COVID-19 Q&A

COVID-19 Questions & Answers

BMH’s Infection Preventionist Meredith Burt, RN, provides BMH staff and community members with answers to common questions about the novel coronavirus. She also explains the meanings of many covid-related terms and phrases. Check back often to read Meredith’s latest post.

But first, Here are Some Important Infection Prevention Reminders:

  • Wash your hands often for at least 20 seconds.
  • Wipe down and disinfect regularly-used surface.
  • Cover your mouth in the crook of your elbow when you cough.
  • Try not to touch your face (including eyes, nose, and mouth).

Tuesday, June 9, 2020

What is antibody testing for COVID-19?

  • Antibody tests check your blood by looking for antibodies.
  • In this case the test would be looking for antibodies indicating if you had a past infection with the virus (coronavirus) that causes COVID-19.
  • Antibodies are proteins that help fight off infections and usually provide protection against getting that disease again (immunity).
  • Antibodies are disease specific.
  • An antibody (blood) test cannot tell if you are currently sick with COVID-19.

 What do we know about what the test results mean?

  • If you test positive:
      • A positive test result shows that you may have antibodies from an infection with the virus that causes COVID-19, coronavirus. These antibodies can be from infection from COVID-19 or from a virus in the same family (called coronavirus), such as the virus that causes the common cold.
      • We do not know yet if having antibodies to the virus that causes COVID-19 can protect someone from getting infected again or, if they do, how long this protection might last.
      • You should continue to protect yourself and others since it’s possible you could get infected with the virus again.
      • If you work in a job where you wear personal protective equipment (PPE), continue wearing PPE.
      • You might test positive for antibodies even if you never had symptoms of COVID-19. This can happen if you had an infection without symptoms (also called an asymptomatic infection).
  • If you test negative:
      • You may not have had COVID-19 before.
      • You could still have a current infection.
      • The test may be negative because it typically takes 1 to 3 weeks after infection to develop antibodies. It’s possible you could still get sick if you have been exposed to the virus recently. This means you could still spread the virus.
      • Some people may take even longer to develop antibodies, and some people may not develop antibodies.

Regardless of whether you test positive or negative, the results do not confirm whether or not you are able to spread the virus that causes COVID-19. Until we know more, continue to take steps to protect yourself and others.

Does BMH offer antibody testing of coronavirus?

  • No, not at this time. BMH will continue to evaluate available tests so we can provide accurate and useful information for staff and our community.

Terminology

Herd immunity: Community immunity, is when a large part of the population of an area is immune to a specific disease. If enough people are resistant to the cause of a disease, such as a virus or bacteria, it has nowhere to go.

Thursday, June 4, 2020

The Centers for Disease Control and Prevention states social distancing is “remaining out of congregate settings, avoiding mass gatherings and maintaining distance (approximately 6 feet or 2 meters) from others when possible.”

Maintaining social distance, of at least 6 feet whenever possible is a key component to help decrease the spread of COVID-19.

  • Why is social distancing important to decrease the spread of this and other respiratory illnesses?

o   According to the World Health Organization, when someone coughs or sneezes, small drops of liquid spray from their nose or mouth. If you’re standing too close, you can breathe in the droplets, which may contain the coronavirus if the person coughing is infected.

o   The “6 feet of distance” rule is from respiratory physiology studies done at Vanderbilt University by Dr. William Schaffner, an expert in infectious disease.

  • “Without a cough or a sneeze, if we exhale, the distance 3 to 6 feet from each other is called the breathing zone. And it’s in that kind of volume of air that what I exhale begins to mix with the air that’s already in the room,” Schaffner said. “So if you’re standing within 3 to 6 feet of me, you may well inhale some of what I exhale. And of course if I have the virus, what I’m exhaling microscopically contains the virus.

Visuals to illustrate what 6 feet apart looks like.

Two Golden Retrievers standing nose to tail

One Cow

Terminology of the Day

Telemedicine/telehealth: The practice of medicine when the doctor and patient are separated and utilize two-way voice, visual or written communication via computer, smartphone or other technology.

Reference: https://www.cnn.com/2020/03/24/health/six-feet-social-distance-explainer-coronavirus-wellness/index.html

Monday, June 1, 2020

What is the proper way to wear a face covering/mask?

Examples of when to wear a face covering Examples of when you don’t need to wear a face covering
Any area at BMH that there are others within 6 feet, unless higher level PPE is needed such as N95 mask Alone in your office with no one within 6 feet of you
Trips to the grocery store, pharmacy, doctor or hospital Occupying a shared office space but are greater than 6 feet from others
Essential workers at a grocery store, pharmacy, or other business setting where they cannot maintain at least 6 feet distance between themselves and others Going for a walk in the woods or in your neighborhood. But bring one in case you encounter other people and stop to chat
At home if you are sick and have other people in the house At home, if everyone in the home isn’t showing symptoms
Home care workers caring for vulnerable populations Going for a run on the bike path, if it’s not too crowded
Riding the bus, taxi, or ride share Who should never wear a mask:

•children under the age of 2

•anyone who has trouble breathing, or is unconscious

•anyone who is unable to remove the mask without assistance
Walking on a busy and crowded street

Terminology of the Day

R0  In epidemiology, an R0 is a measure of transmission. It basically represents the average number of people that one infected person will, in turn, infect. Based on current information, coronavirus has an R0 somewhere between 2 and 3, so the average infected person will pass the virus on to two or three more people. That makes it more contagious than the flu, which has an R0 of about 1.5. Measles, one of the most contagious viruses, has an R0 of about 15.

References:
https://www.healthvermont.gov/response/coronavirus-covid-19
https://letstalk.mercergov.org/coronavirus_resources/news_feed/wearing-masks

Thursday, May 28, 2020

As we continue with the process of “reopening” our community and organization I thought this would be a good time to look at what we have learned over the past few months about COVID-19 and review the basics.

  • What is a coronavirus? What is a novel coronavirus? What is COVID-19?
    • A coronavirus is the name for a large set of illnesses, including the common cold and other respiratory infections. The term “novel” coronavirus means it’s a new form of the virus. The 2019 novel coronavirus has been named SARS-CoV-2 and the disease it causes is called coronavirus disease 2019, or COVID-19.
  • How does COVID-19 spread?
    • It’s carried on respiratory droplets when we talk, sneeze and cough and these can land on surfaces or in someone’s mouth or nose. When it comes to respiratory droplets, 6 feet is the magic distance. That’s how far these tiny, infected droplets can travel.
    • When droplets land on surfaces, we can pick them up with our hands and transfer them to our eyes, mouth and nose when we touch our faces. This is why hand hygiene is so important.
  • What are the symptoms of COVID-19?
    • Symptoms of COVID-19  include; fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea.
    • Symptoms can range from mild to severe and may appear up to 2-14 days after exposure to the virus, according to the CDC.
    • Some people with COVID-19 don’t display any symptoms.
  • How can I protect myself and my community? 
    • Wash your hands often: Wash your hands often with soap and water for at least 20 seconds especially after you have been in a public place, or after blowing your nose, coughing, or sneezing. If soap and water are not readily available, use a hand sanitizer that contains at least 60% alcohol. Cover all surfaces of your hands and rub them together until they feel dry. Avoid touching your eyes, nose, and mouth with unwashed hands.
    • Avoid close contact: Avoid close contact with people who are sick, even inside your home. If possible, maintain 6 feet between the person who is sick and other household members. Stay at least 6 feet (about 2 arms’ length) from other people. Stay out of crowded places and avoid mass gatherings.
    • Cover your mouth and nose with a cloth face cover when around others: You could spread COVID-19 to others even if you do not feel sick. Everyone should wear a cloth face cover when they have to go out in public. Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
    • Cover coughs and sneezes: Always cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. Throw used tissues in the trash. Immediately perform hand hygiene.
    • Clean and disinfect: Clean AND disinfect frequently touched surfaces daily. This includes tables, doorknobs, light switches, countertops, handles, desks, phones, keyboards, toilets, faucets, and sinks.
    • Monitor Your Health: Stay home if you are ill. Contact your primary care provider if needed.
  • Can children get COVID-19?
    • Yes, children can get and spread COVID-19.
    • The CDC recently issued a health advisory regarding a newly discovered complication for some children who have been diagnosed with COVID-19. This complication is called multisystem inflammatory syndrome in children (MIS-C).  MIS-C criteria:
      • An individual aged <21 years presenting with:
    • Laboratory evidence of inflammation AND
    • Evidence of clinically severe illness requiring hospitalization, with multisystem organ involvement (cardiac, renal, respiratory, hematologic, gastrointestinal, dermatologic or neurological); AND
    • No alternative plausible diagnoses; AND
    • Positive for current or recent SARS-CoV-2 infection by RT-PCR, serology, or antigen test; or COVID-19 exposure within the 4 weeks prior to the onset of symptoms.
    • Some patients may fulfill all or some criteria for Kawasaki disease. All suspected cases should be reported to the Vermont Department of Health.

