The rise in COVID-19 cases creates anxiety among physicians and other health professionals who worry they might carry the virus home to their families. This remains top of mind for many people in the medical field, leaving them wondering: How do I keep my family safe after caring for patients during the COVID-19 pandemic?
Many physicians are struggling to understand what disinfection is necessary before coming home, or if they should remain in a separate room or home during this unprecedented time. Some have even taken to Twitter to share their routines, including only seeing their family through the window or video calling while others completely strip down and shower before greeting their loved ones.
“Obviously it is heavy on the mind of all providers who are working with patients who are infected and those who we don’t know that are infected with COVID-19,” said Mark Rupp, MD, professor and chief of the infectious diseases division at the University of Nebraska Medical Center (UNMC) in in Omaha. “All of us are having those questions and concerns as we head home to our family and loved ones.”
The AMA and the Centers for Disease Control and Prevention continue to closely monitor the COVID-19 global pandemic. Learn more at the AMA COVID-19 resource center and consult the AMA’s physician guide to COVID-19.
In these uncertain times, Dr. Rupp—who has published hundreds of articles on infectious diseases, infection control and epidemiology in the peer-reviewed literature—shared some tips to keep in mind when physicians, nurses and other health professionals return home to continue to protect their families from COVID-19.
Whether at a hospital, health system or small practice, it is important to take all preventive measures available. Using appropriate precautions at work can help minimize risk and exposure to COVID-19 patients and, in turn, can protect families too.
“The first and probably most important step is not so much what you do when you get home, but it’s what you’re doing at work that really is going to count,” said Dr. Rupp, also medical director of infection control and epidemiology at UNMC. “What I mean is that you need to be using the appropriate precautions when you encounter patients.”
“If you do that, then patient care continues to be pretty safe,” he said, adding that it is important for everyone to make “sure that anybody who comes into the organization is immediately screened for any sort of fever or respiratory disease and is immediately taken into the appropriate setting to where they can be evaluated and cared for as safely as possible.”
For UNMC, this means screening right when a patient enters the building and providing people with instructions.
“In many instances, we’re trying to get them to call ahead beforehand so that we know they’re coming, and we can take appropriate precautions,” said Dr. Rupp, a former president of the Society for Healthcare Epidemiology of America. “Again, trying to get folks into the right setting and using the appropriate respiratory protection, gowns, gloves, droplet protection, and N95 or higher respiratory protection.”
“Institutions need to concentrate on providing as safe a work environment as possible with careful attention to administrative and engineering controls to reduce risk,” he said.
For example, administratively, patient contact can be minimized and the number of health care professionals interacting with a potentially infected patient can be reduced by use of telehealth or other electronic means to interact.
“Similarly, engineering solutions should be sought. For example, we are now using an intubation box to decrease the risk of our personnel coming into contact with infected respiratory secretions,” said Dr. Rupp. “Negative air pressure airborne isolation wards should be created to best care for persons infected or potentially infected with the virus that causes COVID19.
“Also, it is important that personnel be provided with adequate personal protective equipment—the gowns, gloves, masks, and respirators—that are needed,” he added.
Learn how UNMC is tackling the N95 shortage with novel decontamination, and find out about the plea to nation from doctors fighting COVID-19: #GetMePPE.
“Health care providers need to be meticulous about wearing appropriate protection as well as performing appropriate hand hygiene and not touching their face,” Dr. Rupp said, adding that “those are the things that you can do to not get sick and not bring anything home to your family. That’s by far the most important thing to do to protect your family.”
“You don't need to go out in the garage and spray yourself down with some sort of disinfectant—that's just not necessary,” he said, adding that practicing good hand hygiene, however, is key.
“Before you leave work or the first thing you do when you want to get home, it would be a reasonable thing to wash your hands carefully or use the hand gels,” said Dr. Rupp. “There really isn't any information that if you're using appropriate gowns and gloves at work that you need to worry about bringing the coronavirus home on your clothing.”
“If folks are doing the right practices at work and they're being as careful at home as they can, they can ameliorate most of these concerns and be safe,” he said.
It seems common that physicians, nurses and other health professionals are changing their clothes immediately before entering their homes as an added layer of precaution.
“A lot of folks do change clothes when they arrive home, just to get out of their work clothes and that’s fine,” said Dr. Rupp. “If you put your clothes through just normal laundry, that should take care of things just fine.”
“I would advise people—just to give them a little peace of mind—to wash their hands and change out of their work clothes,” he said, adding that it is also important to “practice a little bit of common sense precautions with your family.”
This includes not sharing utensils or toothbrushes, and using separate plates, cups and bowls.
It might also be appropriate to “do a bit of judicious social distancing,” however, it is important not to “separate ourselves completely from our families,” said Dr. Rupp. “That’s just not something that’s necessary, nor do I think it is healthy for people’s mental health.”
During these hard times, a physician’s family is key to maintaining optimal mental health while facing the uncertainty of COVID-19 at hospitals, health systems or small practices. Learn about six ways to address physician stress during COVID-19 pandemic.
“Some of these emotional supports that people need and require are very important, and if we get into a situation where we're expecting health care providers to come to work and then go home and be isolated,” said Dr. Rupp. “That is not going to be a healthy situation for anybody.”
“We’re all in this together, and we will get through this together,” Dr. Rupp said. “If we do the right thing over the coming weeks, we will be able to weather this storm.”