Wednesday, February 19, 2020

Outstanding post over at Sarah Hoyt's blog regarding epidemics

An OUTSTANDING post over at Sarah Hoyt's blog from a nurse who recently lived through an outbreak of Norovirus.

Her take-aways:
  • Any outbreak will probably hit caregivers hardest, because they will have already been exposed by the time they realize that this is something unusual.
  • We were lucky – we were associated with a sister facility that could share staff with us if we offered bonuses. In a large outbreak, this isn’t possible.
  • Norovirus sucks. It can be shed before a patient has any symptoms. Even after staff no longer had symptoms, they had to wait 72 to report to duty, because of how long virus could be shed. It hasn’t been clarified how long novel corona virus will be shed before or after symptoms.
  • Norovirus sucks. Although the most common method of contamination is fecal (touching something contaminated and then touching the mouth, or eating something contaminated), aerosolized emesis (vomit) can cause Norovirus to act like an airborne or droplet contagion. From infection patterns on the Diamond Princess, it appears that the novel corona virus can cause airborne contamination. This is bad. Please don’t run and buy all the N95 respirators and filters – leave some for health care.
  • Having supplies in advance (and a bedroom with an ensuite bathroom) allowed me to do in-home quarantine. This isn’t possible in a large outbreak, because the supplies are needed by the medical facilities.
  • Taking care of an outbreak uses So. Many. Supplies. Disposable gowns. Disposable masks. Disposable face shields. Disposable gloves. Bleach wipes. Steri-wipes for equipment that cannot be bleached. Disposable plates and flatware. Disposable bottles and cups. Gelatin cups not needing refrigeration. Sleeves of soda crackers. Juice cups. Applesauce cups. Trash bags, laundry bags, so much extra linen, hot water, and laundry soap. More bleach.
  • The holiday brought food, guests, and outings. All potential sources of contamination. The ultimate primary source of contamination was never truly pinpointed. It was narrowed down to three possibilities—one of them was the hospital kitchen, but norovirus was not found on any surface there.
  • The staff member who went home sick first? Went to Jamaica on the planned vacation, because she was symptom free by then. Had a family member get sick on the plane. Had four extended family members sick at the all-inclusive resort. Mentioned that “they must have had it there, too, ‘cause lots of people were sick there.” Oy, vey. Really. I don’t care what your plans were. Don’t share the horrible stuff.
  • Over the next six months, we had multiple staff resignations. Exhausted staff still work, but may be lost to caregiving professions entirely after they have time to take stock. The night CNA I was with now works in a factory.
  • Long-term care centers, dormitories, casinos, and cruise ships are frequently the centers of outbreaks, because people have communal dining areas, and share hallways, and may share bathing spaces.

1 comment:

  1. During my time working at a university, I was always amazed that there weren't rampant outbreaks of everything from STDs to the Black Death among students. During a wifi upgrade project, I walked every room in every building, including residence halls, mapping coverage. To say these kids often live like pigs is an insult to swine the world over. WTH are their parents teaching them at home?

    And amazingly enough, I never caught anything. I attribute this to a wife who is an elementary school teacher. I've been exposed to *everything*, so I guess I've gained some immunity. I'm hoping that, plus precautions like hand washing and so on, will see us through the coming pandemic. Heck, maybe we get lucky and the thing fizzles out.


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