Thursday, May 26, 2020

As states start to open what are the guidelines to safely start to interact with friends and family?

Guidance from Vermont Department of Health includes:

  • These steps will help protect you and others and keep COVID-19 from spreading.
    • Keep a 6-ft distance from other people.
    • Wear a face mask or cloth face covering.
    • Wash your hands with soap and water or use hand sanitizer.
    • Stay home if you are sick or have recently been exposed to someone who has COVID-19. Call your doctor to see if you should be tested.
  • These steps will make it easier to know who else may have been exposed and needs to self-isolate if someone gets sick.
    • Choose one other trusted household that is also taking health and safety precautions. This could be another family, or members of your own family who live in a separate household.
    • Keep a list of who you have been in close contact with each day.
  • These steps will lower the chance of you having to stop along the way to your final destination.
    • Limit non-essential travel to short distances. (Vermont Executive order still requires, residents and non-residents coming to Vermont ­– for anything other than an essential purpose ­­– should quarantine at home for 14 days.)
    • Consider outdoor spaces and open areas where it is not too crowded and easier to keep a physical distance.
    • Choose activities that do not require sharing food or touching shared objects or other surfaces.
  • People age 65 and over and people with underlying medical conditions are more likely to develop more severe illness.
    • Those at higher risk for serious illness should continue to stay at home.
    • Connect with one another by phone, computer or video.
    • Protect those at higher risk

Terminology of the Day
Screening: A basic series of questions posed by medical personnel to determine if someone should be tested for a particular disease or condition. In the case of coronavirus, screening may include taking your temperature, and questions about possible exposure to someone with confirmed or suspected COVID-19.

Thursday, May 21, 2020

Terminology of the Day
Super-spreader: A highly contagious individual who can spread an infectious disease to a large number of uninfected people through a network of contacts.

Tuesday, May 19, 2020

What is the effectiveness of cloth masks in stopping the spread of COVID-19?

  • In one study, homemade cotton masks captured 50% of 0.02-1 micron particles. (This is with one mask providing filtration, remember we are each wearing cloth masks as are our patients. This will increase the capture.) (mayoclinic.org).  Coronavirus particles are .05 and .2 microns in diameter
  • Data in the study indicated that DIY masks made with a single layer of cotton clothing or a tea towel can remove around 50-60% of virus-sized particles. Smartairfilters.com

Why weren’t face masks recommended at the start of the pandemic?

  • At that time, experts didn’t yet know the extent to which people with COVID-19 could spread the virus before symptoms appeared. Nor was it known how many people have COVID-19 but never have any symptoms. We now know both groups can unknowingly spread the virus to others.
  • “Any kind of a mask is better than no mask at all,” Johns Hopkins University Professor of Mechanical Engineering Rajat Mittal, said. “Protection from someone who has an infection and is wearing the mask is almost as important in this pandemic as protecting the person wearing the mask.”
  • Masks are not a replacement for all the other steps we need to take right now to protect ourselves from the coronavirus — especially social distancing and good frequent hand hygiene.

Terminology of the Day

Surgical mask: Sometimes called a medical mask, it protects people from the wearer’s respiratory emissions. It’s designed to protect against large droplets, splashes or sprays of bodily fluid or other type of fluid. Surgical masks are regulated by the Food and Drug Administration.

Friday, May 15, 2020

Is it safe to order take-out?

According to the Food and Drug Administration (FDA), there have not been any cases of COVID-19 known to be caused from eating food or handling food packaging.

Here are some steps you can follow to help protect yourself when ordering groceries or carryout:

  • Before ordering groceries or carryout, check to see if you can pay online or over the phone.
  • Ask the delivery person to leave your packages at the door or on the porch.
  • If you go in person and curbside pickup is not available, make sure you maintain 6 feet of distance between you and the cashier.
  • Because carryout bags and containers have been touched recently by others, it is important to wash your hands after handling these.
  • Dispose of all packaging, and wash your hands again before eating.

Can humans get coronavirus from dogs or cats?

Jason Villano, D.V.M., M.S., M.Sc., a veterinary expert at Johns Hopkins, says, “Despite the very few reports worldwide, including here in the United States, of sick and healthy domestic animals, including pets, testing positive for SARS-CoV-2, the official name for the virus that causes COVID-19, there is little evidence at this time that such animals are easily infected with the virus under normal conditions, or could transmit it.”

Reliable sources for updates include the CDC, USDA and the American Veterinary Medical Association.

The World Organization for Animal Health in Paris, and in the U.S., the Department of Agriculture (USDA) and the Centers for Disease Control and Prevention (CDC), are closely monitoring the situation but do not recommend routine testing of animals.

The cases of the tigers in the Bronx Zoo and, more recently, of the two pet cats in New York, should not be cause for public alarm but a reminder that the COVID-19 crisis is actively evolving and that we have yet to learn more about the virus and its effects on both human and animal health.

  • At this time, experts recommend keeping pets indoors or avoiding socialization of pets with other animals, and maintaining good hygiene when handling or caring for your animals.
  • Wash your hands before and after interacting with animals.
  • Don’t kiss your pets or let them lick you or share your food.
  • Walk dogs on a leash. Do not allow pets to interact with people or other animals outside of the household.

Terminology of the Day

Immunocompromised – People with a weakened immune system are sometimes described as being immunocompromised. Cancer patients in active treatment, people being treated for autoimmune conditions like lupus, pregnant women and others may have weaker immune systems, which may make them more vulnerable to COVID-19 transmission or symptom severity.

Thursday, May 14, 2020

What is the difference between cleaning and disinfecting?

  • Cleaning with soap and water removes germs, dirt, and impurities from surfaces. It lowers the risk of spreading infection.
  • Disinfecting kills germs on surfaces. By killing germs on a surface after cleaning, it can further lower the risk of spreading infection.

Is cleaning alone effective against the virus that causes COVID-19?

  • Cleaning does not kill germs, but by removing them, it lowers their numbers and the risk of spreading infection.
  • If a surface may have gotten the virus on it from a person with or suspected to have COVID-19, the surface should be cleaned and disinfected. Disinfecting kills germs on surfaces.

Should sidewalks and roads be disinfected to prevent COVID-19?

  • CDC does not recommend disinfection of sidewalks or roads. Spraying disinfectant on sidewalks and roads is not an efficient use of disinfectant supplies and has not been proven to reduce the risk of COVID-19 to the public.
  • The risk of spreading the virus that causes COVID-19 from these surfaces is very low and disinfection is not effective on these surfaces.

Terminology of the Day

Community Mitigation– are actions that people and communities can take to slow the spread of infectious diseases, including COVID-19. Community mitigation is especially important before a vaccine or drug becomes widely available.

Wednesday, May 13, 2020

As stores start to reopen, how can I protect myself while shopping?

