Q: Am I safe when I go into a room with a patient who is in Special Droplet/Contact precautions for COVID-19? I have read recent articles that suggest the virus can float in the air of a patient’s room.
Yes, you are safe when you use the appropriate precautions. As we gained experience and learned more about this infection, we recognized that using Airborne/Respirator/Contact precautions (which include an N95 mask or PAPR unit) in all clinical situations is not necessary and may actually increase risk as healthcare workers use unfamiliar equipment. We agree with the World Health Organization that the primary mode of transmission from person to person is via larger droplets. There are some specific procedures, such as during intubation when microscopic particles (aerosols) are generated and may require a different level of personal protective equipment (PPE), including Airborne/Respirator/Contact precautions.
In order to ensure that our healthcare workers have full access to the PPE that is best for care activities, UW Medicine recommends Special Droplet/Contact precautions (mask, eye protection, gown and gloves, and trained observer) for all ambulatory, acute care, and ED patients with known or suspected COVID-19.
We are using Airborne/Respirator/Contact precautions with eye protection and a trained observer for patients with known or suspected COVID-19 who are having aerosol-generating procedures, such as intubation or nebulizer therapy. This is consistent with WHO guidelines for use of personal protective equipment for COVID-19.
Based on available evidence and expert opinion, SARS-CoV-2, the virus that causes COVID-19, is similar to other respiratory viruses like influenza and is primarily transmitted through close contact and large droplets. For a full summary of UW Medicine PPE recommendations and rationale, please refer to our UW Medicine COVID-19 Website.
Q: Can exposed staff without any symptoms of acute respiratory infection work? Are asymptomatic exposed staff supposed to wear a mask while at home or work? Can they continue to spend time with their family?
- Although people without symptoms of respiratory infection may have detectable virus before noticing any symptoms, based on available data, we believe that transmission from asymptomatic healthcare workers is unlikely. Transmission relies on large droplets (e.g., secretions, cough, sneezing). Staff members who have any symptoms of respiratory infection are required to go home immediately. Remember, standard precautions for the care of every patient require staff members to always clean their hands before and after seeing a patient, even in the absence of any special precautions.
- UW Medicine does not recommend or support asymptomatic healthcare workers using masks. Strict adherence to standard precautions for all patients remains essential and masks should be conserved for the care of patients under precautions who require their use. It is critically important that we maintain a stock of PPE for the future while keeping everyone safe.
- We recommend that exposed employees continue to monitor symptoms closely while they spend time with their family, friends and co-workers. They should self-isolate if they develop any symptoms of acute respiratory infection. This is a big change for many of us who are used to coming to work no matter how we feel. The days of coming to work sick are behind us.
Q: Are UW Medicine frontline healthcare workers acquiring COVID-19 in the hospital or clinics?
We have tested over 1,100 employees (including undergraduate students, researchers, non-clinical faulty and healthcare workers) with symptoms of acute respiratory infection across the University of Washington in our drive-through clinic. Very few clinical staff have tested positive thus far (across HMC, SCCA, UWMC – Montlake and UWMC – Northwest) and almost all acquired COVID-19 through an identified community exposure. The overall rate of infection in our healthcare workers is lower than the general population being tested at the UW Medicine Virology Lab.
