to be quarantined is important so that we’re not unnecessarily quarantining healthcare workers.
I am finding the grassroots efforts to sew masks to be inspiring, but also disconcerting, and I wonder if we could do better for our healthcare workforce if we had a uniform, more nuanced approach to triage and care.