Some suggestions from the CDC include:

  • Stay at least 6 feet away from others while shopping and in lines.
  • Cover your mouth and nose with a cloth face covering when you have to go out in public.
  • When you do go to stores in person, go during hours when fewer people will be there (for example, early morning or late night).
  • If you are at higher risk for severe illness, find out if the store has special hours for people at higher risk. If they do, try to shop during those hours. People at higher risk for severe illness include adults 65 or older and people of any age who have serious underlying medical conditions.
  • Disinfect the shopping cart, use disinfecting wipes if available.
  • Do not touch your eyes, nose, or mouth.
  • If possible, use touchless payment (pay without touching money, a card, or a keypad). If you must handle money, a card, or use a keypad, use hand sanitizer right after paying.
  • After leaving the store, use hand sanitizer.

I am being quarantined due to my recent travel or exposure to someone with COVID-19. What can I do to reduce the 14 days I need to be in quarantine?

Based on new guidelines from the State of Vermont:

  • Individuals who are in quarantine can be tested on or after day 7; if the results are negative and they are asymptomatic, they can end quarantine (they should remain in quarantine while awaiting test results).

Terminology of the Day

Transmission-Based Precautions– the second tier of basic infection control and are to be used in addition to Standard Precautions for patients who may be infected or colonized with certain infectious agents for which additional precautions are needed to prevent infection transmission.

Some examples of this are Contact-Plus Precautions would be used while caring for an individual with C-diff or Enhanced Droplet Precautions would be used while caring for an individual with COVID-19.

Monday, May 11, 2020

Is a Healthcare Acquired Infection (HAI)?  

HAIs also known as nosocomial infections, are infections that patients get while receiving treatment for medical or surgical conditions. HAIs occur in all settings of care, including hospitals, surgical centers, ambulatory clinics, and long-term care facilities such as nursing homes and rehabilitation facilities.

What is a Catheter-Associated Urinary Tract Infections (CAUTI)?

A CAUTI is a urinary tract infection that is associated with a Foley catheter inserted in a healthcare setting.

A urinary tract infection (UTI) is an infection involving any part of the urinary system, including urethra, bladder, ureters, and kidney. UTIs are the most common type of healthcare-associated infection reported to the National Healthcare Safety Network (NHSN).  Among UTIs acquired in the hospital, approximately 75% are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine.  Between 15-25% of hospitalized patients receive urinary catheters during their hospital stay.  The most important risk factor for developing a catheter-associated UTI (CAUTI) is prolonged use of the urinary catheter.

Which body fluids can spread this coronavirus?

Coronavirus (SARS-CoV-2) RNA has been detected in upper and lower respiratory tract specimens, and SARS-CoV-2 virus has been isolated from upper respiratory tract specimens and bronchoalveolar lavage fluid. SARS-CoV-2 RNA has been detected in blood and stool specimens, and SARS-CoV-2 virus has been isolated in cell culture from the stool of some patients.

While infectious SARS-CoV has been isolated from respiratory, blood, urine, and stool specimens, viable, it is not known whether other non-respiratory body fluids from an infected person including vomit, urine, breast milk, or semen can contain viable, infectious SARS-CoV-2.

Terminology of the Day

Nasopharyngeal swab-Looks like an extra-long Q-Tip or a plastic wand with a collection surface on the end. It is inserted up the nose, far back where the health-care professional collects a sample by swabbing.

Wednesday, May 6, 2020

Can COVID-19 be caught from a person who has no symptoms? 

Yes. There appears to be transmission from:

  • Asymptomatic Individuals-that carry the virus in their body but never develop symptoms
  • Presymptomatic Individuals-who have been exposed and have not developed symptoms yet
  • Very Mildly Symptomatic Individuals-that have very mild symptoms and continue with close interactions with others

How can we protect others and ourselves if we don’t know who is infected? 

Practicing hand and respiratory hygiene is important at ALL times and is the best way to protect others and yourself. Respiratory hygiene means doing the following:

  • Stay home when you are sick.
  • Cover your nose and mouth with a tissue when you cough or sneeze, and then discard the tissue. If you don’t have a tissue, sneeze or cough into your upper sleeve or elbow.
  • Clean your hands frequently with soap and water or an alcohol-based hand rub (hand sanitizer), especially after coughing or sneezing and disposing of your used tissue.
  • Wash and disinfect high touch surfaces frequently.
  • Do not touch your face.
  • Maintain at least a 6 feet between yourself and others. This is especially important if you are standing by someone who is coughing or sneezing.
  • Since some infected persons may not yet be exhibiting symptoms or their symptoms may be mild, maintaining a physical distance with everyone is a good idea.
  • You should wear a facial covering while in public.
  • Healthcare workers should use appropriate PPE while are work.

Terminology of the Day

Public health orders-These are legally enforceable directives that may place restrictions on the activities of individuals or groups in the name of protecting the public’s health. Federal, state or local agencies may issue public health orders, such as restricting people’s movements or requiring that their movements be monitored by health authorities.

Tuesday, May 5, 2020

Myths and Facts from “Live Science” and  “WHO”

Myth: Mosquitoes can cause COVID-19.

  • Fact: The CDC and WHO have said mosquitoes don’t spread coronavirus. The  U.S. Department of Agriculture is currently studying this to make sure this is not a way that coronavirus is spread.

Myth: Myth: If you have coronavirus, “you’ll know”

  • Fact: COVID-19 causes a wide range of symptoms, many of which appear in other respiratory illnesses such as the flu and the common cold. Specifically, common symptoms of COVID-19 include fever, cough and difficulty breathing, and rarer symptoms include dizziness, nausea, vomiting and a runny nose. In severe cases, the disease can progress into a serious pneumonia-like illness —some infected people may show no symptoms at all.

Myth: If you can hold your breath for 10 seconds, you don’t have coronavirus.

  • Fact: There is no do at home test for coronavirus.

Myth: If you don’t have hand sanitizer, you’re going to get coronavirus.

  • Fact: The CDC explains that washing your hands with regular soap and water is far more effective than a squirt of hand sanitizer.

Myth: Introducing disinfecting to your body will kill COVID-19.

  • Fact: Spraying and introducing bleach or another disinfectant into your body WILL NOT protect you against COVID-19 and can be dangerous. Do not under any circumstance spray or introduce bleach or any other disinfectant into your body. These substances can be poisonous if ingested and cause irritation and damage to your skin and eyes. Bleach and disinfectant should be used carefully to disinfect surfaces only. Remember to keep chlorine (bleach) and other disinfectants out of reach of children.

Terminology of the Day

Elective procedure– A surgical, medical or dental procedure that is not urgent or immediately needed (like a knee replacement) is considered elective. Elective procedures are being canceled or delayed during the coronavirus pandemic in an effort to limit the spread of the virus.

Monday, May 4, 2020

The University of California San Francisco, Department of Hospital Epidemiology and Infection Prevention published a question and answer document that reviews glove use in healthcare during COVID-19.

Q: Does CDC recommend wearing gloves to prevent COVID-19?

A: No. The CDC recommends the public wear a cloth face covering or mask when unable to stay at least 6 feet away from others, but does not recommend routine glove use.

Q: Does wearing gloves prevent my hands from picking up germs and lower my chances of getting sick with COVID-19?

A: Probably not. Studies show that wearing gloves increases germs on surfaces, which increases the risk to self and others. Most people studied removed their gloves incorrectly or did not clean their hands, causing more germs to be on the person taking off gloves.

Q: Will the hospital give patients new gloves if removed for screening?

A: No. The hospital does not support glove use for routine use by the public and is not able to provide replacements. We offer many opportunities for you to clean your hands, and support you cleaning your hands often! This is to help minimize the risk to yourself and others from routinely wearing gloves.

Q: What if I choose to keep my gloves on at the entryway screening?

A: Everyone is required to clean their hands upon entry, which cannot be done with gloves on. You may not be allowed to come into the building or area if you do not remove your gloves and clean your hands.

