This week marks the fall equinox and nearly seven months since UW Medicine opened the Emergency Operations Center (EOC) to launch our response to COVID-19. As usual, the fall weather arrived suddenly, driving us indoors. Fall quarter at the UW will be starting on Sept. 30, and this week a smaller than usual number of residential students are arriving on campus to begin remote and limited in-person learning. UW Medicine is supporting the UW community this week by providing on-campus testing for students, staff and non-clinical faculty. Starting next week, the Husky Testing Program will take over and continue to provide testing throughout the rest of the quarter.
Our community has taken all of the right steps to slow the rate of new infections. We have learned to adapt over the last seven months to keep everyone safe. As the cooler and wetter weather returns, we will need to find ways to combine what we have learned with the limits that will come with less access to the outdoors. The small gatherings of pods in backyards may need to move to virtual meet-ups. If you have access to outdoor space, think about using tarps to extend the outdoor season. For those who decide to have one or two people inside their homes, masking will be more important than ever. We know what works, and I am confident that we will continue to take actions to keep everyone safe.
The COVID-19 situation in Western Washington remains stable, with data trends largely unchanged over the past few weeks. My message today highlights this positive regional trend, as well as updates to the UW Medicine hospital visitation policy.
Updates for today:
- UW Medicine COVID-19 Activity Summary
- Local/National/Global Epidemiology
- Updated COVID-19 Inpatient Precautions Policy
- Changes to Visitor Restriction Policy
UW Medicine COVID-19 Activity Summary
Local/National/Global Epidemiology
King County: Public Health – Seattle & King County is reporting 21,803 total cases and 758 deaths as of Thursday, Sept. 24. Approximately 3.6% of all tests performed are positive, and the number of new positive tests is currently at 51/14 days/100,000 people. As of Sept. 23, the effective reproductive (Re) number was estimated to be 1.0 (estimate range: 0.0-2.1).
Washington: The Department of Health reports 84,238 cases and 2,080 deaths as of Sept. 23. Of the 1,783,279 people who have been tested, 4.7% have been positive.
United States: The Centers for Disease Control and Prevention reports 6,916,292 COVID-19 cases and 201,411 deaths as of Sept. 24.
Global: The WHO COVID-19 Dashboard as of September 25 reports 32,110,656 confirmed COVID-19 cases and 980,031 deaths.
Update to the COVID-19 Inpatient Transmission-Based Precautions Policy
Earlier this week, UW Medicine transitioned to the updated COVID-19 patient clearance protocol at UW Medical Center (both campuses) and Harborview. Instead of using multiple tests to “clear” patients in COVID-19 precautions, we are now using a time and symptom-based strategy. This means that, depending on illness severity, and to what degree patients are immunocompromised, patients can move out of COVID-19 precautions after 10 days (if on an acute care unit) or after 20 days (if on a critical care unit). These are the minimum lengths of time patients with COVID-19 must remain in precautions. Before discontinuing precautions, patients must also have improvement in their initial symptoms and be afebrile (without a fever) for at least 24 hours without anti-fever medications (like acetaminophen).
This policy replaces the prior need to obtain multiple negative test results before clearing precautions. Over the last seven months, we have learned that many patients continue to test positive for weeks after an initial COVID-19 diagnosis but are not actually able to pass the virus on to another person. The time and symptom-based approach helps prevent unnecessary testing, unnecessary use of PPE, and delays in patient care. For more details, read the full policy and FAQ.
Changes to Visitor Restriction Policy
UW Medicine has updated the visitor restriction policy as it applies to laboring mothers who are COVID-19 positive. As a reminder, the goal of revising our guidelines is to keep our patients, staff, trainees, students and faculty as safe and supported as possible.
Please note the following key updates:
- Laboring patients who are COVID positive at UWMC campuses may have one accompanying asymptomatic support person when the following conditions are met:
- The support person must remain masked in the mother’s room with PPE on at all times.
- The support person will not have the ability to come and go, but will remain in the mother’s room for the entirety of the hospital stay.
- The support person will be screened by a unit RN to ensure the visitor has no symptoms prior to approval to remain with the patient.
- If a laboring patient declines COVID testing, visitor restrictions will be the same as those patients who are COVID positive.
- COVID positive pregnant antepartum patients may not have a support person.
- During a Cesarean delivery, COVID positive pregnant patients may not have a support person in the operating room.
- No visitors are allowed under the age of 16 except newborns under 3 months of age attending their mother’s postpartum visit.
Routine visitation in UW Medicine hospitals remains limited until the transmission of COVID-19 is no longer a threat to our patients, staff and community. Read the complete visitor restriction policy for more information. You can also view the policy on the external UW Medicine COVID-19 Resource site here.
It is critical that all staff, trainees, students and faculty do not circumvent this policy. It is very distressing for patients, visitors and families to hear from one person that they can have more visitors and then find out that they cannot. Families that are more empowered are more likely to ask for leeway, which leads to inequities that impact patients and visitors. Clinical teams should refer all questions to the unit manager.
It seems like 2020 continues to be a year that keeps on taking, evident again last Friday with the passing of Supreme Court Justice Ruth Bader Ginsburg and this week with the lack of justice and accountability for the senseless death of Breonna Taylor, a fellow healthcare worker. In reflecting upon these losses, I was inspired by a quote from Justice Ginsburg: “One lives not just for oneself but for one’s community.” This sentiment resonates with what our colleagues at UW Medicine are doing every day during this pandemic to keep our community safe. I continue to be grateful and inspired by your commitment to see beyond yourselves. Let’s keep checking in with each other.
One last reminder: The UW Medicine employee influenza program is back in action starting this Monday, Sept. 28. All UW Medicine employees can get vaccinated at their Employee Health Centers and by rovers in the clinics and inpatient floors. Please reference the hospital Infolines and intranet for additional details on location and hours. Remember to get a flu shot by early November – for your own health and the health of our community!
Sincerely,
John Lynch, MD, MPH
Medical Director, Infection Prevention & Control
Associate Medical Director, Harborview Medical Center
Division of Allergy & Infectious Diseases, UW School of Medicine
