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With the increased number of cases locally, in Washington state and nationally, we are going to resume sending more regular messages to keep everyone up to date. As I mentioned last week, many of us felt like we finally had a chance to catch our breath in the middle of June as the numbers (cases, hospitalizations and deaths) continued to decline. Then came the increased movement and interaction as King County entered Phase 2 of the reopening plan, and we started to see the number of new cases increase again.

Per the most recent Public Health – Seattle & King County data, the total number of new infections per day has recently been about 150. This is compared to about 200 per day during the initial surge. It is important to recognize that interpreting these numbers is not always straightforward. They depend on who gets tested, access to testing, guidance at the time of testing and other factors. Regardless, too many people are getting COVID-19, and the numbers have been going up.

Unlike the earlier surge, this time we are seeing a lot more people between the ages of 20 and 40, which may be why our hospital inpatient census remains below previous levels. Still, UW Medicine hospitals are seeing an increase in admissions, including people in their 30s, 40s and 50s. With more infections, we will see more people in our primary and urgent care clinics, emergency departments and hospitals. As we have talked about before, we still have a long way to go. Let’s keep using physical distancing, hand hygiene, masks and staying home when ill (and getting tested!) to do our part.

UW Medicine Hospitals COVID-19 Activity

UW Medicine COVID-19 Daily Census Trend

UW Medicine Staff, Trainee and Faculty COVID-19 Exposure Policy

UW Medicine has updated the policy for exposures to COVID-19 at work based on an Exposure Matrix that identifies three levels of risk categories. For higher-risk exposures, employees will need to quarantine for 14 days from the day of the most recent exposure even if they test negative for COVID-19.

Employee Health and Infection Prevention & Control will determine the risk level based on the matrix, PPE, the symptom status of the infected individuals and proximity of the employee to someone with COVID-19. Administrative leave will be available to employees who go into quarantine following an exposure at work from a patient or colleague.

Employees who are exposed in the community can be risk assessed using the Exposure Matrix, but final determinations will be made in accordance with public health contact tracing team recommendations. Employees must use their personal leave time if they are unable to work as a result of a community exposure.

For more information, please refer to the policyprotocol and Q&A.

COVID-19 Patient and Employee Testing

With the increase in COVID-19 cases, testing of patients remains a top priority. UW Medicine is collaborating with city and county leaders to maintain sufficient test sites throughout the region. The UW Medicine Virology Lab is also working to maintain fast turn-around times for test results and developing new protocols to avoid delays for patients who are scheduled for surgeries and procedures.

The first two phases of employee antibody testing are nearly complete, and we are now ready to begin our final phase of testing for those employees not involved with direct patient care. If you would like to be tested, you should start by taking the UW Medicine Employee COVID-19 Testing Survey, and you will then be directed to a calendaring system to make an appointment for a blood draw. Schedules become available on a rolling basis and new times open daily.

We are reviewing the results of our Phase I employee antibody testing of frontline UW Medicine healthcare workers. The results show an approximately 3% prevalence of previous COVID-19 infection, which is below the rate found in the general population of patients who have been tested. These early results support our current practices and guidelines, including those on PPE, visitors, air handling, precautions and screening. The antibody test is offered to employees at no cost, and the test results will be part of your employee health record. For more information, please see the antibody testing FAQ.

PPE Updates

  • Training: If you are new to UW Medicine, please go to the intranet homepage of the facility you are working at where you can access videos on PPE donning and doffing. If you haven’t used precautions for the clinical care of patients with COVID-19 in a while, now is a good time to revisit using the same links. If you are at a non-UW Medicine site like the VA or Seattle Children’s Hospital, please check with your attending, supervisor or manager to find the local resources.

HMC Infection Prevention & Control COVID-19 site

UWMC Infection Prevention & Control COVID-19 site

  • UW Medicine continues to have adequate supplies of PPE thanks to the ongoing work of our Supply Chain colleagues to source items and their flexibility to make appropriate substitutions when necessary. Please remember, unless specifically informed otherwise, healthcare workers should be using PPE on a single-use basis.
  • If you are working directly with patients or visitors, please consider wearing eye protection in addition to your mask. This adds one more layer of protection for unexpected encounters with patients who we may later learn have COVID-19. Face shields or goggles (disposable or not), in addition to a mask, can be worn throughout the day and re-used after disinfecting. Please contact Infection Prevention & Control or Employee Health with any questions.

In-Person vs. Remote Team Meetings

We recognize that remote meetings are not practical in some situations and, especially, for employees without access to cameras at work. While more specific guidance is being developed, it is acceptable for small groups (5-10 people) to meet for teaching and team meetings that cannot be held remotely. In these cases, please use the largest space available, practice physical distancing and wear masks always.

We now find ourselves in a very different place compared to how we started the year. A considerable amount of uncertainty lies in front of us: how we work, see our friends and family, educate our children and explore the world. It is tough when we have given so much, and it might feel like it has not been enough.

What can I say that might help? Well, I know that we are truly in this together; we started this journey that way and will continue. We will change how we do things, learning more all the time. We will continue to serve our community, working to keep people healthy, reduce suffering and save lives. In our work and personal lives, we can find ways to drive equity and justice forward and racism, which is tightly linked to this pandemic, down. I find strength and purpose in what UW Medicine has done and remain committed to what we are doing together.

Sincerely and Gratefully,

John Lynch, MD, MPH
Medical Director, Infection Prevention & Control
Associate Medical Director, Harborview Medical Center
Division of Allergy & Infectious Diseases, UW School of Medicine