Q: Why can’t I wash or sanitize my gloves?

A: Sanitizing gloves with a disinfectant or alcohol gel can damage the glove material and make the gloves ineffective. It also gives the wearer a false sense of security that they are clean.

Q: Where can I find more information about CDC guidance for using personal protective equipment in public?

A: cdc.gov/coronavirus/ has many recommendations for face coverings and strategies for frequent hand cleaning and surface cleaning to help stop the spread of COVID-19.

Q: Why do the screeners wear gloves, but I can’t?

A: Screeners are required to clean their hands often and wear gloves for certain tasks (such as when cleaning their station with sanitation wipes or passing out masks). They have been instructed on how to take them off safely and clean their hands after removal.

Terminology of the Day

Anti-viral medicines-Yale Medicine experts define anti-viral medications as: A class of drugs used to treat viral infections—not bacterial ones (which are treated with antibiotics). COVID-19 is caused by the virus coronavirus. Remdesivir is an antiviral that on May 1, 2020 the FDA issued an Emergency Use Authorization (EUA) for   the treatment of some  hospitalized 2019 coronavirus disease (COVID-19) patients.

Monday, April 27, 2020

These are some of the articles and websites I’d recommend for research/reading:

Terminology of the Day

Zoonotic-A disease that infects humans but originally came from other animals. The genetic sequence of the COVID-19 virus is similar to a coronavirus found in bats, so that may be where this disease originated. It may also have passed through other species on the way to humans, like snakes.  

Friday, April 24, 2020

Terminology of the Day

Hand hygiene-Cleaning your hands by using either handwashing (washing hands with soap and water), antiseptic hand wash, antiseptic hand rub (i.e. alcohol-based hand sanitizer including foam or gel), or surgical hand antisepsis.

Hand hygiene  is one of the most important steps to take to protect against COVID-19 and many other diseases.

Thursday, April 23, 2020

How contagious is the virus that causes COVID-19?

Dr. Fauci, (Director of the National Institute of Allergy and Infectious Diseases and a member of the White House Coronavirus Task Force) stated,  “It is a virus that is quite good at transmitting from one person to another.”

  • The virus that causes COVID-19 is very infectious.
  • The WHO states, an average coronavirus patient infects at least 2 others.
  • That means it’s more contagious than the seasonal flu, but less contagious than measles.
  • The coronavirus that causes COVID-19 may spread through the air in tiny droplet particles that people who are infected exhale during normal breathing and talking.
  • People infected with COVID-19 appear to be most infectious when they are most ill.
  • Much is still unknown about the spread of the virus that causes COVID-19.

What are emergency medical service (EMS) providers doing about COVID-19?

EMS staff are trained to handle persons with possible COVID-19.

  • Emergency Medical Dispatch (EMD) centers question callers about signs, symptoms, and risk factors for COVID-19.
  • If COVID-19 is suspected, prehospital care providers and healthcare facilities are notified in advance that they may be transporting, caring for, and/or receiving a patient who may have COVID-19.
  • EMS personnel work closely the wider EMS system, healthcare facilities, the public health system, city and county health departments, state health departments, and CDC.

CDC has guidance for EMS providers on modifying their practices for COVID-19.

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-for-ems.html

 Terminology of the Day

Vaccine- is a biological preparation that provides active acquired immunity to a particular infectious disease. A vaccine typically contains an agent that resembles a disease-causing microorganism and is often made from weakened or killed forms of the microbe, its toxins, or one of its surface proteins.

Wednesday, April 22, 2020

Can COVID-19 be spread through coins and bills? 

There is currently no evidence to confirm or disprove that COVID-19 virus can be transmitted through coins or bills. However, respiratory droplets expelled from an infected person can contaminate and persist on surfaces. Wash your hands regularly and thoroughly after touching any frequently-touched surface or object, including all money. Avoid touching your eyes, mouth and nose, if your hands are not cleaned.

Is COVID-19  spread through airborne transmission?

Airborne transmission refers to situations where droplet nuclei (residue from evaporated droplets) or dust particles containing microorganisms can remain suspended in air for long periods of time. These organisms must be capable of surviving for long periods of time outside the body and must be resistant to drying. Airborne transmission allows organisms to enter the upper and lower respiratory tracts. Fortunately, only a limited number of diseases are capable of airborne transmission.

  • The virus that causes COVID-19 is mainly transmitted through droplets generated when an infected person coughs, sneezes, or speaks. These droplets are too heavy to hang in the air. They quickly fall on floors or surfaces.
  • You can be infected by breathing in the virus if you are within 3-6 feet of a person who has COVID-19, or by touching a contaminated surface and then touching your eyes, nose or mouth before washing your hands.
  • Due to this coronavirus being a new virus that scientists are still learning about, The CDC recommends the use of “airborne isolation” for any PUI or known COVID-19 positive patient.

Terminology of the Day

Essential jobs: Essential jobs are jobs required to keep our society running. These are the employees who are required to report to work, even when everyone else has been ordered to stay home. What’s considered an essential job may vary, depending on local concerns and the nature of the emergency, but they generally include hospital staff and law enforcement, as well as people who work at gas stations, grocery stores and pharmacies.

 

 

Tuesday, April 21, 2020

Can you get re-infected after recovering from COVID-19?

There remains a lot of uncertainty, but experts say that it’s unlikely.  They indicate that reports of patients who seemed to have recovered but then tested positive again were not examples of re-infection.  Instead these are more likely to be cases where lingering infection was not detected by tests for a period of time.

 As of April 8th the Vermont Department of Health recommends that all individuals wear cloth face coverings when outside of the home to help slow the spread of COVID-19.

A face covering will help protect others around you if you are infected and don’t know it.

A cloth mask is not a substitute for physical distancing and other prevention measures.

When to Wear a Face Covering When Not to Wear a Face Covering
Trips to the grocery store, pharmacy, doctor or hospital Going for a walk in the woods or in your neighborhood. But bring one in case you encounter other people and stop to chat
Employees at a grocery store, pharmacy, or other business setting where they cannot maintain at least 6 feet distance between themselves and others At home, if everyone in the home isn’t showing symptoms
At home if you are sick and there are other people in the house Going for a run on the bike path, if it’s not too crowded
Home care workers caring for vulnerable populations

Riding the bus, taxi, or ride share

Walking on a busy and crowded street

 Who should never wear a mask:

• Children under the age of 2

• Anyone who has trouble breathing, or is unconscious

• Anyone who is unable to remove the mask without assistance

Terminology of the Day

Antimicrobial – destroying or inhibiting the growth of microorganisms and especially pathogenic microorganisms. Hand sanitizer that’s at least 60% isopropyl alcohol is antimicrobial. Some hand sanitizers are only antibacterial and will not protect against coronavirus.

Monday, April 20, 2020

Can COVID-19 be passed from a woman to her unborn or newborn baby? 

  • We still do not know if a pregnant woman with COVID-19 can pass the virus to her fetus or baby during pregnancy or delivery.
  • To date, the virus has not been found in samples of amniotic fluid or breastmilk.

 How do I stay safe while exercising during the  COVID-19 pandemic? 

  • Do not exercise if you have a fever, cough and difficulty breathing. Stay home and rest, seek medical attention and call in advance. Follow the directions of your local health authority.
  • If you are able to go for a walk or bicycle ride always practice physical distancing and wash your hands with water and soap before you leave, when you get to where you are going, and as soon as you get home.  If water and soap are not immediately available, use alcohol-based hand rub.
  • If you go to a park or public open space to walk, run or exercise always practice physical distancing and wash your hands with water and soap, before you leave, when you get to where you are going, and as soon as you get home.  If water and soap are not immediately available, use alcohol-based hand rub. Follow the directions of your local health authority in regards to any restrictions on the number of people with you and/or restrictions on the use of public outdoor play or exercise equipment.

