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Covid-19

Frequently Asked Questions

Should we place COVID patients in a negative pressure room or just have a door?‍

EB: As per the CDC guidance, an AIIR room (negative pressure) is ideal, but if that type of room isn’t available, a private room would be next best.

TT: Most hospitals don’t have many negative pressure rooms, and it is unlikely there will be one available due to the surge of patients infected with COVID-19. Putting the patient in a private room is acceptable.

Why is it seen more in adults than kids? Are kids more likely to be asymptomatic if they get it? ‍

EB: We won’t fully understand some of these things until we can look back at the outbreak. The challenge with most children getting mild symptoms is that they might spread the illness to other older relatives who are more susceptible to the virus and who might ultimately have a more critical illness.

TT: We know COVID-19 does not spare anyone. Anyone is at risk for infection from COVID-19, with immunocompromised adults and the elderly more at risk than children. We don’t know why adults are more infected than children. Children are likely to have mild symptoms. What we have learned is anyone who is asymptomatic or has mild symptoms can also spread COVID-19 to other people. That’s why we are having people shelter-in-place to reduce the risk of spreading COVID-19 in the community.

Should these patients be on a specialized unit?‍

EB: Negative airflow is desirable. If a unit can be identified which is separated from typical patients, I do think that is wise.

TT: It is ideal to put the COVID-19 patients in a negative pressure room. Every hospital has at least one negative pressure room. The negative pressure room is expensive to build and maintain. Given the design of the U.S. hospital and in response to the surge of COVID-19 cases, administrators could identify a floor for COVID-19 patients separate from non-COVID patients.

How easily can I spread it to my grandparents that I live with? I am terrified of giving it to them.‍

EB: Your concerns are valid, but there are many things we can do to prevent transmission. All household members should practice social distancing and good hand hygiene. Frequently cleaning and disinfecting high touch surfaces is also important. If you can identify a room and bathroom that only you use, that will help to reduce their exposure to you.

TT: We all know the importance of practicing good hand hygiene (soap and water are preferred and if soap and water are not available, use hand sanitizers with 60% alcohol or higher). For healthcare workers, wear gowns, gloves, face mask, and face shield prior to handling any human body wastes or body fluids. Because of the shortage of PPE, some reports noted healthcare providers are reusing PPE. The CDC notes face masks reuse is acceptable during a time when we are having PPE shortages.

For a family member who enters the room of the individual infected with COVID-19, you want to keep your distance as much as possible to minimize respiratory droplets from landing on your clothes, hair, etc. Change clothes if needed. You don’t want to walk around with respiratory droplets on your clothes and infect others. As we found out recently on March 18th, we had the first death among the pediatric population. There is more about COVID-19 that we still do not know.

Clean and disinfect surfaces. Make sure you allow the disinfectant to have contact time with the surface. Each disinfectant has a manufacturer’s recommended disinfectant contact time. For example, if the disinfectant product says disinfectant contact time is 2 minutes, then you should allow the surface to be visibly wet for at least 2 minutes to ensure the disinfectant is given enough time to kill the microorganism. Disinfect regularly using household cleaning wipe or spray. The EPA has a list of recommended disinfectants here.

When are you no longer contagious?‍

EB: The best indicator is when you no longer have symptoms. I know this can be difficult to determine, but a good rule of thumb might be at least 24-48 hours after any medications for symptoms are needed… similar to what we do everyday for day care settings. Even after feeling well, keeping up your social distancing is important. You may still shed some virus after the illness has improved.

Do you have any tips on not bringing it home with us after work? Change clothes? Bleach wipe shoes?

EB: It seems very reasonable to bring your uniform to work and change into it there. Then you can leave your work at work and wear your personal clothes home. Bringing your work clothes home to wash should be fine, but you may want to wash them separately with a warmer setting for wash and drying to ensure a good disinfection. Bleach or disinfectant wiping your shoes is good practice, and if they can be left at work, all the better. This limits exposure to your car, your home, and your community. ‍

TT: Hospital disinfectant wipes are meant to be used only in the hospital or healthcare settings. These wipes are made using very strong chemicals to kill most pathogens. Tips to not bring home COVID-19 would be to change clothes before you go home. Disinfect your shoes before you leave the hospital, or change out of your work shoes into your regular walking shoes. Get in the habit of washing your hands before and after your shift ends. You don’t want to bring any hospital microorganisms home.

I work in the NICU. I have symptoms but was told to come to work wearing a mask. Is this safe?‍

EB: If your symptoms are mild and could be caused by something like allergies or sinusitis, wearing a mask would protect your patients from any harm. If the symptoms persist or get worse, work with your managers or employee health to be evaluated further.

TT: What we do know is COVID-19 could spread while the individual is asymptomatic or has mild symptoms. If you have symptoms that may or may not be specific to COVID-19, check with your primary care doctor to determine what you have and whether you are allowed to work.

What should we be aware of/get tested/quarantine? Especially if we are younger and exposed to patients in the ER.‍

EB: Unfortunately, the symptoms of COVID-19 can be vague. Following the CDC’s guidance on when to test is important. Fever is probably the best indicator of active infection, but know its presence could indicate a number of illnesses. Work with your employee health office to monitor your symptoms and determine if testing is warranted.

TT: Signs and symptoms of COVID-19 are dry cough, tiredness, fever, muscle aches, and shortness of breath. These have been reported as the most common symptoms. Symptoms may appear 2 to 14 days after the exposure to the infected patient. Four emergency signs are troubled breathing, pressure or pain on the chest, new confusion, inability to arouse, or blue lips or face. Do not wait for mild symptoms to progress to these emergency warning signs. If you have mild symptoms, discuss with the primary care provider prior to checking into the hospital.

My advice is if you have mild symptoms, stay home and use supportive therapy to manage COVID-19. The hospital is flooded with many sick patients. Unless your symptoms are severe resulting in any of the emergency warning signs, this is not a good time to check into the hospital for mild symptoms. Let the primary care provider (physician, nurse practitioner, or physician assistant) decide on whether to recommend you to self-quarantine or check into the hospital.