Terminology of the Day

Fomite: Describes an inanimate object or surface that could act as a vehicle for transmitting an infectious organism like the coronavirus. It may be possible that a person could get COVID-19 by touching a fomite contaminated with the virus and then touching their own mouth, nose or eyes, according to the Centers for Disease Control and Prevention. Fomites can include household utensils, door handles, light switches, blankets, faucet, paper tissues, cloth gowns, phones and sponges among many other frequently touched items

Friday, April 17, 2020

For those who work in healthcare, here are some ways to protect your household members:

  • Change your clothes upon entry to your home.
  • Put a clothes hamper lined with a garbage bag just inside your home’s entrance. Clothes worn outside which may have come in contact with the coronavirus should be placed inside the garbage bag. Throw them directly in the wash (on hot or warm) if you can.
  • Shoes can be placed in another garbage bag or left outside your home if possible.
  • Clean keys, cell phones and other items you’ve been carrying with disinfecting wipes.
  • Door handles and light switches near the entrance should also be disinfected.
  • You should shower when you return home from work and before close interactions with household members.

How long does coronavirus live on various surfaces?

“Coronaviruses can remain infectious on inanimate surfaces at room temperature for up to 9 days. At a temperature of 30°C [86°F] or more, the duration of persistence is shorter.”

According to several recent studies

  • Copper- Coins, jewelry, pipes, wires, brass fixtures, hospital equipment
    • Up to 4 hours
  • Cardboard – Delivery boxes, food packaging
    • Up to 1 day
  • Plastic- Milk, detergent or soap containers, shopping bags, light switches
    • Up to 2-3 days
  • Stainless steel- Kitchen appliances, cutlery, cookware, electronic gadgets including cellphones
    • Up to 2-3 days
  • Paper- Printing and tissue paper
    • Up to 3 hours
  • Clothing-Scrubs and cloth surgical masks
    • Up to 7 days
  • Glass-windows or glass doors
    • Up to 4 days

Terminology of the Day:

N95 masks- N95 respirator is a particulate-filtering facepiece respirator that meets the N95 standard of the U.S. National Institute for Occupational Safety and Health (NIOSH) air filtration rating, meaning that it filters at least 95% of airborne particles, while not resistant to oil like the P95.

Wednesday, April 15, 2020

How can you tell the difference between allergies and Covid-19?

Typical symptoms with seasonal allergies Typical symptoms with COVID-19
Runny or stuffy nose Fever— Biggest distinction between the two
Wheezing Body aches
Itchy watery eyes Shortness of Breath
Sneezing Dry cough

With spring just around the corner how can we enjoy the outdoors safely?

From the Vermont Department of Health: Go outside!
Take the proper precautions and go outside. Be sure to stay close to home, practice social distancing, choose low-risk activities, respect all signs for closed areas and check regularly for ticks.

For more info visit: https://fpr.vermont.gov/recreation/outdoor-recreation-and-covid-19 and healthvermont.gov/BeTickSmart

Terminology of the Day

Mitigation– is the effort to reduce loss of life and property by lessening the impact of disasters. One of the main strategies to mitigate COVID-19 is to practice “social distancing.”

Tuesday, April 14, 2020

Myth vs. Facts from Johns Hopkins University and FEMA

Myth: The new coronavirus was deliberately created or released by people.

  • Fact: Viruses can change over time. Occasionally, a disease outbreak happens when a virus that is common in an animal such as a pig, bat or bird undergoes changes and passes to humans. This is likely how the new coronavirus came to be.

Myth: Ordering or buying products shipped from overseas will make a person sick.

  • Fact:  Researchers are studying the new coronavirus to learn more about how it infects people. As of this writing, the World Health Organization (WHO) says that the likelihood of becoming infected with COVID-19 from a commercial package is low since it has likely traveled over several days and been exposed to different temperatures and conditions during transit.

Myth:  Older people and those with existing conditions are the only ones at risk for coronavirus.

  • Fact:  Older adults and people with serious chronic medical conditions are at higher risk of serious illness. But anyone can become sick, and symptoms can range from mild to severe regardless of how old you are or if you have other medical conditions.

Terminology of the Day:

 

PUI: Person Under Investigation, or a PUI, is an individual who is suspected of potentially having COVID-19. This could be someone who has symptoms or direct contact concerning for COVID-19 and/or someone with a pending test.

Monday, April 13, 2020

Will warm weather stop the outbreak of COVID-19?
It is not yet known whether weather and temperature affect the spread of COVID-19. Some other viruses, like those that cause the common cold and flu, spread more during cold weather months but that does not mean it is impossible to become sick with these viruses during other months. There is much more to learn about the transmissibility, severity, and other features associated with COVID-19 and investigations are ongoing.

Are there any medicines or therapies that can prevent or cure COVID-19?
There are no drugs or other therapeutics approved by the US Food and Drug Administration to prevent or treat COVID-19. Current clinical management includes infection prevention and control measures and supportive care, including supplemental oxygen and mechanical ventilator support when indicated. Interim guidelines for the medical management of COVID-19 will be provided soon by the Department of Health and Human Services COVID-19 Treatment Guidelines Panel.

Terminology of the Day:
Antibodies: Are substances that a person’s or an animal’s body produces in their blood in order to destroy substances that carry disease.

Why knowing about antibodies matter as it relates to COVID-19:
An antibody test detects antibodies that people produce after they’ve become infected with a bacterium or virus. Those antibodies can appear in the blood one to three weeks after infection, and they’re part of the immune system’s response to infection.
The antibody-based tests can identify people who were not known to be infected “either because they never developed symptoms, or they had symptoms that were never correctly diagnosed,” says Lauren Ancel Meyers, a biology professor at the University of Texas at Austin.

Friday April 10, 2020

Why should I quit smoking or vaping now more than ever?

The new coronavirus attacks the lungs, making it harder for people who smoke or vape to fight off the virus. There has never been a better time to quit. Find resources at 802Quits.

What does “close contact” to an infected person mean?

Examples of close contacts        

  • You live in the same home
  • You are intimate partners
  • You rode in the same car while the person was infectious
  • You had dinner together while the person was infectious

Examples of not close contacts

  • You are a cashier who waited on the person at the grocery store
  • You are a pharmacist who gave the person medication
  • You were in front of the person in line at the store
  • You are a coworker who briefly walked by the person to ask a question

How does the State of Vermont Department of Health define “recovered from COVID-19”?

Someone has recovered from COVID-19 when all three have happened:

  1. It’s been three full days of no fever without the use of fever-reducing medication, and
  2. Other symptoms have improved, and
  3. At least seven days have passed since symptoms first appeared.

 Terminology of the Day:

Droplet transmission -A mode of transmission for a contagious disease that involves relatively large, short-range (less than 6 feet) respiratory droplets produced by sneezing, coughing, or talking.

Thursday, April 9, 2020

Can you get COVID-19 from mail packages or imported goods that arrive from infected areas?

No cases of COVID-19 have been reported from packages or imported goods.

  • Experts believe there is little or no risk of COVID-19 from shipped products or packages.
  • If you think a package may be suspect based on factors like origin, clean it with disinfectant.
  • Initial studies suggest the virus that causes COVID-19 can survive on surfaces for at least a few hours and may survive on plastic, glass, and metal for several days.
  • Wash your hands for 20 seconds with soap and water after bringing in packages, or after trips to the grocery store or other places where you may have come into contact with infected surfaces.

What are some less common symptoms being reported for COVID-19?

Loss of smell, loss of taste, runny or stuffy nose, sore throat, body aches and pains, headache, and diarrhea.

Terminology of the Day:

Eye protection– (e.g., goggles or disposable face shield that fully covers the front and sides of the face) Personal eyeglasses and contact lenses are not considered adequate eye protection.

Wednesday, April 8, 2020

Why do we stay 6 feet away? What’s magic about that number?

The coronavirus spreads primarily by droplets from your mouth and nose, especially when you cough or sneeze. Six feet is the approximate range of larger droplets that are likely to be infectious and this is the distance recommended by the CDC.

Are antibiotics effective in preventing or treating the COVID-19? 

No. Antibiotics do not work against viruses, they only work on bacterial infections. COVID-19 is caused by a virus, so antibiotics do not work. Antibiotics should not be used as a means of prevention or treatment of COVID-19. They should only be used as directed by a physician to treat a bacterial infection.

Terminologies of the Day:

Coronavirus vs Sars-Cov-2 vs COVID-19

Coronaviruses- are a large group of viruses that are common among animals. In rare cases, they are what scientists call zoonotic, meaning they can be transmitted from animals to humans, according to the US Centers for Disease Control and Prevention.

Sars-Cov-2-is another name for COVID-19. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), previously known by the provisional name 2019 novel coronavirus (2019-nCoV), is a positive-sense single-stranded RNA virus.

COVID-19- A new Chinese coronavirus, a cousin of the SARS virus, has infected hundreds since the outbreak began in Wuhan, China, in December. Scientist Leo Poon, who first decoded the virus, thinks it likely started in an animal and spread to humans. COVID-19 follows a naming convention the WHO employs and it’s simple to see the framework for tracking future outbreaks: CO stands for Corona (this type of virus has “crown-like structures” on its surface) VI stands for virus; D represents Disease; 19 is the year of the outbreak for this specific viral outbreak.

Tuesday, April 7, 2020 

When will there be a vaccination for COVID-19?

No one can say for sure.

Human trials have started but it will still be quite a while before vaccinations is readily and safely available for the general public.

Scientists say that developing a coronavirus vaccine:

Should people wear gloves in public?

The Centers for Disease Control and Prevention doesn’t recommend the general public use personal protective equipment, including gloves. Wearing gloves can lead to a false sense of security for people and can actually contribute to the virus being spread. Washing your hands is best practice after touching surfaces that might be contaminated.  If soap and water is not available alcohol based hand sanitizer can also be used.

I had the coronavirus, or probably did, and I feel fine now. Can I go about my life?

The latest CDC advice for people with Covid-19 who had symptoms is that they no longer need to self-isolate when:

  • They have had no fever for at least a full 72 hours without the use of medicine and
  • Other symptoms have gotten better and
  • At least seven days have passed since their symptoms first started.
  • But the guidance on this is changing all the time as we learn more.

Terminology of the Day

Comorbidity-the simultaneous presence of two chronic diseases or conditions in a patient.

“Patients with a comorbidities such as heart disease, diabetes and chronic lung disease are at a higher risk for severe illness when they contract COVID-19.”

Friday, April 3, 2020

What is the BMH employee travel restriction policy and why is it important to follow?

Procedure:

The hospital imposes the following restrictions on employee travel effective immediately and indefinitely: Brattleboro Memorial Hospital strongly discourages personal travel by employees domestically or internationally.

  • Employees who will be traveling outside of a 75 miles radius must notify Human Resources/Employee Health of their plans to travel at their earliest opportunity. This should include destination, dates of travel, method of travel, and expected return.

Purpose:

  • To help keep our staff and community healthy.
  • To reduce the amount of employees potentially subject to quarantine due to the state order that anyone entering Vermont will require a 14 day quarantine, unless traveling for essential work e.g. coming from Massachusetts or New Hampshire to work at BMH.
  • To help encourage our employee’s compliance with Vermont’s “Stay home/Stay Safe Order”

 How is trash and linen handled for a patient who has known or suspected COVID-19?

All trash and linen can be disposed of in the same way you would normally dispose of it.

Terminology of the Day

Terminal Cleaning-is a cleaning method used in healthcare environments to control the spread of infections.  Terminal cleaning methods vary, but usually include removing all detachable objects in the room, cleaning lighting and air duct surfaces in the ceiling, and cleaning everything downward to the floor.

Thursday, April 2, 2020

Here are the recommendations from Lenovo for disinfecting your computer, keyboard and LCD display

1. Squeeze out excess liquid from wipe or disinfecting cloth before using

2. It is safe to use a disinfecting wipe designed for office/home use. Some disinfecting wipes designed for medical use may cause discoloration, harm surfaces, or even affect functionality of your device. To minimize symptoms, we recommend the following:

    • Gently wipe the system thoroughly, being careful to ensure no liquid drips into the computer. Do not wipe on connector pins.
    • After disinfecting, follow the cleaning procedure from the wipe supplier to minimize chemical buildup of disinfectant residue (i.e. wiping away any residual disinfectant after the prescribed contact time).
    • Always allow the computer to completely dry prior to any use.

3. Medical wipes and their chemical composition vary greatly. Depending on the chemicals, frequency, and duration of use, medical wipes may impact cosmetic appearance1 and system functionality2. To minimize this risk, we recommend:

    • Hydrogen peroxide wipes (such as Virox Accel wipes w/ a maximum of 0.5% hydrogen peroxide)
    • Alcohol based wipes (such as PDI Germicidal or Braun Meliseptol Wipes sensitive)
    • Do not use wipes containing sodium hypochlorite (bleach)
    • Wiping away residual solvent as soon as possible after the prescribed contact time and wiping the surface again with a dry, lint-free, soft cloth
    • Lenovo says do not use bleach and products.
    • https://support.lenovo.com/us/en/solutions/ht035676

Can I get COVID-19 from my pets or other animals?

According to the CDC:

There is no reason at this time to think that any animals, including pets, in the United States might be a source of infection with this new coronavirus that causes COVID-19. To date, CDC has not received any reports of pets or other animals becoming sick with COVID-19 in the United States.

Pets have other types of coronaviruses that can make them sick, like canine and feline coronaviruses. These other coronaviruses cannot infect people and are not related to the current COVID-19 outbreak.

However, since animals can spread other diseases to people, it’s always a good idea to practice healthy habits around pets and other animals, such as washing your hands and maintaining good hygiene.

Terminology of the Day:

Contact tracing: means the practice of identifying and monitoring individuals who may have had contact with an infectious person as a means of controlling the spread of a communicable disease.

Wednesday, April 1, 2020

Who is susceptible to community spread?

Everyone is susceptible to community spread, so it is important to practice all of the items that I share with you in these daily blogs:

  • Wash your hands often and for 20 seconds duration
  • Wipe down and disinfect often-used surfaces
  • Cough into your elbow and cover your mouth
  • Don’t touch your face, including eyes, nose, and mouth
  • Maintain a distance of at least 6’ from another person

We continue to strongly encourage the reusable homemade/cloth masks while at work and require the full complement of PPE in appropriate circumstances.

Terminology of the Day:

Point of Care Testing (POCT):  Is testing that can be performed at the bedside, or near the patient.

The most general way to think about POCT is that it’s any testing performed in a healthcare setting that’s not done in the lab.

POCT can be performed in the following settings:

  • Hospitals
  • Urgent Care Clinics
  • General Practitioner’s Offices
  • Retail Clinics

Tuesday, March 31, 2020

Why are some hospitals using surgical masks for direct patient care with a patient who has known or suspected COVID-19 and why is BMH not following this practice?

Major distributors in the United States have reported shortages of PPE, specifically N95 respirators, facemasks, and gowns.

BMH does not currently have a shortage of N95 masks. This mask remains first option by CDC guidance. This may change over time and I will update as the situation evolves.

How long can you use an N95 for?

Per CDC recommendations N95 masks can perform optimally for 6 to 8 hours of intermittent or nonstop use.

Masks should be replaced if they have any of these problems:

  • The respiratory resistance is significantly increased;
  • The mask is damaged;
  • The mask cannot be tightly attached to the face;
  • The mask is contaminated (such as stained with foreign matter such as blood, sweat or other moisture droplets)

Terminology of the Day:

Extended use: Refers to the practice of wearing the same N95 respirator for repeated close contact encounters with several patients, without removing the respirator between patient encounters. Extended use may be implemented when multiple patients are infected with the same respiratory pathogen and patients are placed together in dedicated waiting rooms or hospital wards. Extended use has been recommended as an option for conserving respirators during previous respiratory pathogen outbreaks and pandemics.

Reuse: Refers to the practice of using the same N95 respirator for multiple encounters with patients but removing it (‘doffing’) after each encounter. The respirator is stored in between encounters to be put on again (‘donned’) prior to the next encounter with a patient.

Monday, March 30th, 2020

Wash your hands – a lot!

Sing the ABC song to know if you are washing your hands long enough.
Watch this video to see how to wash your hands properly.

Terminology of the Day:
Flatten the Curve: This term is a reference to how many people are infected with COVID-19 across a period of time. The total number of cases will continue to rise, but if they happen quickly the graph of these cases shows a steep curve. The curve is flatter if the cases happen more slowly. Social distancing and other infection control interventions help the cases rise slowly over a longer period of time instead of rapidly bunched together.

If the virus spreads too quickly – as it has in Italy – an example of a steep curve, it increases the strain and possibility of overwhelming the healthcare system. A flatter curve means that the virus is spreading more slowly, allowing hospitals the time and resources to treat more people. This is why proper social distancing is so important.

Friday, March 27th, 2020

How can someone sanitize their cellphone?

I would recommend that you always follow guidelines for your device, you can ask your cell phone provider for guidance.

Here are some resources you could refer to:

There are also products available that are designed specifically for the task of sanitizing a cell phone:

What is my role in helping co-workers with proper social distancing at work?

  1. Speak up!  Be empowered to help protect yourself, our BMH community and our patients.
  2. Take a step back from someone who stands too close to you.
  3. Ask someone who stands too close to you, to move back to the appropriate 6ft distance recommend.
  4. Remind each other that you are standing apart for each other’s protection.
  5. If you happen upon colleagues walking too close, standing too close, or sitting too close, give gentle reminders.

Humans are social beings, social distancing will take practice and reminders to break life-long habits but it is the right thing to do for your health and the health of those around you.

Is it safe to donate blood during this time?

In healthcare settings all across the United States, donated blood is a lifesaving, essential part of caring for patients. The need for donated blood is constant, and blood centers are open and in urgent need of donations. CDC encourages people who are well to continue to donate blood if they are able, even if they are practicing social distancing because of COVID-19. CDC is supporting blood centers by providing recommendations that will keep donors and staff safe.

Examples of these recommendations include spacing donor chairs 6 feet apart, thoroughly adhering to environmental cleaning practices, and encouraging donors to make donation appointments ahead of time.

To learn about local blood donor days visit www.redcrossblood.org and enter 05301 in the zip code field.

Terminology of the Day:

Ventilator: A ventilator moves air into and out of the lungs (oxygen in and carbon dioxide out). It can be inserted through the mouth or nose, and down the trachea, or through a surgical opening, via tracheostomy.

Depending on the patient’s medical condition, they may be able to use a respiratory mask in lieu of the breathing tubes. This is known as non-invasive mechanical ventilation.

Thursday, March 26, 2020

Your cell phone is dirty and you should sanitize it.

A typical cell phone has 18 X more bacteria on it than a public restroom.  Whatever your hands touch, your phone collects.

Throughout the day, all the bacteria you touch on grocery carts, gas pumps, doorknobs, and even other people are transferred and stored on your phone.  We wash our hands to stay healthy, but not many people do not think to sanitize their phones.

A cell phone is like having petri dish in your pocket. Warm places like pockets and purses are breeding grounds for bacteria. When we use our phones, germs are transferred back to our hands, faces and everyday items like food.

I have a homemade “surgical” “dust” mask, am I allowed to wear it while working?

Yes. If you have a surgical mask or dust mask of your own that you want to wear while working you are allowed to wear it.

The purpose of the masks is to:

  • Create a physical barrier between the mouth and nose of the wearer
  • Help block large-particle droplets, splashes, sprays, or splatter, keeping it from reaching your mouth and nose.
  • Help decrease the potential of someone who is asymptomatic from spreading the virus to others.
  • They do not filter out small particles like airborne viruses .
  • You will still be required to wear a N95 for patients with known or suspected COVID-19.

Terminology of the Day:

Novel virus: Refers to a virus not seen before. It can be a virus that is isolated from its natural reservoir or isolated as the result of spread to an animal or human host where the virus had not been identified before. It can be an emergent virus, one that represents a new strain, but it can also be an virus not previously identified.

Wednesday, March 25th, 2020

What are some social distancing guidelines for the workplace?

  • Avoid meeting people face-to-face.
  • Employees are encouraged to use the telephone, online conferencing, or e-mail to conduct business as much as possible, even when participants are in the same building.
  • If a face-to-face meeting is unavoidable, the meeting time should be for a minimum period of time, in a large meeting room, keep meeting to 10 people or less whenever possible and participants should sit at least 6 feet from each other, whenever possible.
  • Avoid handshaking. Possible alternatives may include using a slight bow, elbow bump or toe kick when greeting others.
  • Do not congregate in work rooms, pantries, halls, copier rooms or other areas where people socialize.
  • Eat at your desk or breakroom away from others (do not eat at nursing stations or in patient care areas).
  • Avoid recreational or other leisure classes, meetings, or activities where you might come into contact with contagious people.
  • Use only your knuckle to touch light switches, elevator buttons, etc.
  • When opening doors (especially bathroom or other public area doors) or touching other public surfaces, use a paper towel, tissue or disposable glove.
  • Wash your hands frequently with soap and warm water for at least 20 seconds or use hand sanitizer when handwashing is not possible.
  • Use general surface cleaning products or wipes to clean commonly touched surfaces.

Where are some easy, reliable symptom checker resources?

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/index.html

Or if you have an Apple phone, say “Siri, do I have coronavirus?”

Can community members donate homemade PPE?

We are accepting all donations of PPE from community and business members. There is a donation box on the front porch of the Community Relations Office  – 55 Belmont Ave, Brattleboro (white house, green shutters). Please refer questions to Gina Pattison, (802) 251-8485. All donations will be evaluated by myself and Susan Caffery, Director of Purchasing and Environmental Services to find the appropriate use for the donation.  Thank you to our staff and community who have reached out asking how they can help, it is wonderful to see everyone joining together in this challenging time.

Terminology of the Day:

Febrile: having or showing the symptoms of a fever.

Tuesday, March 24, 2020

What should I do if I think I’ve been exposed to COVID-19, or I’ve developed symptoms related to the virus?

If you have symptoms that include fever and or cough, call your primary care provider. Proper screening and assessment will occur over the phone, and you’ll then be advised on next steps.

Is there a specific way to put on and take off PPE?

Yes. Please refer to this visual document put out by The World Health Organization –

https://www.who.int/csr/resources/publications/PPE_EN_A1sl.pdf?ua=1

What does “Standard Precautions” mean?

Standard precautions are meant to reduce the risk of transmission of bloodborne and other pathogens from both recognized and unrecognized sources. They are the basic level of infection control precautions which are to be used, as a minimum, in the care of all patients.  Standard precautions include:

  • Hand hygiene
  • Use of personal protective equipment (e.g., gloves, gowns, masks)
  • Safe injection practices
  • Safe handling of potentially contaminated equipment or surfaces in the patient environment
  • Respiratory hygiene/cough etiquette

Terminology of the Day:

Close contact: a) being within approximately 6 feet of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a health care waiting area with a COVID-19 case – or – b) having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on).

Monday, March 23, 2020

Can kids get COVID-19?

Yes, children can get COVID-19.

So far, most children who do get it seem to have milder infections than adults or older people. Children can potentially be carriers of the virus and could infect others.

Due to the increased risk to a certain population, caregivers should limit children’s time with older adults and people with chronic medical conditions when possible.

Please refer to this helpful CDC link for more information about children and COVID-19:

https://www.cdc.gov/coronavirus/2019-ncov/prepare/children.html

Has the Visitor Policy been updated?

Yes. Effective immediately, no visitors will be allowed into Brattleboro Memorial Hospital. Exceptions are at the discretion of Brattleboro Memorial Hospital and are as follows:

  • One parent or guardian for a patient under the age of 18
  • One birthing partner for a patient in labor
  • One person at a time for a hospice or end of life patient
  • One clergy member for an end of life patient
  • One caretaker for a completely dependent patient

What PPE should be worn by healthcare providers providing care to asymptomatic patients with a history of exposure to COVID-19 who are being evaluated for a non-infectious complaint (e.g., hypertension or hyperglycemia)?

Standard Precautions should be followed when caring for any patient, regardless of suspected or confirmed COVID-19. If the patient is afebrile (temperature is less than 100.0F) and otherwise without even mild COVID-19 related symptoms (e.g., cough, sore throat, shortness of breath), then precautions specific to COVID-19 are not required. However, until the patient is determined to be without such symptoms, healthcare providers should wear all recommended PPE for the patient encounter.

 

 

Terminology of the Day:

Aerosol-generating procedures (AGP) are procedures that stimulate coughing and promote the generation of aerosols. Additional infection prevention and control precautions are required for some AGP where an increased risk of infection has been identified. Examples of AGP: Intubation, Manual ventilation, Non-invasive ventilation (e.g., BiPAP, BPAP), Tracheostomy insertion, sputum induction, open suctioning of airways).

Friday, March 20th

What should I do if I am sick with COVID-19 like symptoms?

Do not come to work if you have a fever and cough or shortness of breath.  Contact your primary care provider and inform your supervisor of these symptoms. If you need a primary care provider you can call centralized scheduling and they will assist you with an acute visit appointment (802-251-8777).

What should I do if I have been diagnosed with COVID-19?

  • Stay home except to get medical care
  • People who are mildly ill with COVID-19 are able to recover at home. Do not leave, except to get medical care. Do not visit public areas.
  • If you are sick, you should wear a facemask when you are around other people, even in your own home when others are in the same room.
  • Be in touch with your clinician, especially if you start to feel worse.
  • If you have a medical emergency, call 911.  Be sure to let the dispatcher know that you have or think you have COVID-19.

Why is 14 days the length of time for monitoring and quarantine?

Two weeks is the longest incubation period known so far for a coronavirus case. For COVID-19, the period of quarantine is 14 days from the last known date of exposure.

 

Terminology of the Day:

Pandemic: refers to a disease that has spread across a large region, for instance multiple continents, or worldwide.

Thursday, March 19th

If someone in Brattleboro seeks testing, and their medical provider agrees, what are the next steps?

If the provider determines that a COVID-19 test is appropriate, they should follow the following steps: The ordering provider will call the internal COVID-19 testing hotline number. The hotline coordinator will provide an appointment time for the patient to arrive to the testing site. The testing site is now located behind the Community Health Team office, near the Gannett building. The patient remain in their car for the testing.

Has Brattleboro Memorial Hospital changed the visitor policy?

Yes. We now have staff members located at all entrances that are open to the public. Staff is asked to enter through the Richard’s building or main entrance or through employee only entrances (administrative hallway or Tyler Conference Room entrance).

One dedicated visitor, over 16 years of age is allowed per patient.  Visitors are limited to accompany patients with medical needs, such as outpatient lab testing or physical therapy appointments or those here to visit an active patient.  Exceptions will be made by the attending physician if needed for other circumstances such as end of life care.

Visitors will be given a sticker/badge to wear with their name and room they are visiting and date.  Please look for this and encourage visitors to remain at their designated location.

Employees need to have their badge displayed when entering the hospital.

What cleaning products can be used to disinfect for COVID-19?

There are a long list of products that can be used to disinfect for COVID-19.  You can find a full list here  https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2 .

All BMH hospital approved products used for routine cleaning are effective for cleaning and disinfecting COVID-19. This include Virex-plus (extra strength) and Oxivir wipes.  For “dwell” time for each product (how long the product needs to remain wet to be effective) ask your department EVS expert.

 

Terminology of the Day:

Social Distancing: A way of preventing the spread of contagious illnesses, as suggested by the World Health Organization. Social distancing doesn’t mean staying inside. It means keeping a generous amount of personal space in between yourself and others. This will prevent you from inhaling the majority of the droplets expelled by coughing or sneezing.

Wednesday, March 18th

How long does COVID-19 live on a surface?

It is not fully known at this time how long this novel coronavirus can live on surfaces.  Current evidence suggests that novel coronavirus may remain viable for hours to up to 9 days on surfaces made from a variety of materials. Disinfecting of frequently touched surfaces is the best practice for prevention of COVID-19 and other viral respiratory illnesses.

When should a patient go to the Emergency Room?

If someone is experiencing difficulty breathing or shortness of breath, persistent pain or pressure in the chest, new confusion, inability to be awakened, bluish lips or face they should go to the emergency room.  If they are experiencing fever and dry cough they should call their primary care clinician first.  If they do not have a primary care clinician then they should call BMH Centralized Scheduling (802-251-8777) to schedule an acute appointment.

Could an infected person be spreading the virus before they have symptoms of COVID-19?

People are thought to be most contagious when they are most symptomatic (the sickest).

Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.

 

Terminology of the Day:

Isolation is used to separate ill persons who have a communicable disease from those who are healthy. Isolation restricts the movement of ill persons to help stop the spread of certain diseases. For example, hospitals use isolation for patients with infectious tuberculosis.

Vs.

Quarantine is used to separate and restrict the movement of well persons who may have been exposed to a communicable disease to see if they become ill. These people may have been exposed to a disease and do not know it, or they may have the disease but do not show symptoms. Quarantine can also help limit the spread of communicable disease.

Tuesday, March 17th

How is COVID-19 spread?

Person-to-person spread of the virus occurs mainly via respiratory droplets produced when an infected person coughs or sneezes.

What is the new construction in the Emergency Department entrance?

This is a screening area for all patients and visitors that are coming into the Emergency Department.  This space allows staff to screen people arriving for COVID-19 symptoms before they go to registration.

Do patients need to have a fever and cough or just one of the symptoms to initiate a call to Vermont Dept. of Health?

Clinicians should use their judgment to determine if a patient has signs and symptoms compatible with COVID-19 and whether the patient should be tested. Most patients with confirmed COVID-19 have developed fever and/or symptoms of acute respiratory illness (e.g., cough, difficulty breathing).

 

Terminology of the Day:

Community Spread (Community Transmission): Is said to have occurred when people have been infected without any knowledge of contact with someone who has the same infection.

Monday, March 16th

What is a N95 mask?

N95 masks are also known as a respirator and are for hospital staff use only.  They are to be used for close-prolonged contact with patients that are known or suspected to have COVID-19.  They come in various sizes and so staff that require them need to be fitted.

What are the symptoms of COVID-19?

Fever, dry cough, fatigue and shortness of breath are the common symptoms. Less common symptoms are sneezing and sore throat. Some people have no symptoms at all.  At least 80 percent of infected patients will experience minor symptoms and recover as they would from any cold or flu.  Not all that test positive will be hospitalized.

Can I work if I have been exposed to someone that is being monitored but has no symptoms?

If you were exposed to someone who is being “monitored” due to travel or exposure history, but have no symptoms of COVID-19, you can work without restrictions.  If you develop a cough and fever or any respiratory illness, you should not come into work and should notify your supervisor.

Who should wear a surgical mask?

Healthy individuals do not need to wear masks—a mask won’t protect you. Healthy people wearing masks could cause shortages of masks for those who need them. If you do have symptoms, wearing a mask can help you avoid transmitting the virus to others.

 

Terminology of the Day:

Incubation Period: The period of time between exposure to an infection and when symptoms begin.